Lipoedema treatment and management

Is there a connection between lipoedema and varicose veins?
May 31, 2021
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Lipoedema treatment and management can greatly improve a patient’s quality of life. Lipoedema is a fat disorder that causes fat cells to disproportionately build up in the legs, thighs, buttocks (and sometimes arms). It is often misdiagnosed as it can be mistaken for other diseases, such as polycystic ovary disease, obesity, and lymphoedema. Symptoms include enlarged limbs that do not reduce with diet and exercise, unexplained bruising, “cuffing” or “braceleting” at the ankles and wrists, legs with a column-like shape with little definition, sensitivity, and pain on touch, loss of mobility, which can lead to psychological distress. With a complex disease like lipoedema and so many associated symptoms playing a part, managing the condition involves a multi-pronged approach.

Issues to address when managing lipoedema

  • Swelling and tissue enlargement
  • Pain
  • Psychological wellbeing, management of expectations, and education
  • Healthy eating and weight management
  • Physical activity and improving mobility.
  • Skincare and protection

Benefits of lipoedema treatment

  • Reduce pain
  • Improve the shape of the limbs
  • Avoid impairment or improve mobility
  • Manage or avoid obesity
  • Reduce the likelihood of progression to lipolymphoedema (lipoedema with lymphoedema). Where present, reduce the severity of lipolymphoedema and reduce the risk of complications (eg: cellulitis).
  • Minimise secondary joint problems, such as osteoarthritis in the hip or knee
  • Minimise impact on the ability to perform daily activities
  • Enhance ability to self-care
  • Improved wellbeing

Who can treat lipoedema?

Medical or allied health professionals treat different aspects of the condition. Here is a brief guide as advised by Wounds UK’s Best Practice Guidelines: The Management of Lipoedema.

Lipoedema/lymphoedema specialists can address:

Tissue enlargement with or without swelling

Pain, aching, sensitivity to touch

Physiotherapists can address:

Abnormal gait

Muscle weakness

Joint pain

Podiatrists can address:

Flat feet

Abnormal gait

Occupational therapists can address:

Mobility problems

Difficulty with day-to-day activities

Dietitians can:

Give advice and education about weight management, healthy eating, disordered eating, nutritional supplements, diabetes

Pain clinics can address:

Unmanageable/chronic pain

Phlebologists can address:

Varicose veins and venous disease

Appropriate specialist services (e.g. diabetic clinic, psychological services) can address:

Associated conditions

Plastic or cosmetic surgeons can address:

Severe tissue enlargement causing mobility impairment

Bariatric surgeons can address:

Management of severe obesity

Severe tissue enlargement causing mobility impairment

Treating lipoedema at Sculpture Clinic (part of the Paras Clinic)

In our clinics, we treat two aspects of lipoedema.

First, we treat underlying venous disease, which we often find is an associated condition with lipoedema. It is also our protocol to scan for venous insufficiency before carrying out liposuction to the legs, as untreated varicose veins can create unnecessary risks for liposuction to the legs. Read more about the link between venous disease and lipoedema.

Second, we use tumescent liposuction to gently suction away excess fatty tissue cells. This reduces the overall mass of the limbs, improves function, mobility, confidence, and reduces pain, swelling, and bruising.

Key Takeaways

  • A multi-pronged approach to lipoedema management can give patients a better quality of life and decrease the severity of symptoms.
  • Different aspects of the condition can be treated by a range of medical and allied health professionals.
  • At Sculpture Clinic (part of the Paras Clinic), we treat associated venous disease and use liposuction to lessen the bulk of the areas of concern which alleviates multiple symptoms.
  • To find out if liposuction could help your lipoedema, please book a consultation with Dr Paraskevas.