Lipoedema

A guide to understanding lipoedema

Although the term oedema refers to fluid accumulation, lipoedema is in fact a clinical condition characterised by abnormal accumulation and altered distribution of body fat. It is a disorder of adipose tissue marked by disproportionate and symmetrical fat deposition, most commonly affecting the lower limbs and typically extending from the hips to the ankles.

This condition is frequently associated with overweight and obesity in a high proportion of cases. It is also often confused with other conditions such as different types of oedema, cellulite, obesity or localised fat. However, lipoedema is a clinical condition rather than a purely aesthetic one, even though it has a clear impact on body contour.

Lipoedema affects almost exclusively women. Although its exact causes are not fully understood, a genetic predisposition is clearly recognised, as most affected patients have a family history. Hormonal factors also play a significant role, with the condition most commonly appearing at puberty.

Symptoms of lipoedema

Lipoedema is characterised by an increase in leg volume due to fat accumulation. As the condition progresses, a clear disproportion develops between the lower and upper halves of the body.

This increase in leg volume is commonly associated with a sensation of heaviness and hypersensitivity to pain, where even mild pressure on the affected area can cause discomfort. This pain sensitivity appears to be related to inflammation and tissue hypoxia (reduced oxygenation). Capillary fragility is also common, leading to easy bruising, either spontaneously or following minor trauma.

Symptoms typically begin at puberty and may worsen over time, particularly when associated with significant weight gain.

Lipoedema can lead to substantial emotional distress, negatively affecting mood and self-esteem, and can significantly impair quality of life. In more advanced cases, body contour may be markedly altered, potentially resulting in functional limitations and reduced mobility.

How lipoedema is diagnosed

As lipoedema may be confused with obesity, fluid retention or firm cellulite, assessment by a specialist physician is essential. It is also important to note that lipoedema may occasionally coexist with lymphoedema, resulting in lipo-lymphoedema, a more complex clinical condition that requires a specific multidisciplinary approach.

For these reasons, at Grupo Pedro Jaén we emphasise that any swelling, oedema or abnormal fat accumulation should always be evaluated by a specialist. Accurate medical assessment is crucial, as not all increases in leg volume share the same underlying cause or characteristics, and therefore require individualised management strategies.

The diagnosis of lipoedema is primarily clinical, based on the patient’s medical history and physical examination. In addition, specialists perform bioelectrical impedance analysis to assess body composition and the proportion of different tissues (fat, muscle, fluid). Ultrasound examination is also used to evaluate subcutaneous tissue characteristics and to identify any associated oedema.

In certain cases, blood tests, venous system studies using Doppler ultrasound, or isotopic lymphoscintigraphy may be required to assess possible associated lymphatic alterations.

“In general, the best outcomes are achieved by combining different therapeutic options and initiating treatment at an early stage”

Treatment of lipoedema

Management of lipoedema must be individualised and adapted to the clinical situation of each patient. In general, treatment involves several complementary approaches:

Treatment of complex lipoedema cases

Liposuction may be considered a therapeutic option in carefully selected cases and must be evaluated by our specialised plastic surgeons. In order to maintain long-term results, strict weight control and the permanent adoption of healthy lifestyle habits are essential.

In cases of associated severe obesity, bariatric surgery may be considered. This procedure, commonly referred to as stomach reduction surgery, aims to achieve significant and sustained weight loss, supporting redistribution of body fat and improving overall clinical outcomes.

Treatment of lipolymphoedema

Lipoedema may sometimes be associated with impairment of lymphatic system function, leading to lymph accumulation. This mixed condition, known as lipolymphoedema or lipo-lymphoedema, is a complex clinical entity that requires a different therapeutic approach, targeting both adipose tissue and lymphatic fluid.

More information

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