What is lipoedema?
Lipoedema, also popularly known as ‘riding breeches fat’, ‘riding breeches syndrome’ or ‘columnar leg’, is a progressive disease. Lipoedema is characterised by an atypical, symmetrical accumulation of painfully altered fatty tissue on the sides of the hips and thighs. The upper arms and, later on, the lower legs, forearms and trunk (especially the neck) can also be affected.
The swelling associated with the disease, which is caused by the retention of fluid from the vascular system, can be accompanied by pain and tenderness as well as an increased tendency to bruising. You can find more clear signs of lipoedema here.
This condition almost exclusively affects female patients, i.e. the female sex, so hormonal causes can be suspected. In contrast to lymphoedema, lipoedema usually occurs symmetrically. Columnar changes and deformations occur in the affected areas of the body. The legs, buttocks and hips are particularly affected. Lipoedema is sensitive to pressure and touch.
There is often a tendency to bruising and a familial predisposition as well as nodular or dimpled skin structures. Lipoedema cannot be alleviated by weight loss cures (diets etc.) as the fat deposits are not the result of being overweight.
- Here you can find out how to find out whether you suffer from lipoedema.
Non-surgical treatment, for example with medication or ointments, is not recommended for this condition. Lipoedema cannot be improved in this way. Reducing additional excess weight is helpful, but does not lead to any significant improvement in the affected areas of the body. In their helplessness, many patients resort to compression therapy with special stockings, some of which are worn around the clock (even during sport). If the lipoedema progresses, complex physical decongestive therapy (CDT) may be necessary at an advanced stage. Exercise often leads to a subjectively perceived worsening of the symptoms and is only tolerable with compression garments.
HOW IS LIPOEDEMA CLASSIFIED?
In plastic surgery, a distinction is made between three stages and five degrees of severity of lipoedema:
Stage 1: fine nodular skin surface, colloquially known as orange peel skin
Stage 2: coarse nodular skin surface with larger dents, ‘mattress phenomenon’.
Stage 3: large, deformed skin flaps and skin bulges
Degrees of severity of lipoedema:
Type I: Increased fatty tissue on the buttocks and hips
Type II: the lipoedema extends to the knees, additional fatty flap formation on the inside of the knees
Type III: the lipoedema extends from the hips to the ankles
Type IV: arms and legs are affected up to the wrists and ankles, i.e. with the exception of the feet and hands.
Type V: Increasing water retention in the back of the hands and feet as well as the fingers and toes.
For many years, so-called guidelines have been used in medicine to define the procedure for certain diseases. The guideline for this clinical picture is very clear with regard to the optimal surgical treatment of lipoedema: in the S1 guideline on lipoedema (download here), liposuction is described as an effective treatment for the permanent reduction of abnormal subcutaneous fatty tissue on the legs and arms. Targeted compression therapy should be carried out beforehand to relieve pain.
Conclusion
If there has been no improvement in symptoms despite consistent conservative therapy (lymphatic drainage and compression garments), water-jet assisted liposuction with the BODYJET® device should definitely be considered. Liposuction is scientifically proven and achieves lasting treatment success, essentially even curing the disease ‘lipoedema’. There is a medical indication. The guidelines, which reflect the medical opinion of the relevant professional association, are clear with regard to the treatment of lipoedema.
