Lipoedema is a symmetrical, abnormal increase in fatty tissue, which is a chronic and progressive disease of the fatty tissue. It usually affects the lower extremities in the area of the hips and thighs. Less frequently, the lower legs and/or upper arms can also be affected by the pathological fat distribution disorder. The abnormal fat distribution disorder can be associated with pain and increased sensitivity to touch in the affected areas of the body. Even minor trauma to these areas can often lead to the formation of bruises very quickly and easily. In advanced stages, the proliferation of fatty tissue can lead to skin bulges, which often form on the inside of the knees and can cause redness and irritation of the skin.
According to the current state of science, lipoedema is triggered by hormonal processes in the body. Only women are affected by this condition and this fat distribution disorder is often triggered by hormonal changes during puberty or pregnancy.
Around 10% of all women are affected by the disease, although a significantly higher number of unreported cases can be assumed due to the difficulty in making a correct diagnosis.
There are other diseases whose symptoms are very similar to those of lipoedema. These include lymphoedema, phleboedema and secondary lymphoedema. It often takes many years before a correct diagnosis is made. For many patients, this is often associated with a long ordeal, which can involve a number of dietary changes, exercise or visits to the doctor. This can have a significant impact on quality of life and, in extreme cases, have psychosocial consequences. The diagnosis is often made late, as many colleagues are not yet familiar with this fat distribution disorder. An experienced doctor can recognise lipoedema with the naked eye and a detailed clinical examination, as a typical body silhouette is marked and the tissue shows typical skin changes.
A Self-test can narrow down the diagnosis somewhat. Answer the questions below. The more questions you answer with “yes”, the more likely it is that you have lipoedema.
Skin surface smooth, subcutaneous fat thickened, fat structure finely nodular
Tissue additionally coarser and harder, coarse-knotted skin surface with distinct dents
Severely thickened and hardened tissue, large, deforming flaps of skin and fatty tissue (so-called dewlap formation)
In addition, the pathological fat distribution disorder can be categorised into types depending on the affected body region:
The subcutaneous fat is increased, especially in the buttocks and hips, resulting in so-called saddlebags.
The disease has spread to the lower leg and there is an increased formation of fat on the inside of the knees.
The disease now extends from the hips to the ankles.
The fat distribution disorder now also affects the arms. The wrists are not affected.
The aim of treatment is to eliminate the cause of the symptoms, which are triggered by the pathological proliferation and alteration of the fat cells. In principle, any type of lipoedema can be treated conservatively and surgically by liposuction at any stage. Gentle liposuction can remove the majority of the abnormally altered fatty tissue and thus normalise or at least significantly improve the lymphatic drainage of the tissue. This procedure must always be carried out in combination with essential conservative treatment using compression and manual lymphatic drainage, which should ideally be started beforehand.
Ideally, the aim of the therapy is to normalise or improve lymphatic drainage (complex physical decongestive therapy). The following methods are used for this purpose:
In addition to conservative treatment options, liposuction is the most efficient and safest method of treating lipoedema permanently and slowing down or even stopping the progression of the disease.
The health insurance company will only cover the treatment under clearly defined conditions: The decisive factors are a specialist diagnosis by a non-surgical specialist, at least six months of conservative treatment without sufficient success and complete documentation including stable weight and appropriate BMI values. Fixed limits apply in statutory health insurance, while private health insurance also depends on the individual tariff.
Further information can be found here: Cost coverage for lipoedema
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