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Up until recently, complex physical therapy has been the mainstay in treatment of lipedema. This generally improved edema and reduced pain and tension in affected patients. More recently, surgical approaches such as liposuction have been used to reduce the fat volume under tumescent local anesthesia. Combining both methods, dramatic improvements can be achieved in treating the disease and in improving the quality of life. However liposuction in lipedema should only be performed in specialized medical centers.
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Lipoedema: a new therapy regimen b Lipoedema, a disease in women, is characterised by circumscribed accumulation of subcutaneous fat, mainly in the legs, with oedema, tension pain, tenderness and haematomas.
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Modern aspects of pathophysiology, epidemiology, symptoms, diagnosis and therapy in lipedema are presented. Within recent years the development of new techniques in local anaesthesia and surgery has revolutionized therapy. By using surgical and conservative methods (tumescent liposuction and combined decongestive therapy) a normalization of body proportions and a reduction of subjective and objective symptoms with a distinct improvement in the quality of life can be achieved.
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Combined decongestive therapy (CDT) in lipedema can only reduce edema, not the fat components; therefore only a portion of the symptoms can be treated. In contrast liposuction is able to reduce the increased volume of fatty tissue; it also decreases the tendency to develop edema. Only by combining conservative and surgical therapy regimens optimal results can be achieved. From the theoretical and practical point of view nowadays in lipedema grade I, II and partially grade III conservative treatment alone can be considered as an insufficient therapy.
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Introduction: In the scientific literature complaints in patients with lipoedema are described as pain due to pressure or as tenderness. Objective: To better classify the quality of pain in lipoedema and to find out about the extent of complaints. Methods: 50 patients with lipoedema stage II received a questionnaire with 30 items containing adjectives of sensory and affective pain qualities. For these items they could choose between »fits exactly«, »fits fairly well«, »fits little« or »does not fit«. In addition, patients were asked to describe their complaints with their own words. Results: In most cases the items pressing and lumpish were chosen. Many patients used the characterizations heavy, tearing, distressing, enervating, fierce, unbearable, exhausting, and pinching. The median values of all the patients´ sensory and affective scores showed – compared to people with chronic pain – »average« values. However, by using their own words, the complaints were often described as extremely burdensome. Conclusion: For describing pain in lipoedema only few items were used by the patients. There were great interindividual variations. Aspects of pain can be quite burdensome; they should be used in the characterization and the grading of lipoedema. Key words: lipedema, pain assessment, pain experience scale
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Introduction: Complaints of lipoedema are mainly referred to as pressure pain or tension in the scientific literature. Objective: The objective was to enable a further differentiation of the quality of the perceived discomfort and provide a preliminary quantification of pain severity. Methods: 50 patients with Stage II lipoedema were asked to complete a questionnaire containing 30 items corresponding to sensory and affective pain sensations. For these items, they could choose between “completely applicable”, “largely applicable”, “somewhat applicable”, or “not applicable”. The patients were also asked to describe their complaints in their own words. Results: The items pressing and dull were specified most frequently. The following were indicated to a lesser extent: severe, tearing, nagging, unnerving, fierce, unbearable, exhausting, and sharp. Compared to patients with chronic pain, the mean values of all the patients’ sensory and affective scores yielded an average pain severity. However, when the patients used their own formulations, the complaints were often described as being very pronounced. Conclusion: Only a small portion of the adjectives offered was suitable for characterising the sensations of lipoedema. There were considerable inter-individual variations in how the pain was perceived. The severe symptoms, which are partially subjective, should be considered when characterising lipoedema.
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Lipoedema is a disease of women, characterised by a circumscribed accumulation of subcutaneous fat, mainly in the legs, with oedema, hematomas, and pain from tension and pressure. Up to now, only conservative treatment with manual lymphatic drainage and compression was possible. Nowadays surgical therapy with liposuction under tumescent local anaesthesia can not only improve morphology but can also reduce complaints. When performed with modern techniques by experienced surgeons, liposuction is very safe and highly effective. The combination of conservative and surgical methods can considerably improve quality of life.
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