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23rd
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Medically Speaking... Lipoedema
DO YOU HAVE LIPOEDEMA?
There is only one sure fire way of getting a diagnosis, and this is usually through a Lymphoedema clinic, via your GP.
Lipoedema was first diagnosed in the 1940's but things have progressed very little since then. Only 10% of medical professionals have any knowledge of Lipoedema, often getting confused with Lymphoedema. Lipoedema is a bi-lateral (and symmetrical) limb swelling mainly affecting the legs and thighs (but sometimes arms too) and is thought to occur as a result of an abnormal accumulation of fat cells in the tissues under the skin. At present, we do not understand why lipoedema occurs but a family history suggests a genetic basis. It seems to affect females exclusively and it is usually first noticed when there is a hormonal change such as at puberty or pregnancy or even menopause.
Lipoedema UK is associated with St Georges Hospital in London, here they have specialist doctors and nurses dealing with Lipoedema patients. There is also a genetic research team working with St Georges lead by Dr S Mansour, Mr G Brice & Professor Mortimer with the hope of finding the Lipoedema strand in our DNA. When this is found they have information needed to start trying to find a cure. They need funds to enable the research to continue, so please do donate if you are able via Lipoedema UK and state that this is what your money is to be used for.
A Link to Lipoedema UK can be found on our Links Page.
WHAT AM I LOOKING FOR?
Lipoedemic women generally have very large lower limbs that are similar in shape and size on both sides.There is often a very distinctive pad of fat below the knees and many patients have a similar area on the thighs that can resemble a ‘saddle bag’ in appearance. The thighs, hips and buttocks often tend to be disproportionately (larger) than the rest of the upper body, the feet and hands are hardly ever affected.
The tissues of the limbs appear to be very loose and ‘floppy’ and are often very tender or painful to touch. Bruising occurs easily and spontaneously (without any apparent cause). Due to the increased amount of fat under the skin, the skin can appear pale and feel cold compared to the unaffected parts of the body. Bulging fat can often lead to a mattress effect on the skin, often described as Cellulite.
Click THE STAR for a more complete refrence of what to look for.
TYPES OF LIPOEDEMA
The type of Lipoedema is part knowledge and part guess work, here are also stages of it.
The importance of not getting Lymphoedema as a result of your Lipoedema is most important.
Types of Lipoedema (1 to 5):
1.Increase of the adipose tissue in the region of the pelvis and the backside.
2.The lipoedema goes as far down as the knees.
3.Marked clinical picture of a lipoedema from the hips down to the ankle (Hareem Trouser shape).
4.Special particularity: the arms are affected.
5.Special particularity: restricted to the lower leg.
There is also a subcategory of each stage being A(without pain) and B (with pain). You can also have a combination of the types, with or without pain.
Click THE STAR for an in depth study by W. Schmeller, I. Meier-Vollrath.
TREATMENTS
In Europe, compression and complex decongestive therapy are considered standard therapy for lipoedema.
In both Europe and North America, removal of the excess adipose tissue has been successfully accomplished in the last 10 years by liposuction; however, if present, lymphoedema should be treated first. According to the guidelines of the German Society of Phlebology, a reduction of the subcutaneous fat through operative measures is a sensible therapy and is often able to relieve the complaints long-term as well as simultaneously reducing the extent of the misshapen extremities.
Liposuction of lipoedema is not cosmetic and must be carried out in a proven lymph sparing operation such as targeted liposuction using fine (power vibrating) cannulas in the Tumescent "wet technique" or using the WAL (water assisted Liposuction), since here (in comparison to the traditional dry technique) practically no lymphatic vessels are damaged. There are published aspirations from some German surgeons to prove it spares the lymphatics. This liposuction requires a great deal of experience by the surgeon carrying out this technique and should only be performed by physicians who also have sufficient knowledge in the treatment of Lipoedema.
You should be offered conservative treatment and management through your lymphoedema clinic. The Liposuction treatment needs individual funding that is applied for by your GP and with the agreement of a plastic surgeon.
Click THE STAR for a list of private MLD Therapists
How to get the lipoedema treatment you deserve....
CLICK ON THE PHOTO OF THE PAPERS FOR MORE INFORMATION ON HOW TO OBTAIN TREATMENTS> NOTE: THAT AREAS OF THE UK AND TREATMENTS AVAILABLE IN EACH AREA DIFFER GREATLY FROM ONE TO THE NEXT. HOWEVER DO NOT LOOSE SIGHT OF THE FACT IT IS YOUR HUMAN RIGHT TO RECEIVE TREATMENTS FOR YOUR CONDITION OR DISEASE IN THE UK.
Are you a Medic and would like to learn?
Watch our films from Dr K Herbst, world leading Lipoedema Specialist, and learn and benefit your patients with your knowledge.