What are lymphoedema and lipoedema?
Lymphoedema and lipoedema (sometimes spelled lymphedema/lipedema) are debilitating physical conditions that involve severe swelling of limbs, usually the legs. The afflictions are often misunderstood, and with no cure, cause untold misery for the individual suffering.
We have prepared this post to explain in simple terms the difference between both conditions, telltale signs, and what to do if you think you are suffering.
What is lymphoedema?
Lymphedema refers to swelling that generally occurs in one of your arms or legs but can afflict both arms and legs too. It is most commonly caused by the removal of or damage to lymph nodes as a part of cancer therapy.
A blockage in the lymphatic system, which is part of the immune system, stops lymph fluid from draining, and the buildup leads to swelling. The swelling triggered by lymphedema can swing from mild, almost invisible changes in the size of your arm or leg to extreme changes that make using the limb impossible.
It can be either primary or secondary. This means it can occur on its own (primary lymphedema), or it can be caused by another disease or condition (secondary lymphedema). Secondary lymphedema is far more common than primary lymphedema. Lymphedema caused by cancer treatment may not show for months or years after treatment.
There is presently no cure for lymphedema, but it can be managed with early diagnosis and diligent care of the affected limb.
What is lipoedema?
Lipoedema is a bilateral, symmetrical limb swelling that usually affects the legs and thighs, although in some cases the arms too. Little is known of the cause, however, it is believed to be the result of an abnormal accumulation of fat cells in the tissues under the skin.
Sufferers usually have very large lower limbs that are similar in shape and size on both sides; thighs, hips and buttocks can be disproportionate, usually much larger, than the rest of the upper body, while feet and hands are almost never affected.
The tissues of the limbs appear very loose and are often very tender or painful to touch. Bruising through lipoedema occurs easily and spontaneously, without any touching.
Other common features are painful knees, which tends to cause increased patient discomfort and disability.
Due to the abnormal level of fat under the skin, it can appear pale and feel cold to touch compared to unaffected parts of the body.
Why lipoedema occurs remains a mystery, although genetics is thought to play a part. It tends to exclusive affect females and usually first appears when there is a hormonal change such as at puberty or pregnancy or even the menopause.
What is the difference between lymphoedema and lipoedema?
It helps to compare the two conditions in order to understand the differences:
Lipoedema
- Swelling of the lower limbs, and sometimes arms, which is symmetrical on the body
- General body shape is usually disproportionate
- The swelling is usually soft and often comprises of loose, floppy, connective tissue and fat
- Often a pad of fat just under the knees and hips
- Feet or hands are usually not affected, making ankles and wrists look a little like bracelets
- Firm pressure on the skin leaving obvious indentations is absent
- Pain in the joints, especially the knees
- Tenderness of the tissues
- Limbs will often bruise easily and through no apparent cause
- Risk of infection in affected areas no greater than normal
- The affected skin condition is usually soft and supple and not thickened
- Affects females only
- Losing weight will not improve the affected areas, however being overweight does not help
- There is often a family history of the condition
Lymphoedema
- Swelling may be unequal on each side of the body, with one thigh larger than the other, for example
- Feet are frequently affected
- Pressure on the skin will leave an indent, especially in the early stages of the condition
- No pain is felt if pressure is applied to the skin, but tissues will feel tight
- Limbs do not bruise easily
- Increased risk of infection (cellulitis) in affected, swollen areas
- Can affect females and males of any age
- The affected skin is often thickened and may have other features such as warty change or papillomatosis
- Losing weight usually has a beneficial effect on the swelling
- There is a family history of the condition in 20% of cases
How is it possible to mix up lymphoedema and lipoedema?
Lipoedema is often inaccurately diagnosed or even misdiagnosed and mistaken for other conditions, particularly lymphoedema, as well as obesity.
This happens most frequently in the later stages of the disease when the fat obstructs the lymphatic drainage leading to a mixture of lipoedema and lymphoedema, sometimes called lipo-lymphoedema. In this instance, patients may be offered treatment for lymphoedema, but the underlying lipoedema can often be missed.
Lymphedema treatment
There’s no cure for lymphedema, instead, treatment focuses on reducing the swelling and controlling the pain through exercising, compression garments, massage, and other non-surgical forms of compression
Lipoedema treatment
Each individual sufferer presents a different issue, making the condition debilitating and frustrating to manage. As a result, any treatment must take the form of specialist planning, with careful consideration of the time between sessions and any other ongoing medical issues. For such a sensitive condition it is imperative patients are cared for by a specialist such as Dr Gupta, who has extensive experience in treating lipoedema.
Dr Gupta has helped many people with lipoedema through tumescent liposuction (microlipo) and VASER lipo surgery.
Given the sensitivities of the condition, microlipo is widely considered to be the safest and the most appropriate method for managing and ease the strain of the symptoms.
Taught by the creator of the technique, Dr Gupta is one of only a handful of experts in Europe with the necessary skills to perform microlipo. Microlipo uses tumescent local anaesthesia instead of general anaesthesia, and the surgery is performed with very small instruments (cannulas) to remove fat, guaranteeing smooth and natural results.
The procedures are done step-by-step, usually starting with the outer thighs, and split over a timeframe of up to about six weeks.
Dr Gupta only works with clients who he feels will benefit from a liposuction procedure.
No client is the same and it is only after the consultation that Dr Gupta can gauge suitability and then suggest a cost for the procedure.
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