Lipedema - You Magazine Health Notes - Dec 24, 2006

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Lipedema - You Magazine Health Notes - Dec 24, 2006

Postby patoco » Fri Jan 12, 2007 12:25 am

Lipedema - You Magazine Health Notes - Dec 24, 2006



You Magazine / Health Notes Dec 24, 2006

Health Editor Sarah Stacey asks the experts for answers to your health queries.

Q – My wife suffers from lipoedema, with very swollen lower legs, which measure 60cm around the calf and 55cm above the ankle. Do you know of any therapies that can help?

Lipedema – from “lipid” meaning fat, and “oedema” swelling – is a condition where excess fat collects below the waist (and sometimes on upper arms) but not at the foot. The classical shape of lipoedema sufferers, according to consultant dermatologist Professor Peter Mortimer of St. George’s Hospital, London is a relatively small, even slender top hal with a disproportionately large pear-shaped lower half and thick, heavy legs tapering to normal feet. The fatty areas, which are symmetrical on both legs, are tender and often painful.

Although a handful of men are affected, lipoedema almost exclusively affects women, usually after puberty, pregnancy or some other event involving the reproductive hormones, such as taking the contraceptive pill or HRT (Men with lipoedema invariable have liver disease, which affect the way they metabolize estrogen.)

As well as the psychological distress of the disfigurement, sufferers report that the widespread ignorance of the medical profession is profoundly depressing.

“Many patients don’t feel listened to or understood,” says Professor Mortimer. In recent surveys, about half the doctors who responded confessed that they didn’t know what lipoedema was. Very often, patients are told to diet and exercise but, says Professor Mortimer, “overeating is not the cause and many women with lipoedema find it’s more acceptable to be fat rather than thin because their disproportionate shape is not so obvious.”

If the swelling becomes severe, the condition can cause damage to the body’s lymphatic system resulting in lympoedema, too (known as lipoedema/lymphoedema syndrome). Until this point the conditions are quite separate.

Lymphedema is an accumulation of fluid and proteins, which cause swelling in many different parts of the body from head to feet. For more information, see the ‘differential diagnosis’ on

Sadly, there is little convential help for lipoedema. “The bottom line is that the standard treatment for lymphoedema – mainly manual lymphatic drainage massage and compression bandages or stockings – has little impact on the lipoedema,” says Professor Mortimer. “There are concerns about recommending conventionnal liposuction because there is no evidence that it works, and it may damage the vulnerable lymph routes, causing lymphoedema.”

However, there is hope that ultrasonic lippsuction may provide an effective and safer alternative. David Ross, head of plastic surgery at Guy’s and St. Thomas’ Hospital, London, has carrier out this procedure on a handful of patients with severe lipoedema with ‘pretty spectacular results’, he says.

Ulstrasonic liposuction works by transmitting shock waves through a special hand piece to the end of a cannula (fine tube), which is inserted into the area to be treated.

The waves break up the fat, turning it into a milky emulsion, which is then sucked up by the cannula.

Used incorrectly, the procedure may cause burns to the skin and underlying tissues, but Mr. Ross has been using it for many years without problems. “Our experience has shown that the diameter of thighs and calves can be significantly reduced, greatly improving the patient’s shape and really enhancing their self-confidence.” He warns that patients may be left with excess skin on the inner thighs, which needs a separate skin-tightening operation. Because the ultrasound technology is costly, few NHS hospitals have it, so the procedure is currently only available privately although Mr. Ross hopes this will change.

Dr. Steve Gascoigne, a GP who also practices traditional Chinese medicine, uses herbs and acupuncture to treat lipoedema. “It’s a long-term therapy, not a miracle cure, but patients should see a reduction in swelling and discomfort, plus more energy, with six to eight weeks.” He says. (To find a local practioner contact the British Acupuncture Council, tel: 020 8735 0400,

The Lymphoedema Support Network also provides some information on lipoedema – visit However, there appears tobe no lipoedema patient support group in this country. If readers know of one, please let me know and I will publish it. Visit for a journal by Jane, an American sufferer.

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