Page 105 - Read Online

Wiedner et al. Plast Aesthet Res 2020;7:10 Plastic and
DOI: 10.20517/2347-9264.2019.51 Aesthetic Research

Review Open Access

Differential diagnoses and treatment of lipedema

Maria Wiedner, Donia Aghajanzadeh, Dirk F. Richter

Department for Plastic and Aesthetic Surgery, Dreifaltigkeitskrankenhaus Wesseling, Wesseling 50389, Germany.

Correspondence to: Dr. Maria Wiedner, Department for Plastic and Aesthetic Surgery, Dreifaltigkeitskrankenhaus Wesseling,
Bonner Strasse 84, Wesseling 50389, Germany. E-mail maria@wiedner-plastic.com
How to cite this article: Wiedner M, Aghajanzadeh D, Richter DF. Differential diagnoses and treatment of lipedema. Plast Aesthet
Res 2020;7:10. http://dx.doi.org/10.20517/2347-9264.2019.51
Received: 3 Nov 2019 First Decision: 29 Nov 2019 Revised: 15 Jan 2020 Accepted: 3 Feb 2020 Published: 6 Mar 2020

Science Editor: Xiao Long Copy Editor: Jing-Wen Zhang Production Editor: Jing Yu

Abstract

Lipedema is a frequently unrecognized and misdiagnosed disorder of the fatty tissue of extremities and hips, which
affects almost purely women. The beginning of the disease usually occurs with hormonal changes, such as puberty,
pregnancy, or menopause. Women suffer from pain, easy bruising, and disfigurement, which may lead to early
immobility and social stress. Accurate diagnosis and treatment are essential. The differentiation between obesity
and lipedema is difficult, as these two different entities often occur together. Other differential diagnoses are
lymphedema, benign lipohypertrophy, and Dercum’s disease. A therapy targeting the underlying cause of lipedema
is not available because the exact etiology of the disorder is not clarified yet. Decongestive physical therapy is the
basic conservative treatment, which is usually necessary lifelong. However, liposuction has led to a paradigm shift in
the treatment of lipedema. The purposes of this article are to describe the symptoms and treatment options of the
still fairly unknown disease Lipedema and to show the distinctions to its differential diagnoses.

Keywords: Lipedema, lymphedema, obesity, symmetrical limb enlargement, adipositas dolorosa

INTRODUCTION
Lipedema is a painful disease of the subcutaneous tissue, which was first named in 1940 by Allen and
Hines. They described a syndrome characterized by “large legs due to the subcutaneous deposition of fat
[1]
in the buttocks and lower extremities and the accumulation of fluid in the legs” . It is a painful, possibly
chronically progressive disorder of adipose tissue that is characterized by symmetrical swelling of the lower
and/or upper limbs. Patients typically complain about increased pressure sensitivity and easy bruising and
may also experience ankle edema. In advanced stages, lymphedema may additionally occur, especially in
those who are obese.

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

www.parjournal.net