# Lipoedema

> Chronic disease of the adipose tissue and loose connective tissue that mainly affects women, with a disproportionate, bilateral and symmetrical increase in leg volume, usually with pain, tenderness, heaviness, and easy bruising.

**URL:** https://clinicadrmolina.es/en/lipedema-what-it-is-symptoms-diagnosis/

- **Cause:** Multifactorial origin that is not yet fully understood: genetic and hormonal factors, alterations in adipose tissue and the extracellular matrix, inflammation, fibrosis, and microvascular dysfunction have all been proposed.
- **Risk factors:** Hereditary predisposition in some families; Hormonal changes (puberty, pregnancy, menopause)
- **Signs and symptoms:** Disproportionate, symmetrical increase in leg volume; A feeling of heaviness; Easy bruising; Relative sparing of the feet; Irregular tissue texture; Pain or tenderness on pressing the skin (in around a third of patients)
- **Possible treatment:** Individualised management: patient education and clear diagnosis, adapted exercise, weight control where associated obesity is present, individualised compression, physiotherapy and self-care, psychological support if needed, and, in selected cases, reduction surgery with specific liposuction.

## Frequently asked questions

### Can lipedema be cured by losing weight?

Not necessarily. If associated obesity is present, weight loss may improve general health, mobility and some symptoms. However, tissue affected by lipedema may respond less than other areas of the body. That is why many patients lose weight in the trunk or abdomen while maintaining disproportion in the legs.

### Is lipedema always painful?

Pain or tenderness are very characteristic elements for diagnosis, but they appear in only approximately 30% of patients with lipedema.

### Is there a test that confirms lipedema?

There is currently no single test that can confirm it on its own. The diagnosis is clinical. Imaging tests can help rule out other problems or assess associated diseases, but they do not replace medical examination.

### Does venous Doppler ultrasound diagnose lipedema?

No. Venous Doppler ultrasound does not diagnose lipedema, but it can be very useful for studying whether there are varicose veins or venous reflux and for excluding other circulatory problems that may explain or worsen leg symptoms.

### Is compression mandatory in all cases?

Not necessarily. It may be useful in many patients, but it should be individualized according to symptoms, tolerance, tissue type, daily activity and the presence of associated problems.

### Is surgery always necessary?

No. Surgery may be considered in selected cases, especially when there is persistent pain and functional limitation despite appropriate conservative management. This treatment is usually carried out by plastic surgeons. The decision should be individualized and cautious.


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**About the clinic: Dr. Jorge Molina – Clínica de varices en Valencia**

Hospital LA SALUD, Consultas Externas, Planta 2ª, Consultas 211-212. Calle Dr. Manuel Candela, 41, 46021 Valencia, España.

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