Lymphedema v.s. Lipedema

Lymphedema and lipedema (also known as lipoedema) are two distinct medical disorders even though both involve swelling in the arms and legs. In short, Lymphedema is a disorder of the lymphatic system and is commonly caused by dysfunction in the flow of lymph fluid through the arms or legs. Lipedema, in contrast, does not involve the lymphatic system, but it is a pathologic, symmetric deposition of fat that most often effects the lower extremities and almost exclusively occurs in women.

Lymphedema:

  • A disorder of the lymphatic system
  • Usually occurs after cancer treatment, but can be spontaneous (congenital)
  • Usually affects one arm or leg
  • Often associated with severe infections (cellulitis)
  • Requires treatment by a certified lymphedema therapist
  • Solid-predominant form may be successfully treated with SAPL surgery
  • Fluid-predominant form may be successfully treated with VLNT and/or LVA surgery
  • Worsened by obesity
  • Can be caused by morbid obesity

Lipedema:

  • A disorder involving pathologic fatty deposits in legs and sometimes arms
  • Occurs spontaneously
  • Usually affects both legs and/or both arms equally
  • Fatty deposits usually are painful
  • May result in walking/gait abnormality and skeletal issues over time
  • May benefit from treatment by a lymphedema therapist
  • May be successfully treated with lymphatic sparing liposuction (Lipisuction)
  • Worsened by obesity
  • May or may not be associated with obesity
  • May be associated with lymphedema as well, especially in the legs

Lymphedema Summary

Lymphedema is a disorder of the lymphatic system. It involves circulation of lymph fluid and is related to the immune system. When blockages occur in the circulation of lymphatic fluid, then swelling in an arm or a leg can result. In most cases, Lymphedema in the United States occurs following radiation therapy and/or removal of lymph nodes as cancer treatment. In a small number of cases, Lymphedema can be spontaneous in onset or congenital. Typically, one extremity, either and arm or a leg, is effected. Lymphedema in the arms typically occurs after treatment for breast cancer and Lymphedema in the legs typically occurs after treatment for gynecologic malignancies such as cervical cancer.

Treatment

Lymphedema is treated with conservative therapy such as complete decongestive therapy, which is administered by a trained Lymphedema therapist. Highly technical surgeries can also be used to treat Lymphedema. Fluid-based Lymphedema can be treated with vascularized lymph node transfer (VLNT) or lymphatic venous anastomosis (LVA). In chronic, solid-predominant cases, Lymphedema can be treated with suction-assisted protein lipectomy (SAPL). These procedures have been shown to be very effective in significantly decreasing excess volume, compression garment use and therapy required for patients with Lymphedema in the arms or legs. The type of procedure must be carefully matched to the type of patient for the best result.

Lipedema Summary

In contrast, lipoedema is a disorder that involves the deposition of pathologic fat mostly in the legs. The fat distribution is disproportionate to the normal distribution of fat. These fatty areas often resemble fatty tumors and are typically quite painful to the touch. The fat mainly deposits on the insides of the legs and knees, causing pain when the legs touch and rub together. This causes the legs to be pushed further and further out during walking, causing eventual damage to the knees and ankles, with significant wear on the insides of the feet and shoes.

Treatment

The typical treatment for lipedema is initially conservative therapy with complete decongestive therapy by a trained Lymphedema therapist. Otherwise, some patients may be candidates for tumescent liposuction aspiration and removal of the pathologic fat.

In some cases, lipoedema and Lymphedema disorders may overlap and the excess fat deposited in lipoedema may even cause Lymphedema. Therefore, some patients who have been treated for lipoedema with either complete decongestive therapy or tumescent liposuction may require long-term treatment with compression garments as well.

Dr. Granzow’s comprehensive treatment systems for lymphedema and lipedema patients can effectively treat these conditions. Please contact our office with further questions or to schedule a personal consultation.