Living in Merseyside and Looking for Lipoedema Treatment?

If I Don't Have The Ankle Pantaloon, Does That Mean I Don't Have Lipoedema?

Lipoedema has a spectrum of presentation and not all patients have the ankle pantaloon deformity. Absence of the ankle pantaloon does not exclude the diagnosis of lipoedema. The diagnosis of lipoedema is made on the history and examination findings i.e. symptoms, progressive nature, family history, distribution and consistency of subcutaneous fat etc.

What is Lipoedema?

Lipoedema (US spelling lipedema) is a chronic and progressive medical condition characterised by the abnormal accumulation of fat in the lower limbs and sometimes the upper limbs. Unlike regular weight gain, lipoedema fat is distributed unevenly, creating a disproportionate enlargement of the lower limbs. This condition almost exclusively affects women, and has significant physical and emotional impact on those affected.

How is Lipoedema Diagnosed?

Mr Karri will make the diagnosis of lipoedema based on your history and examination findings. Specific features he looks out for include;

• Bilateral, symmetrical, enlargement of the lower limbs because of disproportionate, excess fat
• Sparing of the hands and feet
• Involvement of the arms (affects approximately 30% of patients)
• Negative Stemmer sign (a specific sign for lymphoedema where the skin at the base of the second toe cannot be lifted or pinched)
• A feeling of heaviness and tension in the affected limbs
• Pain on pressure and touch (pressure hypersensitivity)
• The lower limbs remain enlarged despite weight loss
• Worsening of symptoms over the course of the day

What Happens If I Do Not Want Lipoedema Liposuction?

Liposuction is not the only treatment for lipoedema, and for some patients, non-surgical therapies such as deep oscillation therapy, manual lymphatic drainage and dry brushing may be more appropriate.

It is Mr Karri's opinion that the majority of Stage 1 patients are best managed conservatively and he recommends a 'wait and watch' approach.

For some Stage 3 patients, Mr Karri may recommend weight-loss (bariatric) surgery before lipoedema liposuction.

During your consultation, Mr Karri will explain your options and their pros and cons.

Lipoedema Symptoms

The most common symptoms of lipoedema include:

• Enlargement of the legs, hips, and sometimes the arms because of excess fat.
• Pain and tenderness in affected areas
• Inability to reduce the size of the legs and/or arms with diet or exercise.
• Ankle swelling with prolonged standing (otherwise known as orthostatic oedema)

What Causes Lipoedema?

The cause of lipoedema is not known but three factors have been implicated; hormonal change, genetics and diet. It is not known which one of these factors is dominant. However, it appears the disease is exacerbated by hormonal change, typically seen during puberty, pregnancy and menopause. Some patients have a positive family history of lipoedema which suggests they inherited the disease from their family. These observations help differentiate lipoedema from obesity. However, it can be difficult to make the distinction as a number of lipoedema patients also have central obesity.

Managing Lipoedema in the Arms

In approximately 30% of lipoedema sufferers, the arms are also involved. This can have a significant impact on their quality of life and ability to perform activities of daily living.

Treatment for Arm Lipoedema

Arm lipoedema can be treated in the same way as leg lipoedema with liposuction. The surgery serves to permanently remove the diet-resistant fat cells, improve shoulder range of motion, reduce size and weight of the arm, and reduce soft-tissue pain. Patients are also able to wear blouses more easily and report less shoulder fatigue. The surgery is typically performed as a day case procedure and the recovery is 1-2 weeks.

What is Lipoedema Liposuction?

Lipoedema liposuction refers to removal of the abnormal, painful fat from the lower limbs (or other parts of the body) using liposuction. There are different types of liposuction such as water-jet assisted liposuction (WAL) and power-assisted liposuction (PAL).
Liposuction is performed either as a daycase procedure or with an inpatient stay. Lipoedema liposuction is well-recognised as a safe and effective treatment for lipoedema and is life-changing for many patients.

Does Mr Karri Have a Preference For a Particular Liposuction Method?

Mr Karri performs both water-jet assisted liposuction (WAL) and power-assisted liposuction (PAL), and will discuss which method is best for you.