About Lymphedema and Lipedema

Lymphatic System

Lymphatic System

What is Lymphedema?  

Lymphedema is the abnormal accumulation of lymph fluid in affected limbs, or areas of the body. The lymphatic system moves lymph fluid throughout the body. Lymph nodes are the central operations of the lymphatic system. Lymphedema occurs when there is an interruption in the lymphatic system causing a back up of fluid. There are two types of Lymphedema, primary and secondary.

Primary Lymphedema is often present from birth and is caused by a malformed or non-functioning lymphatic system. Secondary, Lymphedema develops after injury, trauma or surgery causes damage to the lymphatic system. Often cancer surgery to remove lymph nodes can cause a person to develop Lymphedema.

Secondary Lymphedema in the abdomen or legs can often develop in individuals who are morbidly obese because of the excess weight putting pressure on the lymphatic system.

How is Lymphedema treated?

Lymphedema treatment should be performed by a Lymphedema certified therapist. Treatment options include manual lymph drainage (MLD), and compression.

Manual Lymph Drainage (MLD) is a specialized massage technique that stimulates the lymphatic system to promote movement of lymph fluid out of the affected area. Compression wraps are typically applied after MLD. Patients can be taught to perform massage and wrapping on themselves so therapy can continue at home. Other types of home compression include sleeves, garments, and compression pumps. Patients should discuss daytime and nighttime compression options with their physician and therapist to determine which type of products are best suited for their individual needs.

Certain exercises such as walking, cycling, and swimming can help improve lymphatic flow, however, patients should consult with a physician or therapist before starting an exercise program.

How will Weight Loss Surgery affect Lymphedema?

Patients with Lymphedema considering weight loss surgery should discuss the condition with their surgeon and set realistic expectations. Losing weight may improve the ability to manage Lymphedema, however, lifetime compression is often still needed to treat Lymphedema.

Risk of Secondary Lymphedema after Reconstructive Surgery

Secondary Lymphedema is a risk after reconstructive plastic surgery where incisions extend into lymph node areas such as groin and armpits. Discuss all surgical risks with surgeon during consultation.

There are 3-5 million people affected with secondary lymphedema in the United States, and as many as 170 million world-wide.  World Health Organization

legprogress

Lipedema & Lymphedema, note feet are not affected. Photos of same patient from 2001-2007, show improvement with MLD and compression therapy. Patient also had WLS in 2003. Credit: Sarah Bramblette

 

What is Lipedema?

While Lymphedema is the abnormal accumulation of lymph fluid, Lipedema is the abnormal accumulation of adipose tissue affecting the legs, hips, thighs and sometimes arms. Lipedema is a congenital condition and occurs in stages, with advance stages progressing to include the development of Lymphedema. Areas affected by Lipedema can be more sensitive to pain and bruising.

How is Lipedema treated?

Also similar to lymphedema, MLD and compression is the recommended treatment for Lipedema. Treatment should be from a certified Lymphedema specialist.

Manual Lymph Drainage (MLD) is specialize massage technique that stimulates the lymph system to promote movement of lymph fluid out of the affected area. Compression wraps are typically applied after MLD. Patients can be taught to perform massage and wrapping on themselves so therapy can continue at home. Other types of home compression include sleeves, garments, and compression pumps. Patients should discuss daytime and nighttime compression options with their physician and therapist to determine which type of products are best suited for their individual needs. Due to the increase pain associated Lipedema, certain types of compression may not be tolerated.

Lipedema tissue cannot be reduced through restricting calories or intense exercise. This can be frustrating to patients suffering with Lipedema. However, good nutrition and physical activity are still important to maintain health and mobility. Patients should consult with a physician or therapist before starting an exercise program.

How will WLS affect Lipedema?

Weight loss surgery may help morbidly obese patients with Lipedema lose excess normal weight, however, significant weight lose may only occur in non-affected areas. Patients should discuss the benefits and risk of weight loss surgery and have realistic expectations of possible weight loss.

Lipedema affects up to 11% of women. - WebMD

Three_stages_of_lipedema

Three stages of lipedema - from left to right: Stage 1, Stage 2, and Stage 3 Credit: Catherine Seo

LipedemaLymphedema
Symmetric (buttocks involved)Not symmetric
Foot not involvedFoot Involved
Not PittingPitting edema
Stemmer sign negativeStemmer sign positive
Tissue feels rubberyTissue feels firmer (starting stage 2

lymphedema)
Painful to touchGenerally not painful to touch
Easily BruisingGenerally not bruising
Hormonal disturbances frequentGenerally no hormonal disturbance

Additional Resources:

ObesityHelp Lymphedema Forum

National Lymphedema Network

Dr. Karen Herbst - Lipedema