Lipedema – The Pandemic of an Unknown Disease

Pandemic is a modern word with regard to the past. Nowadays, among other things, we can talk about a pandemic of obesity, especially in civilized countries of the world – EU, USA, Australia.

Not all obesity is the same. Obesity is, among other things, defined by the general measure called Body Mass Index (BMI), where ranges are established according to which it is determined whether it is obesity or not. This basic division also includes pathological fat accumulation – so-called Lipedema.

The term Lipedema is well known in German-speaking countries, where especially in Germany we can speak of a Pandemic, both based on absolute numbers of the affected population and because this terminology has been accepted by the professional community as a so-called nosological unit, meaning as a diagnosis (like typhus), although it is not yet included in the International Classification of Diseases.

This results in the general population being confronted with this diagnosis and seeking examination by specialists for subsequent treatment. In our regions – Czech Republic, Poland, Hungary – this “concept” is more or less unknown both to professionals and the general public. The further east, the less this diagnosis is known (also because it affects Asian populations only minimally).

It is unknown to obesity specialists (with rare exceptions) as well as to radiologists who confirm this diagnosis and its stages through ultrasound examination. (Of course, MRI is also highly diagnostic but unnecessarily expensive)

What is Lipedema:

It is abnormal accumulation of pathological fat in predilection sites, mainly on the lower extremities and in some cases also on the upper extremities. It does not affect the palms or soles of the feet. It is a generalized fat disorder.

Many sources indicate that it is a type of inflammatory disease caused by enlargement – hypertrophy and multiplication – hyperplasia of fat cells. The cells are arranged in so-called convolutions (bundles) and are located in connective tissue, something like a natural sponge where cells are placed in the openings.

Since the cells are large, the tissue rubs against itself and aseptic inflammation occurs, resulting in the formation of fibrous tissue – essentially scar tissue. Therefore, lipedema fat tissue is significantly harder compared to ordinary fat tissue. For this reason, the tactics of invasive treatment have changed, moving from using water jet to ultrasound in an invasive manner with the VASER device.

It affects exclusively women and is a metabolically, genetically, and especially hormonally conditioned disease.

There are various classifications of Lipedema, stages and types of Lipedema

Currently, work is being done on classifying Lipedema in combination with morphology and functional aspects with regard to possible treatment.

Prevalence of Lipedema:

There are various statistics citing different numbers for Lipedema prevalence in the population, but several lean towards the figure of 10%. This means that every 10th woman out of 100 women is affected by Lipedema. This means that in Germany, over 8,000,000 women (8 million) are affected. In total, in German-speaking countries, it’s around 10 million women. In the Czechoslovak population, it’s approximately 1.5 million women.

In summer, it’s best possible to see how many women suffer from Lipedema. According to my experience, without statistical proof, it’s almost every 6-8th woman who has visibly apparent Lipedema of various stages and types.

Therefore, it is essential to raise awareness about this “Disease” both among professionals and the general public, so we can help these people, thereby improving the physical and especially psychological health of both communities.

Is Lipedema treatable?

Right at the beginning, it’s necessary to say that Lipedema as such is not yet curable. However, it must be said quite emphatically that it is not a fatal disease and most importantly, its impact on life can be mitigated. Currently, we have technologies that can significantly improve the quality of life for Lipedema patients.

Lipedema treatment requires a comprehensive approach

Advantages of ultrasound liposuction over WAL

• Time factor – operation duration is significantly shortened compared to water jet due to fibrosis, scar tissue that characterizes Lipedema. Ultrasound very effectively breaks down scar-fibrous tissue. This shortens the patient’s anesthesia time
• Significant reduction in blood loss with much faster surgical procedure
• Reduces, though doesn’t completely eliminate, the possibility of creating irregularities. Although limbs affected by Lipedema are primarily – initially uneven.
• Operation acceleration
• Preservation of the so-called fibroseptal network, which is tissue between skin and muscles, responsible for skin laxity.

In liposuction itself, the phenomenon of “sagging” skin is precisely what threatens. FSN is made of collagen, a protein that responds very well to heat and remains after fat suction from this “network,” “grid.”

Maintaining quality FSN is 1/3 of success in skin tightening to the muscle skeleton and thus body contouring, 1/3 lies in radiofrequency-guided plasma current technology of noble gases Argon and Neon, 1/3 remains with the patient – collagen quality, postoperative care, etc.

Target organ – fibroseptal network

The next step is fat removal using vibrational liposuction, which is gentle to tissues and perfectly helps remove fat cells loosened by Vaser.

Finally, it’s necessary to tighten the loose skin – precisely through the application of high heat to collagen fibers – Fibroseptal network – FSN. Ionized noble gas = Plasma is used for this, either Argon or Helium.

Collagen is heated for a short time to a temperature of 85°C. Normally, 65°C is sufficient for collagen contraction, which is the denaturation temperature of proteins. In the case of plasma, however, this is milliseconds and the area is immediately cooled afterward. The plasma current is selectively directed to collagen fibers because the first place this current “goes” is the location of lowest resistance, which is actually collagen. Then follows fat, muscles, etc.

This is a huge advantage over Laser, where thermal energy spreads everywhere around the application cannula and “burns” everything around. Today, Laser liposuction has been completely abandoned!!!!!

The result is tightening and adherence of otherwise sagging skin to the muscle skeleton. However, it should be noted that even plasma cannot work miracles, and where skin is very loose and damaged by processes of weight gain, weight loss, previous liposuction procedures, sun exposure, sometimes the only option is “cutting off” this excess skin.