KEY TAKEAWAYS
- Lipoedema and lymphoedema are both medical conditions that target the limbs. While they do share some overlapping symptoms, they are distinct issues with different treatment approaches.
- Lipoedema swelling is caused by abnormal fat tissue. It affects both sides of the body evenly, is almost exclusively seen in women, and is often genetic. It is driven by female hormones.
- Lymphoedema swelling is caused by fluid buildup. It often affects just one limb. Men and women can both experience this condition, which occurs due to a failure of the lymphatic system, often due to advanced age, cancer, cancer treatment, or an inflammatory disease.
- Sydney’s Be Sculptured (with a Gold Coast satellite clinic) offers the recommended “lymph-sparing” tumescent liposuction / lposculpture procedures for people with Stage 1 and Stage 2 lipoedema.
Understanding Lipoedema and Lymphoedema
Lipoedema and lymphoedema are both quite common, often misunderstood conditions that can cause swelling, heaviness, and discomfort of the legs and/or arms. They are, however, markedly distinct issues with different disease mechanisms, causes, and treatments. It’s extremely important to understand these differences so that an appropriate and effective management approach can be adopted as soon as possible.
What is the difference between lipoedema and lymphoedema?
What is Lipoedema?
Lipoedema is an abnormal buildup of fat cells, usually in the legs, but also potentially affecting the arms. This fat tends to be loose, spongy, and feels nodular compared with the smooth feeling of normal fat. The condition can vary in severity, often worsening over time, and the affected limbs can become very tender or painful, especially to touch.
Lipoedema occurs almost exclusively in women, thanks to the influence of female hormones, and usually begins during puberty, pregnancy, menopause, or when using hormonal birth control methods containing oestrogen. It is often genetic – so if your mother or grandmother had it, you’re more likely to have it too. Too often, it is mistaken (even by doctors) for obesity.
What is Lymphoedema?
The human body has an intricate network of organs, nodes, and vessels called the lymphatic system. Less well-known by most people than other body systems, the lymphatic system critically supports immune function and maintains the body’s fluid balance by draining the leakage of excess fluid from blood vessels and redirecting it back into the bloodstream. If this function fails, lymph fluid can build up in the tissues, especially in the arms and legs. This is referred to as lymphoedema.
While some people may be genetically predisposed to developing lymphoedema, common causes or triggers include advanced age, some types of cancer, cancer surgery (e.g. breast cancer surgery removes the lymph nodes in the axilla or armpit), radiation therapy, and inflammatory diseases such as rheumatoid arthritis, cellulitis, psoriasis, and eczema.
Severe lipoedema can also eventually lead to secondary lymphoedema.
Common Symptoms and How to Differentiate These Conditions
Common symptoms of lipoedema include fat deposits that do not improve with diet and exercise, even if weight is lost; a feeling of soreness and/or heaviness; easy bruising; swelling; and a body that appears disproportionate, with the lower half being much larger than the upper, or the arms/legs being overly large with a small torso. It can make walking difficult and dramatically compromise quality of life, both physically and psychologically.
Common symptoms of lymphoedema include severe swelling in the legs, arms, hands, and feet. This is also frequently associated with tightness and hardening of the skin, a feeling of heaviness, and a loss of the normal range of motion in the affected arm or leg. These can be extremely uncomfortable.
Swelling and Pain, Distribution of Fat, and Tissue Changes
- Lipoedema swelling is caused by abnormal fat tissue.
- Lymphoedema swelling is caused by fluid buildup.
Swelling and pain can be considerable with both of these conditions. One thing that sets them apart is that, with lipoedema, the changes are symmetrical: both legs and/or both arms will be evenly impacted, often from the hips to the ankles (or the shoulders to the wrists). For most people with lymphoedema, however, just one limb may be impacted, or one limb may be worse than the other.
Furthermore, in lipoedema, the hands and feet are unaffected and appear “normal”, with the abnormal swelling stopping at the wrist or ankle. In a person with lymphoedema, the pain and swelling extend into the extremity, and the hand or foot of the affected limb will also display changes.
How To Diagnose Lipoedema and Lymphoedema
Lipoedema can be progressive, and it occurs as a primary condition. It is classified in stages:
- Stage 1 – legs begin to swell, skin remains smooth. Tenderness and easy bruising may be noted.
- Stage 2 – swelling is dramatic. The skin surface is uneven, and the skin looks dimpled without pressure applied.
- Stage 3 – the limbs take on a “trunklike” appearance; the ankles can even be a similar circumference to the thighs.
- Stage 4 – lipo-lymphoedema: severe abnormal fat buildup causes secondary lymphoedema as fat presses on the lymphatic network and restricts its function. The fluid has nowhere to go, making swelling and other symptoms significantly worse.
Lymphoedema often occurs secondarily to another medical issue. It is categorised as Mild (swelling up to but less than 20% of the limb’s normal size), Moderate (swelling 20-40%), or Severe (more than 40%) and classified in stages:
- Stage 0 – normal appearance but impaired lymph flow with pooling in the limb.
- Stage 1 – swelling is present but minimal and alleviated by elevating the limb.
- Stage 2 – elevation does not relieve swelling; skin dimples only when pressure is applied, but pitting/dimpling remains when pressure is removed.
- Stage 3 – the limb becomes misshapen, and the skin hardens and dries (fibrosis). Cellulitis becomes a higher risk, and fat deposits may grow.
Treatment Options
Treating Lipoedema:
There is no cure for lipoedema. Moderate physical exercise, wearing compression garments, massage, remaining hydrated, minimising salt intake, and elevating the legs may alleviate some symptoms. A ketogenic diet low in carbohydrates and high in “good” fats may be beneficial. Gold standard management for Stage 1 and Stage 2 lipoedema (for suitable candidates) involves liposuction for lipoedema.
Treating Lymphoedema:
There is no cure for lymphoedema, though in some people, it can resolve over time, depending on its cause and other factors. Decongestive therapy involves manual lymphatic drainage (massage), the use of compression garments, targeted exercises, and care of the skin to keep it moisturised to prevent cuts and other wounds that risk infection. Skin infections require antibiotic treatment. In severe cases, surgery may be required to transfer lymph nodes from another part of the body, reroute blocked lymphatic channels (anastomosis), or remove excess fat tissue via liposuction to debulk and attempt to return lymphatic function to the affected limb.
You must understand why you’re experiencing limb swelling, as a correct diagnosis is essential for effective management going forward.
Book A Consultation at Be Sculptured
Be Sculpturedoffers inpatient, day-only tumescent liposculpture procedures for lipoedema that are suited to people with Stage 1 or Stage 2 lipoedema and who have a BMI of below 35 and waist to height ratio <0.55. Our experienced proceduralist, Dr Meaghan Heckenberg, is highly trained and has performed this procedure thousands of times. It is the gold-standard recommended approach to care for these patients to provide relief from symptoms.
Our clinic is situated in Sydney, and we have a satellite clinic on the Gold Coast.
To find out whether you are a suitable candidate for our lipoedema treatment, visit our website now or give us a call on 0484 898 977.
Find our consultation form at the bottom of this page.
Alternatively, you are welcome to send us an email at [email protected].
