Is there a connection between lipoedema and varicose veins?

by | May 31, 2021

A connection between lipoedema and varicose veins is plausible. Although a link is not yet well defined in research, they are at least regularly identified together. In today’s blog, let’s look at the possible links and how it affects lipoedema treatment.

Lipoedema is a disease identified by the irregular and excessive accumulation of fatty tissue disproportionately in the thighs, lower legs, and sometimes arms. Other symptoms of lipedema (lipoedema) include the appearance of swelling in the legs, the legs look column-like instead of shaped, painful sensitivity to touch, aching, bruising easily, difficulty walking & exercising.

There has not yet been a link proven between lipoedema and problem veins, however, based on Dr Paraskevas’ clinical observation, he believes there is an increased incidence of venous incompetency in patients with lipoedema. Regardless of any proven comorbid factors, in our clinic we always examine the venous and arterial system in patients who present with lipoedema before treating with liposuction/liposculpture. There are three reasons we do this:

1. Cross-over in symptoms of both varicose veins and lipoedema

Some of the symptoms of lipoedema are also symptoms of varicose veins, such as heaviness, aching, tiredness, and swelling in the legs. At present, lipoedema is diagnosed based on the medical history, physical examination of the patient, and ruling out other similar diagnoses. There are currently no known biomarkers for blood or urine tests for lipoedema. As there is no definitive test for lipoedema, it is sometimes mistaken for other conditions including: varicose veins, congestive cardiac failure, dependency or stasis oedema, obesity, hepatic or renal dysfunction, hypoproteinaemia, hypothyroidism, pregnancy, premenstrual oedema, and drug-induced swelling.

Given this cross-over in symptoms with varicose veins, and the fact that they often appear together in clinical settings, it makes sense to check for vein problems first. If incompetent veins are identified via ultrasound, it is in the patient’s best interest to have them treated, as this may address or reduce the severity of the painful symptoms they are experiencing.

2. Stress on the lymphatic system

Venous insufficiency will almost always put an additional load on the patient’s lymphatic system, compounding the effects of lipoedema.

Lipoedema is often accompanied by fluid oedema (swelling/fluid retention). More research is needed, but there are some indications that the oedema may be the result of an overloaded lymphatic system. It has also been suggested that the effectiveness of the lymphatic system at removing fluid may be reduced by the excess fat tissue build-up, reduced skin elasticity, reduced mobility, and joint problems.

So, although lipoedema puts pressure on the lymphatic system causing swelling, we know untreated vein disease is also putting stress on the lymphatic system. It is good to rule out vein problems as a cause of this first.

3. Always treat varicose veins before leg liposuction

In our clinic, we treat the symptoms of lipoedema using tumescent liposuction. The presence of untreated varicose veins is a risk factor for excessive bleeding if punctured during a liposuction procedure on the legs, and the development of blood clots afterward.

Liposuction reduces the bulkiness of the fat cells, improving mobility and function. It reduces bruising and pain. Patients report an improved quality of life.

Key Takeaways

  • Dr Paraskevas has observed that patients who present in our clinic with lipoedema often have venous disease too.
  • We always test lipoedema patients for vein disease for three main reasons:
    1. Cross-over in symptoms of both varicose veins and lipoedema
    2. Venous disease produces stress on the lymphatic system.
    3. Varicose veins should be treated before leg liposuction to prevent complications during the liposuction procedure.
  • To learn more about lipoedema and varicose veins or to book an appointment with Dr Paraskevas, please give us a call.

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