Lipoedema & Varicose Veins
Lipoedema is a chronic progressive condition characterised by the abnormal and excessive accumulation of the fatty tissue, generally in the lower legs and thighs. Other areas frequently affected by lipoedema include the buttocks, thighs, lower legs and ankles. Varicose vein disease is often present in conjunction with lipoedema and associated mild lymphedema.
Do you suffer from lipoedema?
Without treatment such as liposuction, the symptoms of lipoedema will grow progressively worse over time. Because it is a progressive condition, the majority of patients suffering from lipoedema will eventually suffer from obesity, poor mobility, lower leg tenderness and skin hypersensitivity as their condition progresses.
Symptoms of lipoedema
Patients suffering from lipoedema often present with a body type where the thighs, lower legs and upper arms appear disproportionally larger than other areas of the body, such as the waist, upper chest and abdomen.
It is reported that 75% of patients who are affected by lipoedema present with abnormal fat distribution in the lower limbs, while the remaining 25% of lipoedema patients are also affected in the upper limbs.
Varicose vein disease is often present in conjunction with lipoedema and associated mild lymphedema. Varicose veins are characterised as an abnormal vein located in the lower legs that are unable to effectively transport venous blood. As a result, blood begins to pool within varicose veins and begin to put unreasonable pressure on the lymphatic system which operates to drain fluid.
Who is affected by lipoedema?
The majority of patients suffering from Lipoedema are female and approximately 10-15% of the female population are affected.
What causes lipoedema?
While the root cause of lipoedema remains somewhat of a mystery, anecdotal evidence suggests that there is a genetic component that may cause this condition. The majority of our patients suffering from lipoedema report that their mothers also suffered from this ailment.
Medical research has demonstrated that lipoedema will often begin to present in patients during periods of time that coincide with hormonal fluctuation including puberty, pregnancy or menopause.
Types of lipoedema
The types of lipoedema are characterised by the areas that have been affected.
- Type I affects the buttocks and hips
- Type II affects the buttocks, hips and thighs
- Type III affects the hips, thighs and lower legs
- Type IV affects the arms
- Type V affects the lower leg
Stages of lipoedema
As lipoedema is a progressive condition that worsens with time there are four stages of the condition.
During Stage I the skin is smooth and swelling will grow worse over the course of the day but will improve with rest and elevation. Patients who are treated during Stage I are likely to have a very good response to treatments such as stockings and manual lymphatic drainage therapy.
In Stage II the skin will become hard and lumps and lipomas, skin dermatitis and inflammation may begin to develop. Swelling will grow worse during the day and patients may experience a small amount of improvement from rest and elevation. Treatment may or may not help.
Stage III presents with constant extremely hard skin, evidence of lipodermatosclerosis and large areas of overhanging skin and fat. Patients in Stage III have a poor response rate to treatment.
Stage IV is characterised by severe Fibrosclerosis and in some cased Elephantiasis may be present. The swelling is permanent, large areas of skin and fat are overhanging and Lipo-Lymphoedema is present. Response to treatment is poor.
How We Treat Lipoedema
As treatments that involve diet and exercise are generally ineffective, as lipoedema is resistant to diet and exercise, liposuction can be performed on an outpatient basis with no general anaesthetic and minimal post-operative discomfort. Liposuction can help treat the symptoms of lipoedema that can’t be treated by diet and exercise alone. Before any direct treatment of lipoedema occurs, all patients who suffer from lipoedema or lymphoedema will receive mandatory venous mapping scans by our expert phlebologist who has 15 years’ experience treating varicose veins and associated conditions. A detailed duplex ultrasound examination of the blood vessels of the lower legs will be conducted so that any underlying venous disease can be ruled out or promptly treated through a combination of laser, radiofrequency ablation, sclerotherapy or medical glue before beginning any direct treatment of lipoedema.
Under ultrasound guidance, a laser fibre is placed into the abnormal vein through a tiny incision. When the laser is activated and the fibre is slowly removed, this produces a reaction in the vein wall along the treated section, resulting in collapse and sclerosis of the vein wall with minimal discomfort.
Ultrasound Guided Sclerotherapy is a highly specialised procedure involving injecting a sclerosant solution into the abnormal veins using ultrasound guidance, causing the vein wall to collapse. The veins dissolve and disappear as the body gradually absorbs them.
Radiofrequency ablation (RFA) relies on thermal (heat based) damage to the vein, that leads to immediate closure of the vein. Once the vein is treated by radiofrequency ablation, it will gradually undergo complete absorption by the body and disappear over time.