Lipedema Can Be Treated Non-Surgically: A Report of 5 Cases

Abstract

Case series Patients: Femal, 39-year-old • Femal, 64-year-old • Femal, 52-year-old • Femal, 34-year-old • Femal, 90-year-old Final Diagnosis: Lipedema Symptoms: Edema • pain Medication: — Clinical Procedure: Medications Specialty: Endocrinology and Metabolic Objective: Unusual clinical course Background: Lipedema is a chronic progressive disease characterized by the abnormal accumulation of fat in the subcutaneous region. Both medical and surgical treatments have been described in international guidelines; however, the current literature is biased toward promoting liposuction as the primary treatment of lipedema, and this can lead to the misapprehension that liposuction is the only form of definitive treatment. Case Reports: In the present study, we report 5 cases at various stages of the evolution of lipedema, all with different therapeutic objectives. Case 1 reported having persistent bruising and pain, case 2 reported pain and fat deposition, case 3 reported night cramps and discomfort, case 4 reported leg thickening, and case 5 reported redness in the legs. All of were diagnosed with lipedema in different evolution stages. Our purpose was to demonstrate the possibility of non-surgical therapy, as well as to improve signs and symptoms of lipedema, using the QuASiL questionnaire and measuring changes in volumes and proportions. Good aesthetic outcomes improve both social and psychological status. Conclusions: Currently, there are many described therapies available for lipedema. Liposuction surgery for lipedema should be considered one possible tool. Treatment objectives can be different for each patient. It is imperative to understand each patient’s needs in order to offer the best therapy attainable that meets patient requirements and induces a better quality of life. Non-surgical treatment of lipedema is feasible in selected cases, and it can meet the criteria for achieving selected clinical objectives.

A Scoping Review of Available Tools in Measurement of the Effectiveness of Conservative Treatment in Lipoedema

“…Seven studies reported volume measurement as a tool to assess the effectiveness of conservative lipoedema treatment methods [ 17 , 20 , 21 , 25 , 26 , 27 , 28 ]. Since in the majority of cases the lipoedema applies to the lower part of the body, only the lower extremity measurements were pursued.…”

“…It is a method employing weak electric current to indicate body composition, body fat and muscle mass. The volume reduction in the lower limbs of three patients after 5, 8 and 11 months of MLD, aquatic exercises and an anti-inflammatory diet was significant—1.9 L, 1.2 L and 10.7 L, respectively [ 27 ].…”

“…The last patient scored 115 points at baseline, and after 11 months of therapy the score declined to 59/150. It should be noted that despite the length of the treatment, the Lipedema Symptom Assessment Questionnaire showed a significant reduction in ailments in all the cases [ 27 ].…”

“…Due to the lack of distinct guidelines for lipoedema treatment, more and more new methods are being tested for their effectiveness. Evaluation of the efficiency of therapy should be objectively measured and be reproducible, therefore, specific measurement methods are crucial in examining various therapeutic methods in lipoedema patients treatment [ 17 , 18 , 19 , 20 , 21 , 25 , 26 , 27 , 28 , 29 ].…”

Reply letter to the editor regarding ultrasound examination for en-suite measurements in lipedema

“…Your comment suggests we all believe health care providers should be prompted to diagnose lipedema as early as possible so that patients are offered the best management solutions, 5 avoiding the progression of the disease. 6 We could not agree more because if patients are diagnosed earlier, they can control it and prevent progression, living a normal life.…”