Prevention of Progression of Lipedema With Liposuction Using Tumescent Local Anesthesia: Results of an International Consensus Conference

Sandhofer, Matthias; Hanke, C. William; Habbema, Louis; Rapprich, Stefan; Schmeller, W.; Herbst, Karen L.; Anderhuber, Friedrich; Pilsl, Ulrike; Sattler, Gerhard; Sandhofer, Martina; Moosbauer, W.; Sattler, Sonja; Schauer, P.; Faulhaber, Jörg; Maier, Sabine; Barsch, Martin; Mindt, Sonani; Halk, Anne B

doi:10.1097/dss.0000000000002019

Cited by 38 publications

(60 citation statements)

References 13 publications

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“…Die maximale Gesamtdosis von Lidocain liegt bei 55 mg/kg bei Frauen < 60 Jahren und bei 45 mg/kg bei Frauen über 60 Jahren [21].…”

Section: Definitionunclassified

“…Zwischen der Absaugung zweier Areale soll ein zeitlicher Abstand von mindestens 4-6 Wochen liegen.Seit der Einführung der Tumeszenz-Lokalanästhesie (TLA) Ende der 1980er-Jahre wird die "trockene" Liposuktion aufgrund möglicher Lymphgefäßverletzungen nicht mehr angewendet[16]. Die Liposuktion sollte in örtlicher Betäubung mittels TLA und mit stumpfen Mikrokanülen durchgeführt werden[14,[17][18][19][20][21] Markierung der Behandlungsareale an der Oberschenkelinnenseite vor Liposuktion. Einteilung des Lipödems nach Morphologie.…”

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Die Liposuktion mit Vibrationsmikrokanülen ist eine erfolgreiche Therapie des Lipödems

Korsake¹,

Rapprich

2020

Phlebologie

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ZusammenfassungDas Lipödem ist eine chronische, progrediente, schmerzhafte, übermäßige Fettgewebsvermehrung bei Frauen mit deutlicher Disproportion zwischen Stamm und Extremitäten 1. Zusätzlich bestehen Ödeme, die durch Orthostase verstärkt werden, sowie eine Hämatomneigung nach Bagatelltraumen 2 3 4. Die Ursache ist unbekannt, daher gibt es keine kausale Therapiemöglichkeit. Die vielfach empfohlene komplexe physikalische Entstauungstherapie (KPE), bestehend aus manueller Lymphdrainage und Kompression, ist nur gegen die Ödemkomponente wirksam.Eine dauerhafte Reduktion des krankhaften Unterhautfettgewebes an Beinen und Armen ist mittels Liposuktion durch die Mikrokanülentechnik in Tumeszenz-Lokalanästhesie möglich geworden 5.

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“…Die maximale Gesamtdosis von Lidocain liegt bei 55 mg/kg bei Frauen < 60 Jahren und bei 45 mg/kg bei Frauen über 60 Jahren [21].…”

Section: Definitionunclassified

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Die Liposuktion mit Vibrationsmikrokanülen ist eine erfolgreiche Therapie des Lipödems

Korsake¹,

Rapprich

2020

Phlebologie

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“…Lipedema is also often confused with lymphedema, which causes asymmetric swelling of the limbs and is caused by defects in lymphatic transport [ 3 ] ( Table 1 ). The diagnosis of lipedema is based on the clinical criteria first published by Wold and updated most recently with International Consensus Diagnostic Criteria [ 4 , 5 ] ( Table 2 ). These criteria emphasize heavy, tender, symmetric enlargement of the limbs, sparing the hands and feet, with negative Kaposi-Stemmer’s Sign.…”

Section: Introductionmentioning

confidence: 99%

A 41-Year-Old Woman with Excessive Fat of the Lower Body Since Puberty with Progression to Swollen Ankles and Feet Despite Caloric Restriction, Due to Lipedema and Protein-Calorie Malnutrition: A Case of Stage 3 Lipedema

Wright¹,

Herbst²

2021

Am J Case Rep

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Patient: Female, 41-year-old Final Diagnosis: Malnutrition Symptoms: Leg edema • weakness Medication: — Clinical Procedure: Lymphatic mapping Specialty: Dermatology • Endocrinology and Metabolic • Surgery Objective: Rare co-existance of disease or pathology Background: Lipedema is a common condition that presents as excessive fat deposition in the extremities, initially sparing the trunk, ankles, and feet, and is found mainly in women, usually occurring after puberty or pregnancy. Lipedema can progress to include lipo-lymphedema of the ankles and feet. This report is of a 41-year old woman with Stage 3 lipedema and lipo-lymphedema with excessive fat of the lower body since puberty, with progression to swollen ankles and feet despite dietary caloric restriction. Case Report: A 41-year-old woman noticed increased fat in her legs since age 12. Her weight and leg size increased until age 21, when she reached a maximum weight of 165 kg, and underwent a Roux-En-Y gastric bypass. Over 12 months, she lost 74.8 kg. Her trunk significantly reduced in weight, but her legs did not. Fifteen years later, during recovery from hysterectomy surgery, she became progressively weaker and swollen over her entire body. Laboratory test results showed hypoalbuminemia (2.0 g/dL), lymphopenia, and hypolipoproteinemia. She was diagnosed with protein and calorie malnutrition with marked gut edema requiring prolonged parenteral nutrition. After restoration of normal protein, her health returned and her pitting edema resolved, but her extremities remained enlarged. She was subsequently diagnosed with lipedema. Conclusions: This report demonstrates that early and correct diagnosis of lipedema is important, as women who believe the condition is due to obesity may suffer the consequences of calorie or protein-calorie deficiency in an attempt to lose weight.

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“…Clinicians must consider multiple criteria during the physical examination and conducting the medical history. A frequent comorbidity with 21.5% is cardiac disease 16 , however the risk of diabetes, dyslipidemia and hypertension is low despite an obese median BMI 1,17 .…”

Section: Introductionmentioning

confidence: 99%

SVF-derived extracellular vesicles carry characteristic miRNAs in lipedema

Priglinger

Strohmeier

Weigl³

et al. 2019

Preprint

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AbstractLipedema is a chronic, progressive disease of adipose tissue with lack of consistent diagnostic criteria. The aim of this study was a thorough comparative characterization of extracellular microRNAs from the stromal vascular fraction (SVF) of healthy and lipedema adipose tissue. For this, we analyzed 187 extracellular microRNAs in concentrated conditioned media (cCM) and specifically in small extracellular vesicles (sEVs) enriched thereof by size exclusion chromatography. No significant difference in median particle size and concentration was observed between sEV fractions in healthy and lipedema. We found the majority of miRNAs located predominantly in cCM compared to sEV enriched fraction. Surprisingly, hierarchical clustering of the most variant miRNAs showed that only sEV miRNA profiles – but not cCM miRNAs – were impacted by lipedema. Seven sEV miRNAs (miR–16-5p, miR-29a-3p, miR-24-3p, miR-454-p, miR–144-5p, miR-130a-3p, let-7c-5p) were differently regulated in lipedema and healthy, whereas only one cCM miRNA (miR-188-5p) was significantly downregulated in lipedema. Comparing SVF from healthy and lipedema patients, we identified sEVs as the lipedema relevant miRNA fraction. This study contributes to identify the potential role of SVF secreted miRNAs in lipedema.

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Prevention of Progression of Lipedema With Liposuction Using Tumescent Local Anesthesia: Results of an International Consensus Conference

Cited by 38 publications

References 13 publications

Die Liposuktion mit Vibrationsmikrokanülen ist eine erfolgreiche Therapie des Lipödems

Die Liposuktion mit Vibrationsmikrokanülen ist eine erfolgreiche Therapie des Lipödems

A 41-Year-Old Woman with Excessive Fat of the Lower Body Since Puberty with Progression to Swollen Ankles and Feet Despite Caloric Restriction, Due to Lipedema and Protein-Calorie Malnutrition: A Case of Stage 3 Lipedema

SVF-derived extracellular vesicles carry characteristic miRNAs in lipedema

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