Lipedema: The signs you may not have noticed

Lipedema can be a chronic condition of fat tissue that results in a symmetrical, but disproportionate, increase in size in the legs and arms.

It is often accompanied by pain, heavyness, and frequent bruises. Despite these characteristic symptoms, it remains widely underdiagnosed – largely because it is mistaken for excess weight, obesity or circulatory problems.

The key to recognizing its clinical signs is to recognise the pain when touched, hypersensitivity, and the constant feeling of weight, says Dr Lourdes Ygues, director of a new centre for autoimmune diseases. Lipedema Surgery Unit at Quirónsalud Marbella and Quirónsalud Málaga.

A disease that has its own criteria

Dr Yagues explains that, according to German guideline S2k, which is used as a diagnostic reference, “there should be symptoms, such as pain or heaviness and hypersensitivity, but not only increased volume”.

The pattern includes legs and arm widths that are larger than the trunk. It also has a symmetrical distribution and is associated with bruising and a poor diet response. She says that patients may lose weight on their face or torso but the legs do not change much.

Early diagnosis can improve quality of Life

For many women, putting a name on what’s happening is the first step. Early diagnosis allows conservative measures such as compression, adapted exercise, physiotherapy and pain management – all of which help reduce symptoms and improve mobility.

This helps to identify factors which can worsen a condition such as excessive weight or inactivity, and assess whether surgery may be beneficial. “Lipedema need not worsen unavoidably.” It is dependent on risk factor management and care provided to the patient”, says Dr Yagues.

Surgery for lipedema: Safety and functional improvements

Most common is a liposuction procedure, which has been designed to improve mobility, reduce pain and improve quality of life.

Yagues says that “surgery may be considered if pain and movement restrictions persist despite the conservative treatment.” It is done in a hospital using techniques that protect lymphatic system, and strict safety protocol covering fluid control and thrombosis prevention.

After surgery, studies show that there are significant improvements: less pain while walking or touching your legs, an improved posture, and an ease of daily activities. Even though the full effects take months to become apparent, self-care is essential.

Multidisciplinary treatment of a complex problem

Quirónsalud Marbella has launched a dedicated unit to support patients with an integrated approach. The unit is staffed by specialists in plastic surgery and lymphology as well as nutrition, psychology, internal medicine, angiology, and physiotherapy.

“Coordination is essential. Dr Yagues says that it’s more than just operating. It’s about guiding your patients through the process of preparation, recovery, and long-term monitoring.

Key message to Patients

Specialists stress that persistent symptoms, such as persistent pain, frequent bruises, disproportional limb volume, and poor response to diet, warrant medical evaluation. “The sooner lipedema is identified, the sooner the right treatment can begin – and the sooner quality of life can improve.”

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