When lipedema exerts pressure on the lymphatic system

Lipedema – an ailment that affects mostly female patients only. For many women this diagnosis means a long tale of woe. The same applies to lipo-lymphedema.

How can lipo-lymphedema develop?

It is estimated that in Germany about 4 million women suffer from lipedema. In the case of this chronic lipodystrophy the fat cells increase uncontrollably at the thighs, the hips, the buttocks or the arms. In the early stages of lipedema the lymphatic system can work in the main function without problems.

However, if too much fat tissue exerts at some point pressure on the lymphatic system, secondary lymphedema can then also develop. Lymph transport is impaired and lymph fluid congests. Then the diagnosis is lipo-lymphedema.


The four stages of lipedema. Lipo-lymphedema is also sometimes referred to as stage IV of lipedema.

Accompanying obesity can favour the development of lymphedema. To avoid lipo-lymphedema, it is important to start lipedema therapy as early as possible. It is the only way that the explosive increase in fat cells can be contained.

How can lipo-lymphedema be identified?

In the case of lipo-lymphedema the dorsal surfaces of the foot and hand are swollen (edematized) and at the base of the toe folds of skin develop. This is usually not the case with pure lipedema. As a rule, fingers and toes remain as is also the case with lipedema free of swelling.

In contrast to pure lipedema the so-called Stemmer’s sign is in the case of lipo-lymphedema mostly positive: as a result, the fold of the skin on the dorsal surfaces of the toes or fingers can be hardly lifted, indeed if at all. In the case of lymphedema body shape is usually asymmetrical, as lymphedema can also occur only on one leg or arm. By contrast, body shape can in the case of lipo-lymphedema also be symmetrical because the underlying lipedema is as a rule equally pronounced on both legs.


In the case of lipo-lymphedema the Stemmer’s sign is usually positive (on the right in picture).


For those affected there are several ways of relieving symptoms and supporting therapeutic success.

What can afflicted patients do?

As is the case with lipedema only the symptoms but not the cause can be treated in the case of lipo-lymphedema. Conservative therapy consists of Complex Decongestive Physiotherapy (CDPT) with a variety of components: manual lymphatic drainage, compression therapy, skin care, movement. In the decongestive phase compression bandages are used, during the maintenance phase medical compression stockings (usually ccl 2 and higher).

As a result of Complex Decongestive Physiotherapy the fat pads can indeed be contained but not reduced. A reduction of circumference is only possible by means of liposuction.

Self-help is the motto!

Through active participation the patient can and should contribute significantly to the success of treatment:

  • Exercises, to support lymphatic flow
  • A healthy diet, to avoid obesity (more than half of all lipedema patients are obese)
  • Avoiding extreme heat, such as eg in the sauna, to prevent the edema from spreading

With movement and sport sufferers can support lymphatic flow.

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