When Lipedema exerts pressure on the lymphatic system

Lipedema is 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 about four million women suffer from lipedema in Germany. 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 pressure on the lymphatic system, secondary lymphedema can then also develop, in which lymph transport is impaired and lymph fluid congests. Then the diagnosis is lipo-lymphedema.


The four stages of lipoedema.  Lipo-lymphoedema is also sometimes referred to as stage IV of lipoedema.
The four stages of lipoedema. Lipo-lymphoedema is also sometimes referred to as stage IV of lipoedema.



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

A woman practices yoga.
For those affected, there are several ways of relieving symptoms and supporting therapeutic success.


How can Lipo-Lymphedema be identified?

In the case of lipo-lymphedema, the dorsal surfaces of the foot and hand are swollen (edematized) and folds of skin develop at the base of the toe. This is usually not the case with pure lipedema. As a rule, fingers and toes remain 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 hardly be lifted, indeed if at all. In the case of lymphedema, the body shape of the sufferer 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 usually equally pronounced on both legs.


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


What can afflicted patients do?

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

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 in a sauna, to prevent the edema from spreading
A woman practices ballet.
With movement and sport sufferers can support lymphatic flow.


Please note: This article is for informational purposes only and is not a substitute for professional medical advice.


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