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Lipoedema: a pathology to not be confused 

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June is the month dedicated to lipoedema awareness, a chronic condition that is characterised by an abnormal lump of fat, usually forming in legs or arms. It’s a generic degenerative inflammatory pathology that targets Loose Connective Tissue, and results in an increase in adipose tissue, often followed by systemic inflammation. It is most common in women, first symptoms manifest as early as 14 and 16 years old and worsens after the age of 30 or coinciding with pregnancy. 

There still isn’t a lot of awareness and information regarding lipoedema. Although it was recognised in 2018 by the OMS, the same cannot be said about the Italian National Health Care. Not recognising this condition means not aiding those suffering from it from a financial point of view, considering how treatment can be very expensive in cases of certified disabilities. 

In order to counter this ignorance, and to advocate on behalf of those suffering from this pathology, the Italian lipoedema Association APS/ETS (LIO) was founded. «LIO lipoedema Italy was created to help everyone who needs assistance on their journey -explains Valeria Giordano, president of LIO -. In order to avoid overlaps with other diseases or misdiagnoses». 

A chronic condition that must be kept under control

lipoedema has no cure, it can, however, be managed. Far too often incorrect surgical procedures or therapies were conducted on these patients. Bariatric surgery is an example of this, because lipoedema is often confused for lymphedema and obesity. 

The first approach is a more conservative one. It aims at reducing swelling in the affected areas. «Almost all patients, after being diagnosed with lymphedema, begin a conservative treatment with the help of angiologists and/or physiotherapists, using compression garments», claims Dr. Gianluca Sapino, specialist in aesthetic, plastic and reconstructive surgery at the University Hospital of Losanna. 

When this isn’t enough, it’s important to act decisively. «It’s possible to use liposuction with ultrasounds, with the injection of aqueous solutions or with Power Assisted Liposuction», explains Sapino. Thanks to the new techniques developed, it is possible to significantly improve the quality of life of those affected by lipoedema. For instance, using compression stockings, that is braces to mitigate pain, can be helpful, accompanied by a daily walk of about an hour.

Defining lipoedema based on differences 

lipoedema and lymphedema are two conditions with similar symptoms but differ in their causes. Clarification is needed to intervene correctly. In the first case, there is abnormal proliferation of adipose tissue, while in the second, there is a reference to a defect in lymphatic drainage. Additionally, in lipoedema, the swelling that occurs is “solid”, unlike that observed in lymphedema.

«The term “lipoedema” has been misleading for years – confirms Domenico Corda, a lymphologist and physiatrist, an expert in lymphedema and lipoedema, and a founding member of the International Lipoedema Association -. In reality, the word “edema” deceived everyone. For these eighty years, lipoedema has been treated as if it were an edematous disease of the lymphatic system, with the same therapy that was and is used for lymphedema».
There is still much to understand about lipoedema, as its origin is unclear and therefore cannot be prevented. Intervention can manage comorbidities and, most importantly, diagnose it at a young age without confusing it with other aesthetic issues such as cellulite or water retention. «This is the phase where timely intervention should occur, but it is precisely the phase that eludes most people», concludes Corda.

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