Lipedema is an extremely debilitating condition resulting from a pathological fat distribution disorder, causing pressure pain and feelings of tightness in those affected. Unfortunately, it primarily affects women, who may have to suffer from the symptoms for years. Lipedema is classified into three different stages and four different types to allow for appropriate treatment.

The causes of lipedema are complex and not yet fully understood. Currently, however, doctors and researchers assume that in approximately 85% of all cases it is triggered by hormonal changes, such as those that occur during puberty or pregnancy. The female hormone estrogen plays a key role here, as it leads to the proliferation and enlargement of fat cells. In addition, a hereditary predisposition plays a role, representing another possible cause.

The occurrence of lipedema is extremely unfortunate, as it is a condition that affects only specific parts of the body. Scientific evidence has so far only been established for the legs and arms, while it has not yet been proven to occur in other areas. The thighs of patients are particularly affected, being the most severely impacted in 97% of cases. However, lipedema can also occur in the buttocks and hips, which makes the condition even more distressing. It has also been shown that typical signs of lipedema can be observed in the arms of patients in 31% of cases. This condition is extremely burdensome and can lead to significant physical and psychological distress for those affected. However, our experienced surgeons have specialized in the treatment of lipedema and are able to recognize the precursors of lipedema, even in the asymptomatic stage, which will later develop into a condition requiring surgery. In this way, we can intervene early and offer our patients successful and sustainable therapy that improves their quality of life.

The diagnosis of lipedema presents a significant challenge for many affected women, as the symptoms are often difficult to classify due to their nature and similarity to other conditions. Diseases such as restless legs syndrome, polyneuropathy, and chronic venous insufficiency exhibit similar symptoms to lipedema. These include pain and feelings of tightness in the legs, as well as abnormal sensations in the arms and legs. Exhaustion and fatigue can also occur in all of these conditions, further complicating diagnosis.

To differentiate lipedema from other diseases, the symptoms are divided into primary and secondary symptoms. Primary symptoms are defined as particularly noticeable and primarily perceived symptoms that are crucial for diagnosing and differentiating lipedema from the aforementioned diseases.

The main symptoms of lipedema include, among others:

• Body proportions that are disproportionate to the rest of the body (e.g., thick legs with a slim upper body)
• Tendency to bruise easily
• Pain and tightness in the legs and arms
• Orange peel skin and cellulite
• Affected body areas feel cold
• Pain cannot be relieved by physical activity or elevating the legs
• Symmetrical distribution of fat deposits on the legs and/or arms
• Due to the difficulty of self-diagnosis of these symptoms, it is important that affected women consult a specialist for diagnosis. Please feel free to schedule an appointment for our diagnostic consultation.

To further differentiate the severity of lipedema, there are four different types:

Type 1: Lipedema in the legs, no or only minor effects on the arms

Type 2: Lipedema in the legs with effects on the arms

Type 3: Lipedema affecting the legs and arms, with partial involvement of the trunk

Type 4: Lipedema affecting the legs and arms, with complete involvement of the trunk

The classification into stages and types helps to find the appropriate therapy for patients and to monitor the course of the disease. Early diagnosis and treatment can help to avoid complications such as inflammation or thrombosis.

To treat lipedema effectively, liposuction is performed as part of lipedema surgery. With competent and consistent execution of the procedure, excellent results with very few complications can be expected.

Before the operation, it is of utmost importance that patients wear flat-knit compression stockings continuously for six to eight weeks to decongest the tissue and optimally prepare it for liposuction. If the tissue is severely congested, targeted manual lymphatic drainage is also necessary before the operation. This is part of the post-operative care to further decongest and massage the tissue to prevent lymphatic congestion. The flat-knit compression stockings are not only part of the preparation for the operation but also part of the best possible aftercare. The flat-knit compression protects the tissue and prevents hardening, which in turn benefits the skin's retraction.

To give you and your family an idea of what the day of your operation at the LipoZentrum Dr. Heck might be like, we have outlined a sample daily schedule below: (Please note that your personal stay may, of course, differ slightly from what is described.)

You will arrive at the LipoCenter on an empty stomach at your personal check-in time, which will be communicated to you by our staff. You will fill out your documents and be taken to the changing room. There you will put on the surgical gown, remove your jewelry, and have the surgical cap placed on your head.

This is followed by a pre-anesthesia consultation, which is tailored to your individual needs and conducted in detail by the anesthesiologist. The anesthesiologist will insert an intravenous line through which you will receive medication during the operation.

Once all the formalities are completed, our nurses will collect you, and you can decide whether you would like to take your mobile phone into the operating room. Since lipedema liposuction is an exciting and long-awaited moment for many patients, many women want to capture this moment with a photograph. Our nurses and caregivers will gladly do this for you.

Once you arrive in the operating room, you will be weighed and scrubbed to disinfect the surgical area. You will then be placed on the operating table and draped. The anesthesiologist will administer the medication, and you will drift off to sleep. Of course, you can also opt for general anesthesia. After the operation is successfully completed, the nurses will help you put on your surgical gown while you are still on the operating table and take you to the recovery room, where a pre-warmed bed awaits you.

Once you have recovered sufficiently, a nurse will take you to your room and you will enjoy a delicious dinner with your fellow lipedema patients of the day!

Once you have taken the first step into a new life and successfully completed the operations at the LipoCenter, you should keep a few things in mind:

In the first weeks and months after surgery, the healing and remodeling processes in the operated areas can be most intense, which can lead to tingling, hardening, and swelling. The healing process can take up to a year—in some cases even longer. Your lymphatic system, nervous system, and all the tissue in the surgical area are regenerating, and this takes time and is noticeable during this period.

Give your body time and rest, and remember that liposuction for lipedema is not a minor procedure. If you have any concerns or questions, please feel free to contact us at the LipoCenter; we are here to help.

The relationship between a ketogenic diet and lipedema is often discussed. But why is that?

Why should patients with lipedema generally avoid sugar?

Sugar promotes swelling, weight gain, inflammation, and pain. Excessive sugar consumption can also increase the risk of diabetes. Many nutritionists therefore recommend a balanced diet with whole grains. However, the problem is that these foods also contain carbohydrates and therefore sugar. When sugar from food enters the bloodstream, the pancreas produces insulin, which transports the sugar into the cells. If insulin levels remain too high, insulin resistance can develop, which can be a first step towards diabetes. This disease can lead to calcification and deposits in the blood vessels, causing strokes, heart attacks, and high blood pressure.

A ketogenic diet can help reduce hunger and thus sugar intake. However, if you're following a ketogenic diet alone, those who eat carbohydrates may quickly become hungry again. Therefore, try to motivate your partner to also largely eliminate carbohydrates from their diet. Changing your eating habits can help you stay healthy, avoid constant hunger, and achieve a better physique without having to exercise a lot.