LIPOEDEMA

The clinical picture is divided into three stages:

Stage 1: Finely knotted skin surface
Stage 2: Coarse knotty skin surface with severe dent formation
Stage 3: Severely hardened and already deformed tissue with pronounced bulges of fat

 

It is increasingly recognized that lipoedema, which has a high genetic component, is to be regarded as a "widespread condition" affecting many women as early as the onset of puberty.  Often hormonal factors can be associated with a change in the nature of the disease (puberty, pregnancy, breastfeeding, menopause), which is due to the fact that the adipose tissue in the affected women appears to be more estrogen-sensitive. 

Lipoedema cannot be treated with medication, nor is it curable. That is why it is classified as a chronic disease. Manifest lipoedema can only be minimally influenced by dieting or intensive sport. Many patients are of normal weight. However, overweight should be consistently reduced, since obesity also has a negative effect on lipoedema.  

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In addition to physical stress and pain, the disease represents a significant stigmatization for those affected, since even their immediate personal environment often has little understanding for the diagnosis of lipoedema, and patients feel ashamed when eating, changing clothes in public or having intimate contact, and of course suffer considerably from this.

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Conservative treatment methods are usually limited to complex decongestion therapies, compression garnments that are difficult to put on and uncomfortable, and lymphatic drainage. On the one hand, this complex conservative therapy, which only combats the symptoms of the disease, ignores the living environment of young, working patients, for example. Secondly, this is designed in such a way that it would have to be continued troughout life.

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On the other hand, the only sensible and sustainable therapeutic approach is medical, axis-aligned liposuction using water jet technology (WAL). This is also scientifically based in the current S1 guideline on lipoedema. This method has recently been recognized by health insurance companies as an effective therapy and in individual cases they cover a proportion of the costs of an operation. Unfortunately, they are only willing to do this in the late stages of the disease, when the maximum effectiveness of the treatment is no longer given. Although its progression can be slowed down at this point, the pathological remodeling of the subcutaneous fatty tissue with permanent damage to the lymphatic system has already irreparably begun at this stage. Patients benefit most from treatment during stages 1 and 2, when the costs for liposuction treatment have to be borne by themselves, because health insurance companies still refuse to cover the costs of treatment at this point in the disease.