Lipoedema – fat leg disease

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Fatal edema, lipoedema, lipoedema, lipoedema, lipoedema.

One disease, many names. 
Are unruly legs your problem, which are difficult to control with diet and exercise? Additionally, have you tried all the new products on the aesthetic medicine market, and cellulite still won’t leave you? Sounds familiar?

My discovery and change in my attitude towards this disease began within two years. As a result of various events and frequent work with women suffering from lipoedema, I realized that despite the fact that this disease can make life very difficult, it is often misdiagnosed and confused with other dysfunctions of the body. Even the doctors themselves admit that during their studies, they do not have a single word about this disease.

Today I come to you with the knowledge gathered from publications, books and, above all, my own experience as a physiotherapist working with women struggling with this disease. Hear what lipoedema is and what it manifests itself, as well as what are the ways of fighting this disease.

What is lipoedema?

Lipoedema (i.e. painful fatty edema) is a disease of the subcutaneous fat located mainly on the legs and arms. The exact mechanisms responsible for the development of edema have not yet been fully established, but it is believed to be due to the abnormal deposition of subcutaneous fat. Research has shown that the condition is often genetic and inherited.

The first symptoms may appear at different stages of life depending on the predisposition – during puberty, pregnancy or menopause. The possibility of manifestation or intensification of the symptoms of the disease was also found after gynecological procedures, hormonal treatment, and even during anesthesia. Edema is often translated as venous or lymphatic insufficiency, but studies show that lipoedema is a separate clinical entity and should be considered in these categories. Of course, with lipoedema, venous or lymphatic insufficiency may occur, but they are the effects and not the causes of the disease.


Painful fatty swelling is characterized by (as the name suggests) soreness when applying pressure to the affected tissue. You should know that healthy adipose tissue is not painful and this is the easiest way to distinguish between the disease. In addition, there is easy bruising, broken capillaries, swelling of the lower legs, but above all, disproportion of the body. What does it mean? Most often, the bottom of the body is disproportionately large compared to a slim top. We must remember that lymphedema differs from lipoedema in that lymphedema (due to completely different causes of its occurrence) is asymmetric, i.e. one side of the body swells.

Women with this disease have a double burden. In the advanced stage, the legs are heavy and they rub against the epidermis, which is completely not conducive to sports. As a result, the mobility of the body and the self-esteem of the patients decrease, while the psychological burden increases, which usually results in obesity. Obesity itself is a very serious disease that we also have to fight against, because it causes diseases such as diabetes, atherosclerosis, circulatory failure and many others. We must remember that in lipoedema, sport and diet are important to maintain the health of the body, but unfortunately they do not solve the problem of the so-called thick legs.

What is the treatment?

The most basic way to help yourself in this condition is to wear compression tights. I am not talking about those that we all know well, but about specialized FLATWEAR made to measure. This clothing is sewn differently, and as a result it is more compact and less stretchy, which means that the pressure on the tissues is greater. These properties of compression products include support the outflow of venous blood towards the heart, thus preventing its stagnation in the lower limbs, but also stimulating the muscles and increasing hydrostatic pressure, which restores lymph flow. Another advantage that supports them in everyday functioning is that the legs hurt less, swell less and are lighter.

If you decide to undergo liposuction, flatbed clothing is a must. Thanks to it, the tissues are softer and better supplied with blood, which makes the fat less compact. As a result, the procedure is easier to carry out, and the tissues are not injured as much.

Consequences of untreated

Failure to take steps to combat lipoedema may lead to a lack of control over tissue growth. Losing control over its growth can effectively make life difficult and even lead to disability. Difficulty or inability to go for a walk, take care of children, or stay professionally active are just a few examples of failure to preventive care. For healthy people or people with mild symptoms, these examples may seem abstract, but it should be realized that increasing fatty edema causes increasing pain, additionally healthy fatty tissue swells, lymphoedema appears, and so other things overlap, leading to carousel of health misfortunes. That is why it is necessary to act knockin it is not too late.

Where to start?

It is worth examining the hormones in our body. We must remember that having lipoedema, we may have comorbidities, including Hashimoto’s disease, insulin resistance, disorders of sex hormones, kidneys and liver. Therefore, it is worth examining all these ingredients beforehand in order to possibly exclude the presence of additional factors.

Physical Activity
Any physical activity is better when done than any activity we can think of. 
Examples of exercises that can be performed are: yoga, breathing exercises, pilates, stretching. It is a package of exercises that prepare our body for better and more efficient work.
For people who want to do cardio exercises (most advisable, but at a low heart rate), I recommend starting with a bike. It is the best form of this type of exercise, because it does not burden the joints like any activity in water (aqua aerobics). Everything is an individual matter. Some people do not like to exercise in the water, others spend time in the gym. However, no matter what physical activity is undertaken, we must view our body and test it. Check the effort after which the patient feels well, and after which, for example, more swelling appears. The body knows the answer. You just have to listen to it. 
Just as important as exercise is rest after training, doing a few yoga or breathing exercises. They will calm us down beautifully and relax stressed tissues.

After my observations, I can see that strength training for the legs is not suitable for women with lipoedema, because the legs, instead of being thin, become very massive compared to a slim and well-shaped mountain. It also doesn’t mean that leg training should be skipped. Instead of pressing weights or squats (which can make the pain and swelling worse), it’s better to exercise with rubbers. The tissues are then well oxygenated and nourished, which is the main goal of exercise. 
It should be mentioned again here that it is best to train in compression garments, if we have flat garments, great, if not, you can buy compression products even in a sports shop.

Non-invasive treatment 

BOA lymphatic drainage
For BOA pressure massage, I personally use 24-chamber pants. Drainage gives us a positive effect on the body through:
* Stimulation of venous flow, which leads to an increased supply of oxygen and nutrients to organs and tissues
* Stimulation of lymphatic flow resulting in faster removal of metabolic products, elimination of stagnation symptoms and absorption of edema
* Reduction of artery flow resistance, which makes the heart work easier
* The widening of the blood and lymph vessels leading to faster circulation of body fluids in the body.
* Restores the water and electrolyte balance in the intercellular spaces and prevents the accumulation of deposits.

In addition, I use drainage in aesthetic medicine treatments as an addition to combined therapy, which is developed by me and selected individually to the needs of patients. 
The most important aesthetic indications include: 
* Cellulite, 
* Prevention of varicose veins, 
* Fat swelling, 
* Heavy legs syndrome, 
* Detoxification, 
* Improved skin nourishment.

If any of the ladies has considered using the lymphatic drainage treatment, I suggest asking beforehand what type of device the facility has, whether, for example, the pants are complete, not just the legs, and how many chambers they have (the more the better). It is important that the treatment is effective and not only effective, so choose the best option.

Manual lymphatic drainage

Manual lymphatic drainage is a very effective method in the treatment of lymphoedema and lipodymia. 
Thanks to the use of appropriate grips, it is possible to manually unblock and push the lymph towards the lymph nodes. 
Manual lymphatic drainage helps the lymph flow and facilitates the transport of nutrients to the cells. 
The indications for therapy include, among others. venous insufficiency, removal of lymph nodes (oncology), chronic edema, post-traumatic edema. 
When choosing a physiotherapist, find out if he or she has experience in performing manual drainages, it is very important.


In the case of lipoedema, the diet does not bring any spectacular effects. However, it helps in achieving better health (as a result of improving the work of organs, e.g. intestines) and a lower BMI. Remember, however, that a diet recommended by someone may not be suitable for our body. The ketogenic diet has become very fashionable today. Many people emphasize its effectiveness by omitting inconvenient information. You should know that this diet puts a heavy burden on the liver and kidneys, and in addition, it burns muscle tissue. If we are thinking about a proper diet for ourselves, the best solution is to go to a clinical dietitian who will check our health, the condition of our hormones and lifestyle. Based on the information gathered, it will suggest how we can change our eating style. You can, of course, experiment with diets yourself,but then you have to be rational and listen to your body. Additionally, the determinant of a “good” diet is not only sloppy kilograms. It should be remembered that the diet should not cause us stress caused by the fact that we discipline ourselves because we ate something that we should not.

If you have no idea how to start. I will give you two golden rules that are sure to work: 
* Smaller portions, and more often 
* Discontinue flour, wheat and sweets.


  • it is an operation usually performed under general anesthesia, not local anesthesia as in the case of cosmetic liposuction.
  • is performed by a surgeon.
  • it is an invasive procedure.

During the procedure, adipose tissue is removed, and the final effect depends mainly on the doctor’s skills. 
Examples of fat removal methods include Vaser Lipo or Body Jet.
The amount of tissue removed is measured in liters, and the safety limit is the removal of 8-10% of the patient’s weight expressed in liters of fat. Often times people think that all fat will be removed when they think of liposuction. Unfortunately, this is a mistake, because sucking out more body fat can even lead to death as a result of the shock to the body. That is why the procedure is performed individually, eg only the calves. It all depends on the size of the problem. It should also be noted that lipoedema tissue cannot be transplanted to another place on the body, as it is a diseased tissue. Compared to healthy adipose tissue, lipdemic tissue has slots that block the cannula (a special type of needle that sucks off the fat during the procedure).Transplanting such tissue can lead to various complications later.
An important factor taken into account when deciding on liposuction is BMI, the amount of anesthesia is selected in relation to it, so it is important that it is as low as possible. 
We must remember that after liposuction, there may be a redistribution of adipose tissue, e.g. on the abdomen, chin, but it is a healthy tissue that we can work with through physical effort, aesthetic medicine treatments or diet.

Your decision and a clear conscience

If you have gone through all of the above tips, have checked them on yourself and you know that liposuction is your last chance to get rid of the ballast of “fat legs”, I believe that you are fully prepared for it. However, if you want to start with liposuction, because the previous steps require effort, remember that the procedure does not end there. After the treatment, the adventure is just beginning.

The role of physiotherapy
Physiotherapy before surgery is extremely important, because the softened tissue becomes more susceptible to the work of the cannula, which greatly facilitates the procedure, ultimately determining the quality of the procedure performed. The treatment is followed by a recovery time. In places where adipose tissue is removed, adhesions or swellings may appear, and the skin may be flaccid.
For this reason, we should not forget about post-operative aesthetic physiotherapy. First of all, we should take this into account when planning the budget for treatments.

During the therapy in my office, we use manual lymphatic drainage for the first weeks after the procedure. Later, we introduce to the fight against adhesions myofascial massages, vacuum massages, interspersed with aesthetic medicine treatments using modern machines such as shock wave, tr – therapy – radio waves and boa drainage. 
It gives us a complete package on the way to a new beautiful and healthy body.

I hope that with this extensive entry, I will help a woman who is looking for support and information, what is lipoedema, how we can help ourselves and how to fight it.

Maybe temporarily we feel a bit thicker, maybe there is not an easy way to go in the fight against the disease, but remember there is strength in women.

“There is beauty in everything, but not everyone can see it” Andy Warhol

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