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What is Lipedema?

If the adipose tissue under the skin increasesand creates a thicker appearance in the area, this is called lipedema orpainful cellulite. In the first stages of the disease, there is no obstacle forpatients to continue their daily life habits. However, in the later stages,functional problems such as difficulty in walking or moving may occur.Lipedema, which is often confused with lymphedema, cannot be treated withlifestyle changes, sports, exercise or a balanced diet. Thus, a doctor'scontrol is necessary in cases where lipedema occurs. Lipedema, which usuallystarts in girls in adolescence, can develop at any time in life due to changesin hormones.

What Are the Types of Lipedema?

Lipedema, which may occur due to hereditarycauses, may occur due to changes in hormones or problems developing in theveins. Lipedema is classified into 5 different types and these types are:

Type 1: Fat accumulation has occurred in theabdomen, buttocks and hips.

Type 2: Fat accumulation has reached from thehips to the knees. Especially the inner part of the knees has formed fat folds.

Type 3: Fat accumulation has reached the ankles.

Type 4: Fat accumulation has also started to beobserved in the arms.

Type 5 : Fat accumulation has begun to beobserved in the lower legs.

    If thepatients have been diagnosed with lipedema, the treatment method to be appliedis decided by looking at the type of the disease.

What Kinds of Symptoms Does Lipedema Show?

Lipedema can show itself with the followingsymptoms, as a disease mostly seen in women:

   Whenyou press the area that develops lipedema with your finger, there is little orno residual depression,

   Acoldness may be felt on the skin,

   Incases such as impact, bruising occurs very easily,

    Thearms are rarely affected.

   Although patients lose weight or burn a significant amount of calories, swellingdoes not decrease,

   Complaints increase in severity in summer days or in hot weather.

     Thediagnosis of lipoedema can only be made by a doctor's physical examination. Fataccumulation in lipoedema is disproportionate and manifests itself in variousparts of the body.

What are Lipedema Treatment Methods?

Lipedema and lymphedema treatment methods aresimilar to each other. Lipedema can be treated with skin care, bandaging,manual lymph drainage, or special exercise programs. In addition to this, othertreatment methods that doctors can benefit from include:

   Toincrease physical activities and to implement regular exercise programs inorder to prevent further fat accumulation in the body,

   Implementing personalized diet programs under the control of adietitian,

    Fatinjection (liposuction) treatment to be performed by plastic surgeons,

    Usingpressure clothes.

Lipedema can not only create functionalproblems, but also cause people to feel psychologically uncomfortable with thebad image it creates. Thus, getting additional support to eliminatepsychological problems can be considered as a part of the treatment process.

What is lymphedema?

Lymphedema, also called elephantiasis, occurswhen the lymph nodes, which are part of the immune system, are blocked due todifferent reasons. With another definition, lymphedema means an increase inintercellular fluid due to the deterioration of the lymphatic system. In caseof disruption of the lymphatic system, the intercellular fluid cannot beproperly drained by the vessels. As a matter of fact, the liquid in questionaccumulates in the tissues. The lymphatic system cannot carry the accumulatedfluid and therefore lymphedema develops.

What Causes Lymphedema?

In lymphedema, lymph fluid cannot enter thebloodstream and spreads under the skin. Removal of lymph nodes for any reasonis considered the most common cause of lymphedema development. The main reasonfor removing lymph nodes is cancer treatment. On the other hand, the rate ofdevelopment of lymphedema in patients who have undergone breast surgery isapproximately 25 %. At the same time, there is a possibility of lymphedema incancers that develop in the lower abdomen or prostate region. The greater theamount of lymph nodes removed during the treatment applied to the patients, thehigher the likelihood of lymphedema in patients. We can list other conditionsthat may cause the development of lymphedema as follows:

- Radiation treatments for cancer,

- Trauma or abrasions and cuts,

- Damage to lymph nodes after surgicalinterventions,

- Fungal or similar diseases,

- Parasites transmitted by mosquito or insectbites,

- Infections,

- Hereditary problems in the lymphatic system.

       Finding the underlying cause of lymphedema and eliminating this cause isessential in the treatment process.

What Are the Types of Lymphedema?

The details of these stages in lymphedema, whichis examined in two different groups as primary lymphedema and secondarylymphedema, are as follows:

Primary Lymphedema

When the baby is in the mother's womb, thelymphatic vessels do not develop as much as they should be called primarylymphedema and is a congenital disease. Primary lymphedema, which is seen onlyin one leg at first, can also affect the other leg if the disease progresses.Other conditions called primary lymphedema are as follows: Lymphedemadeveloping after the age of 35, lymphedema due to Meige's disease andlymphedema due to Milroy's disease.

Secondary Lymphedema

Lymphedema that develops due to surgicalinterventions during cancer treatment is considered as secondary lymphedema.Lymphedema due to radiotherapy received within the scope of cancer treatment isalso called secondary lymphedema. Secondary lymphedema is not congenital anddevelops later.

What Are the Symptoms of Lymphedema?

Swelling in the arms or in various parts of thebody are the first signs of lymphedema. If the disease progresses, theseswellings can also be seen on the legs. In the early stages of the disease, thesymptoms sometimes manifest themselves, but sometimes they can go away. Inother words, while swelling is present one day, it may not be the next day.However, in cases where the disease progresses, these swellings becomepermanent. The most common symptoms of lymphedema are:

Swelling in different parts of the body(including fingers),

Skin thickening, hardening or becoming tensethan normal,

If the swelling reaches the joints, movementdisorders,

Pain or discomfort in the areas where the swellingoccurs,

Frequent recurrence of infections

Infiltration of the subcutaneous fluid onto theskin,

The appearance of wart-like formations in theswelling areas,

Formation of folds in the swelling areas.

Depending on the swelling, some patients may notbe able to use the jewelry and accessories they use in normal times, or theymay not be able to wear some clothes.

Diagnosis and Treatment Methods in Lymphedema Disease

During the diagnosis of lymphedema, doctorsoften question whether patients have a history of trauma, infectious disease,or breast surgery. Even though the diagnosis of lymphedema can only be made byphysical examination, help can be obtained from the following diagnosticmethods:

I.     Measurement between arms andlegs,

II.   Ultrasound,

III.  Blood test,

IV.  Bioimpedance application, which is given electricity to the bodyusing metal devices and detects the amount of fluid through current changes,

V.   Lymphoscintigraphy applicationwhich is performed by injection of a radioactive dye into the body, in order tohave information about the amount of fluid in the body and to determine theareas of congestion,

VI.  CT and MR.

While only one of these methods may besufficient for the diagnosis, sometimes several different diagnostic methodscan be used together to avoid any doubt. The methods that can be used in thetreatment process after the diagnosis of the disease are as follows:

Manual Lymph Drainage

In order to relieve swelling, special massagetechniques are applied to the area. With this treatment method, lymph fluid istaken from the edematous area and transferred to the working lymph nodes.

Skin care

Drying of the skin is prevented by usingmoisturizing creams. The pH value of the creams used in this treatment shouldbe 5.5.

Compression with Bandages and Stockings

In these applications, it is aimed to preservethe activity of the lymph system. The pressure of the bandaging used in thismethod can be adjusted in a balanced way. The most important efficacy of thistreatment is the prevention of re-accumulation of lymph fluid in the edematousregion. After the bandaging treatment is completed, compression stockingssupport this treatment. Compression stockings are produced individually bytaking measurements from patients.

Exercise Programs

In this treatment method, which is applied toensure muscle activity, fluid drainage is achieved. The entire exercise programis performed using bandages and socks.

    It isof great importance that the techniques used in the treatment of lymphedema areapplied correctly and that the treatment process is planned individually. Inorder to achieve all these, it is necessary to get support from a specialistand experienced physician.

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