Bauer AT, et al. Plast Reconstr Surg. 2019 Dec;144(6):1475-1484.
Bauer AT, et al., conducted a study to demonstrate a detailed epidemiologic state of postoperative lipedema patients by utilizing an extensive questionnaire focusing mostly on clinical symptoms and co-morbidities.
This study was performed on 209 female patients diagnosed with stage II lipedema and treated with tumescent liposuction. The average age when subjects observed lipedema symptoms initially was 16 years, with a standard deviation of 9 years. The most advanced age recorded was 54 years (Figure 1; Left). The average number of years previously diagnosed was 15, with a standard deviation of 10. The least mean time before diagnosis was less than 1 year. 20.6% of the respondents stated that they survived with the disease for 14 years. Furthermore, 15.8% survived with the disease for 19 years (Figure 1; Right). The least and highest frequency of operations conducted on lipedema patients was 1 and 16. The mean number of operations ± SD performed was 3 ± 2 (Figure 2). In majority of cases, 35.4% of grandmothers (n=74) and 29.7% of mothers (n=62) were affected by lipedema, followed by 23.0% aunts (n=48), 14.8% sisters (n=31), and 11.5% cousins (n=24) (Figure 3). Among co-morbidities, hypothyroidism is one of the most prevalent diseases found among 35.9% (n=75) of lipedema patients, followed by allergies in 34.4% patients (n=72) and depression in 23.0% (n=48) (Figure 4). Out of 47 participants who experienced from a diagnosed migraine prior surgery, 41 patients suffered from migraine attacks no less than five times per month. The remaining patients suffered from migraine attacks at least 10 times per month (Figure 5). Almost 40.4% (n=19) of the migraine patients had only 1 migraine attack per month (Figure 6). After liposuction, 29.8% (n=14) of patients observed reduction in the intensity of the migraine attacks, 53.2% (n=25) of patients observed reduction in the the frequency of migraine attacks, 21.3% (n=10) did not suffered migraine attacks any longer, and 31.9% (n=15) did not notice any improvement (Figure 7). Beyond three-quarters i.e. 169 patients reported severe pain, while 10% (n=19) affected by mild pain (Figure 8; above, left). 97.0% of patients (n=164) reported that pain had declined significantly (Figure 8; above, right). Improvement of tenderness and pressure pain after liposuction was observed in 50% (n=24), 75% (n=24), and 100% (n=71) of patients. Some improvement were observed in 8 respondents, while only 2 patients did not feel any decline in tenderness and pain (Figure 8; below, left). 91.4% (n=191) of the respondents reported that they repeatedly suffered from bruises and hematoma, a phenomenon that improved after surgery, as witnessed by 77.0% (n=147) of the participants (Figure 8; below, right). Among 167, almost 30.5% (n=51) of the premenopausal respondents experienced from imbalances of sexual hormones, while 69.5% (n=116) did not (Figure 9; left). Of the 51 patients who experienced imbalances of sexual hormones, 39.2% (n=20) cured from following liposuction, while the remaining did not (Figure 9; right).
Thus, quality of life improves significantly following surgery with a declined of pain and swelling and lowered tendency to mild bruising. The high incidence of hypothyroidism in patients with lipedema could be linked to the instantly reported lipedema-associated obesity. The low incidence of diabetes, dyslipidemia, and hypertension seems to be a specific feature differentiating lipedema from lifestyle-induced obesity.
Figure 1: (Left) Age at onset of lipedema; (Right) Years until diagnosis.
Figure 2: (Left) Number of operations needed. (Right) Areas of liposuction.
Figure 3: Relatives affected by lipedema.
Figure 4: Comorbidities among lipedema patients.
Figure 5: Number of migraine attacks before liposuction.
Figure 6: Number of migraine attacks after liposuction.
Figure 7: Improvement of migraine after liposuction.
Figure 8: (Above, left) Pain condition before liposuction; (Above, right) Pain condition after liposuction; (Below, left) Improvement of tenderness and pressure pain after liposuction; (Below, right) Reduction of hematoma formation and bruising after liposuction.
Figure 9: (Left) Number of patients suffering imbalances of sexual hormones before liposuction; (Right) Improvement of imbalances of sexual hormones after liposuction.
