Lipedema Fibrosis: Everything You Need to Know

Lipedema can make daily life difficult by causing pain and affecting mobility. In some cases, lipedema fibrosis can develop as a complication of lipedema, which is a particular type of scarring where connective tissue replaces normal tissue. When this occurs, you may be able to feel lipedema nodules in your legs or other affected parts of the body. In this guide, we’ll explore lipedema fibrosis, its causes, treatment options, and more.

What Is Lipedema?

Different Types of Lipedema

Lipedema Stages

Understanding Fibrosis and Lipedema

Treatment for Fibrosis

How Fibrosis Treatment Can Affect Lipedema

Find Relief with Tactile Medical

What Is Lipedema?

Lipedema is a medical condition characterized by an abnormal accumulation of fat tissue in your body, which most commonly occurs in the legs but can also occur in the arms. As this fat builds up in your body, it can cause a visible enlargement of the affected limbs that can lead to symptoms like pain, swelling, and bruising. Additionally, you may be able to feel lipedema nodules beneath the skin, which may feel like peas or rice.

In most cases, lipedema occurs during times when hormone levels fluctuate. Lipedema is a chronic, progressive condition, meaning it can progress over time. By understanding lipedema, it can be easier to find treatment and management solutions to help reduce symptoms and complications.

Different Types of Lipedema

Like many medical conditions, there are different types of lipedema a patient may experience. The different types of lipedema are used to describe the location of excess fat in the body, with each type representing a different location. Here’s a breakdown of the five different types of lipedema and what they mean:¹

• Type I: Patients with Type I lipedema experience fat buildup between the navel area and the hips, often extending around the sides of the hips and to the buttocks.
• Type II: With Type II lipedema, the fat buildup begins at the pelvis and goes down toward the knees.
• Type III: The fat buildup in Type II lipedema starts around the pelvis and goes all the way down to the ankles. This is one of the most visible types of lipedema, with many patients having visible cuffs of fat around the ankles.
• Type IV: Patients with Type IV lipedema experience fat buildup between the shoulders and the wrists, which may cause cuffs of fat near the wrist.
• Type V: With Type V lipedema, the fat buildup is mostly limited to the calves.

Lipedema Stages

While you can be diagnosed with lipedema at any stage, early diagnosis is an important part of preventing complications and minimizing the progression of symptoms. Below is a closer look at the four stages of lipedema:¹

• Stage 1: During stage one, your skin will still look and feel normal. However, you may begin to feel lipedema nodules underneath your skin, as well as minor pain, heaviness, and easier bruising.
• Stage 2: In the second stage of lipedema, the skin may start to appear uneven as lipedema tissue builds up. You may notice additional swelling as well as dimples or indentations in your skin.
• Stage 3: Stage 3 is when patients may begin to develop large amounts of fat and skin that protrude outward, causing folds of fat in the affected limbs. This is typically when lipedema starts to impact a patient’s mobility, which can make it difficult to accomplish basic tasks and exercise.
• Stage 4: The fat buildup during stage 3 leads to reduced blood and lymph flow, which manifests during stage 4 in the form of lymphedema. Patients with stage four lipedema may experience both lipedema and lymphedema, which means the lymphatic system has been damaged.

Lipedema can pose similar symptoms to other health conditions, notably cellulite. This is because cellulite and lipedema can both cause indentations and bumps in the skin. However, lipedema is different than cellulite because lipedema is a medical condition that can progress over time, whereas cellulite is a cosmetic condition that doesn’t pose any health complications or pain.

Understanding Fibrosis and Lipedema

Fibrosis, also known as scarring of tissue, is a medical term for an injury repair process that involves replacing normal tissue with connective tissue, which changes the makeup of the tissue in that area of the body.² When this process occurs with the buildup of fat that results from lipedema, it’s known as lipedema fibrosis. Lipedema fibrosis leads to hard lipedema nodules underneath the skin, which can be felt by gently pressing on the affected limb(s).

The size and firmness of lipedema nodules may vary based on the stage of your lipedema. Nodules typically start out smaller at about the size of a pea, but they can eventually grow to the size of a grape or, in severe cases, a plum.³

Treatment for Fibrosis

Living with lipedema can make life challenging, so it’s important to look for treatment options that help improve your quality of life and reduce your symptoms. Fortunately, there are lipedema treatment options that are specifically designed to treat lipedema fibrosis, so you can get the relief you need. Below, we’ll talk about some of the most common lipedema fibrosis treatment options.

Compression
Compression garments and devices are one of the most-used treatment options when it comes to reducing swelling and the symptoms that come with it. Your doctor may recommend that you wear compression garments such as stockings, but there are also pneumatic compression devices that can offer relief. The Tactile Medical Flexitouch Plus system can help you get targeted relief for swelling, whether it occurs in the legs or arms.

Keep in mind that there are some things you should know before you use compression therapy to treat lipedema fibrosis. Before you purchase compression garments or a pneumatic compression device, you should talk to your doctor or specialist.

Complete Decongestive Therapy
Complete decongestive therapy, or CDT, is a treatment plan that combines various forms of decongestive therapy to reduce swelling. CDT varies from patient to patient, with specialists creating individualized treatment plans depending on the stage of your condition. However, CDT follows two phases.

Phase I is the active phase, where patients work directly with their lipedema specialists to receive scheduled treatment, including lymphatic drainage, skin care, compression bandaging, and exercise. Phase II is the maintenance phase, where patients take what they learned in phase I to apply themselves at home. Phase II can last several years or be a lifelong commitment and involves patients performing manual lymphatic drainage manually or with a pneumatic compression device, using compression, taking care of their skin, and exercising regularly.

Manual Lymphatic Drainage
Manual lymphatic drainage can help patients living with lipedema fibrosis. Manual lymphatic drainage is a massage technique that gently guides lymph fluid away from damaged nodes and vessels and through the lymphatic system. The goal is to prevent lymph from building up in affected parts of the body, which can cause damage to the lymphatic system in addition to swelling.

One of the main benefits of manual lymphatic drainage is that it can be performed at home. Your specialist can show you how to perform a manual lymphatic drainage massage depending on the affected area, and you can spend a few minutes each day doing your own massages at home. You can also work with your health care provider to order a pneumatic compression device, like the Flexitouch Plus system, which mimics MLD with an automated device.

How Fibrosis Treatment Can Affect Lipedema

Understanding the causes and treatment for lipedema can help you reduce your symptoms and make living with this condition easier, but what about fibrosis treatment? Here’s how lipedema fibrosis treatment may affect people with lipedema:⁴

• Reduce pain: Compression therapy and regular exercise can help reduce some of the swelling that’s causing your pain, so you can live more comfortably during everyday moments.
• Prevent progression: Fibrosis treatment helps prevent lipedema progression, which can lead to several complications. Preventing the progression of lipedema is one of the best things you can do to stay healthy after your diagnosis.
• Improve quality of life: From pain and swelling to a lack of mobility, lipedema can make it difficult to live a happy, healthy life. Fibrosis treatment can provide the relief you need to maintain a good quality of life and improve your mental and emotional well-being.
• Increase vascular circulation: Compression therapy, exercise, and other fibrosis treatments can help improve vascular circulation and reduce swelling.

Find Relief with Tactile Medical

Lipedema can make life more difficult if left untreated, so getting an early diagnosis and starting treatment early is important. Early lipedema treatment can help prevent lipedema progression that can eventually lead to lipedema fibrosis, so talk to your doctor about treating your lipedema as soon as possible.

With the Flexitouch Plus system from Tactile Medical, you can get relief from lipedema through the power of pneumatic compression. With several types of devices for different parts of the body, such as the upper body, lower body, and head and neck, you can find targeted relief for your lipedema. If you’re having a hard time getting relief from lipedema and lipedema fibrosis, try the Flexitouch Plus system by Tactile Medical today.

1. Herbst KL. Subcutaneous Adipose Tissue Diseases: Dercum Disease, Lipedema, Familial Multiple Lipomatosis, and Madelung Disease. [Updated 2019 Dec 14]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK552156/
2. Wynn TA, Ramalingam TR. Mechanisms of fibrosis: therapeutic translation for fibrotic disease. Nat Med. 2012 Jul 6;18(7):1028-40. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3405917/
3. Lipedema.net. Lipomatosis Nodules & Manual Extraction. https://www.lipedema.net/lipedema-nodules-manual-extraction.html
4. Ashforth, Karen. Understanding Fibrosis in Lipedema: Inflamed Subcutaneous Adipose Tissue (SAT), and Nodules. Lymphatic Network. https://lymphaticnetwork.org/news-events/understanding-fibrosis-in-lipedema-inflamed-subcutaneous-adipose-tissue-sat