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CC BY 4.0 · Arch Plast Surg 2025; 52(03): 185-196
DOI: 10.1055/a-2530-5875
Extremity/Lymphedema
Review Article

Lipedema: Clinical Features, Diagnosis, and Management

Hatan Mortada 
1   Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University and Department of Plastic Surgery & Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia
,
Abdulmalek W. Alhithlool 
2   College of Medicine, King Faisal University, Alhasa, Saudi Arabia
,
Nouf Z. AlBattal 
3   College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
,
Rashika K. Shetty 
4   University of Minnesota Medical School, Minneapolis, Minnesota
,
Ghaleb A. AL-Mekhlafi 
5   College of Medicine, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia
,
Joon Pio Hong 
6   Department of Plastic and Reconstructive Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
,
Feras Alshomer 
7   Division of Plastic Surgery, Department of Surgery, King Saud bin Abdulaziz University for Health and Sciences, Riyadh, Saudi Arabia
› Author Affiliations Funding None.
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Abstract

Lipedema is an adipose tissue disorder that principally affects women and is frequently misidentified as obesity or lymphedema. There have been relatively few studies that have precisely defined the pathogenesis, epidemiology, and treatment approaches for lipedema. However, successfully recognizing lipedema as a distinct condition is important for proper management. This review aimed to examine the existing literature on the epidemiology, pathogenesis, clinical presentation, differential diagnosis, and treatments for lipedema. The current research indicates that lipedema appears to be a clinical entity related to genetic factors and fat distribution, although distinct from lymphedema and obesity. Some available treatments include complex decongestive physiotherapy, liposuction, and laser-assisted lipolysis. The management of lipedema is complex and differs from that of lymphedema. Further high-quality randomized controlled trials are urgently needed to continue advancing our understanding of this often neglected disease and exploring optimal medical and surgical treatment regimens tailored specifically for lipedema patients. In summary, despite frequent misdiagnosis, enhanced recognition, and research into customized therapeutic strategies for this poorly characterized but likely underdiagnosed disorder represent promising steps forward.

Level of evidence N/A.

Keywords

lipedema - lymphedema - liposuction

Ethics Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted was waived due to the nature of the study.


Authors' Contributions

H.M. conceptualized the study, conducted the literature review, and drafted the manuscript. A.W.A. and N.Z.A. assisted with data collection and analysis. R.K.S. and G.A.A. contributed to manuscript revision and critical review. J.P.H. provided expert input on surgical management and edited the final draft. F.A. supervised the project, finalized the manuscript, and served as the corresponding author. All authors approved the final version.




Publication History

Received: 19 June 2024

Accepted: 17 January 2025

Accepted Manuscript online:
11 February 2025

Article published online:
15 May 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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