Lipedema and lymphedema are two different medical conditions that often get confused. Both can lead to swelling in the legs and arms, but their causes, symptoms, and treatments are distinct. Understanding the difference is key to getting the right diagnosis and care.
Dr. Ali Abtahi, a plastic and reconstructive surgeon in Plano, TX, offers advanced treatment options for lipedema and lymphedema. He works closely with patients from Highland Park, Dallas, Fort Worth, Southlake, and beyond to create personalized surgical solutions that target the root cause of swelling—not just the symptoms.
Whether you’ve recently been diagnosed or are searching for answers about chronic swelling, this guide will help you understand how these two conditions differ and what treatments are available.
Understanding Lipedema and Lymphedema: Key Differences
Though they can look similar, lipedema and lymphedema are not the same. Lipedema is a chronic fat disorder that mainly affects women, leading to symmetrical fat buildup in the legs, hips, and sometimes arms. Lymphedema, on the other hand, is a fluid retention issue caused by a damaged or blocked lymphatic system. It often affects just one limb and can develop after surgery, cancer treatment, or trauma.
The biggest difference lies in the type of swelling:
- Lipedema involves fat accumulation that doesn’t respond to diet or exercise.
- Lymphedema involves fluid buildup that may worsen throughout the day.
Proper diagnosis is essential since the treatments for each condition are quite different.
What Causes Lipedema?
Lipedema is believed to have a genetic and hormonal link. It almost exclusively affects women and often begins or worsens during times of hormonal change, such as puberty, pregnancy, or menopause.
While the exact cause is still under study, researchers believe that certain fat cells in people with lipedema behave abnormally, expanding and becoming resistant to normal fat loss methods. The condition is not caused by obesity, but excess weight can make symptoms more pronounced.
What Causes Lymphedema?
Lymphedema occurs when the lymphatic system is damaged or blocked. This prevents lymph fluid from draining properly, causing it to build up in the surrounding tissues. There are two types:
- Primary lymphedema is inherited and usually appears without an obvious cause.
- Secondary lymphedema is more common and can occur after cancer surgery, radiation, infection, or injury.
Unlike lipedema, lymphedema can affect anyone, regardless of gender or age.
Symptoms of Lipedema vs. Lymphedema: How to Tell Them Apart
While both conditions involve swelling, they differ in how and where the swelling appears, as well as how the tissue feels.
Lipedema Symptoms
- Symmetrical fat accumulation in the hips, thighs, and legs
- Painful, tender fat that bruises easily
- Legs appear column-like, with a cuff at the ankles
- No swelling in the feet
- Fat that does not respond to diet or exercise
Lymphedema Symptoms
- Swelling often starts in one limb (arm or leg)
- Skin may feel tight, heavy, or thickened
- May include swelling in the hands or feet
- Risk of infections (cellulitis) in the affected limb
- Progresses in stages and may become permanent if untreated
If you’re experiencing any of these signs, a full evaluation is necessary to pinpoint the cause and prevent further progression.
How Are Lipedema and Lymphedema Diagnosed?
Diagnosis typically begins with a physical exam and a detailed medical history. Imaging tests may be used to distinguish between fat and fluid accumulation.
Dr. Abtahi and his team can help facilitate the diagnostic process by working with referring physicians, using tools like lymphoscintigraphy, ultrasound, or MRI to assess the extent and source of the swelling. An accurate diagnosis is essential to building the right treatment plan—especially when both conditions are present.
Treatment Options for Lipedema
Lipedema cannot be cured with traditional weight loss methods, but targeted treatment can improve comfort, mobility, and appearance.
Conservative treatments may include:
- Compression garments
- Manual lymphatic drainage
- Anti-inflammatory diets
- Gentle, low-impact exercise
However, liposuction is currently the most effective long-term treatment. Dr. Abtahi performs specialized liposuction to remove diseased fat while preserving lymphatic function. This approach can significantly reduce pain, restore natural contours, and improve quality of life.
Treatment Options for Lymphedema
For lymphedema, treatment focuses on restoring fluid balance and preventing complications. While there is no cure, early management can slow or stop its progression.
Non-surgical treatments include:
- Compression therapy
- Manual lymphatic drainage
- Exercise and skin care
Surgical options may be recommended in advanced cases. These can include:
- Lymphaticovenular anastomosis (LVA): a microsurgical technique that creates new drainage pathways
- Vascularized lymph node transfer (VLNT): transferring healthy lymph nodes from one part of the body to another
- Debulking surgery: in severe cases, to remove hardened tissue and restore mobility
Dr. Abtahi can guide patients toward the appropriate surgical team if lymphedema reaches this stage.
Can Lipedema and Lymphedema Occur Together?
Yes—this condition is called lipo-lymphedema, and it’s more common than people realize. Lipedema can compromise lymphatic function over time, leading to a secondary lymphedema. This combination can cause both fat and fluid buildup, complicating diagnosis and treatment.
Dr. Abtahi takes a holistic, individualized approach when treating patients with overlapping symptoms. By addressing the fat component through liposuction and managing lymphatic health, many patients see a dramatic improvement in both appearance and daily comfort.
Schedule a Consultation with Dr. Ali Abtahi
If you’re experiencing unexplained swelling, pain, or fat that won’t go away with diet and exercise, the first step is a proper diagnosis. Dr. Abtahi offers thoughtful, personalized care and advanced treatment options for patients throughout Plano, Dallas, Highland Park, Southlake, and Fort Worth. Call (469) 293-2533 or arrange your consultation online today to learn more about lipedema and lymphedema treatment. Get clarity, get answers—and get relief.