S1-Leitlinie Lipödem.

Area of Science:

• Phlebology
• Dermatology
• Plastic Surgery

Background:

• Lipedema is a chronic, progressive condition affecting subcutaneous fat tissue, primarily in the extremities.
• It is characterized by disproportionate fat distribution, edema, bruising, and pain.
• Diagnosis relies on patient history and clinical examination, with further investigations reserved for specific cases.

Purpose of the Study:

• To provide updated, evidence-based recommendations for the diagnosis and management of lipedema.
• To consolidate consensus from multiple medical societies for a comprehensive guideline.

Main Methods:

• Systematic literature review.
• Consensus development involving eight medical societies and professional associations.
• Development of a clinical guideline based on reviewed literature and expert consensus.

Main Results:

• Diagnosis of lipedema is based on clinical presentation, including characteristic fat distribution, edema, and pain.
• A four-pillar treatment approach is recommended: complex physical decongestive therapy, surgical interventions (liposuction/plastic surgery), lifestyle modifications (diet, exercise), and psychotherapy.
• Surgical interventions are indicated for persistent symptoms or disease progression despite conservative management.

Conclusions:

• Lipedema management requires a multimodal, individualized approach combining conservative and surgical treatments.
• Addressing comorbidities like morbid obesity is crucial before considering surgical options.
• The guideline aims to standardize and improve the care of patients with lipedema.