Do your legs appear ‘fatty’ even after diet and exercise? Does your skin have a ‘doughy’ texture? Bruise easily? Achy and heavy limbs? All of these symptoms could be signs of lipoedema.

This relatively unknown condition has an estimated prevalence of 11% in the overall female population, however far too often, sufferers are frequently told that their leg growth and swelling is due to their inability to control their diet, or their sedentary lifestyles.

Some are even told that is down to the fact that the women in their family simply ‘have large legs’, as if it's something that should be accepted. The search for "lipoedema surgery" has recently seen a surge in interest, indicating that more people are not only becoming aware of the condition, but are actively seeking solutions.

We speak to the experts who explain how best to treat this often misdiagnosed condition.

What is lipoedema?

Lipoedema is when there is an abnormal build-up of fatty tissue, commonly found in the legs and sometimes the arms, and usually affects both sides of the body equally. “The affected skin can feel soft and often dimpled with an orange-peel texture, pain, tenderness, and heaviness in the limbs are often associated with the condition,” explains Dr Nyla Raja, Dr Nyla Medispa. It’s more common in women, and some may have mild symptoms which do not affect their day-to-day life, but others may struggle with physical problems.

Why does lipoedema occur?

“Causes other than genetic are poorly understood, but it may have a hormonal connection as it gets worse during periods of oestrogen dominance such as puberty, pregnancy and peri-menopause, as well those taking hormone-based contraceptive pills,” suggests Dr Suha Kersh, Clinical Director, 23MD. To help control any hormonal imbalance it is advisable to consult with a BHRT specialist to reduce related symptoms.

How does it differ from cellulite?

“The appearance of cellulite is similar to that of lipoedema in that the skin alterations can be dimpled and uneven, and are both formed by deposits of fat accumulating in the tissues,” explains Dr Nyla. The main difference is that cellulite is a cosmetic condition that doesn’t lead to any health conditions. “Lipoedema is a medical condition, whereas cellulite is more of a cosmetic condition,” explains EV Expert, GP and Aesthetician Dr Ahmed El Muntasar. Both can affect the appearance of the skin and fat. “Cellulite is more the protrusion of fat through the connective tissue underneath which gives it that lumpy appearance, whereas with lipoedema it’s more of an abnormal accumulation of fat under the skin and in the lower limbs.”

Will losing weight and exercising help?

“Lipoedema doesn’t respond to diet and exercise in the same way as ordinary fat, but it can help ease side effects, as well as benefit your overall health,” says Dr Nyla. “Maintaining a healthy lifestyle with a balanced anti-inflammatory diet and regular exercise such as swimming, biking and walking can help to ease symptoms, improve mobility, reduce swelling and stress on your joints, and prevent further complications.”

What can be done to help lipoedema?

There’s currently no cure, but there are things that can help and stop it from getting worse. “An anti inflammatory, low carbohydrate diet has been shown to have positive effects in milder cases, and oestrogen balancing supplements like vitamin B, selenium, and evening primrose oil can slow the progression of lipoedema,” says Dr Suha. Compression therapy and lymphatic drainage via massage may also help manage the symptoms of lipoedema, “but invasive and non-invasive treatments are the best route for minimising the appearance,” advises Dr Nyla.

Are there surgical treatments available?

“Lipoedema surgery is a variation of liposuction, therefore is focused on removal and uses a solution to break down the fat,” explains Dr Ahmed. “It reduces pain and progression, improves mobility, and reduces the appearance of the fat cells.” However, it’s a significant procedure and a major surgery, so this is something to be aware of. The price will depend on how many sessions are needed and there are a lot of variables that will impact this.

Other treatment options are available including CoolSculpting, the non-invasive fat reduction procedure. “It works by freezing the fat cells in the localised area and may require multiple rounds of treatment to create a slimmer body profile, while also creating the appearance of smoother, more toned skin,” says Dr Nyla, who also recommends Emerald Laser, which uses electromagnetic energy to draw from the cells, encouraging the body to naturally eliminate fat; and the injectable treatment Aqualyx, which dissolves unwanted fat deposits and is ideal for areas such as the thighs or upper arms.

“We have found that the best results are achieved using an amalgamation of BTL Exion, which combines fractional radio frequency and ultrasound, and EMSculpt Neo to reduce fat and tighten skin—the combination of electromagnetic stimulation and radio frequency can improve muscle mass increase by 25 per cent and fat reduction by about 30 per cent,” says Dr Suha.