Excess Fats: Could It Be Lymphedema? Causes, Symptoms & Treatments

When we look at weight gain, it is natural to think that excess fats can be easily rid of with aesthetic procedures, or even liposuction. But rapid weight gain has been linked to a multitude of health conditions, including lymphedema. In this article, we look at the causes, symptoms, and treatment options for this condition.  

What is lymphedema?  

Lymphedema is a long-term chronic condition caused by too much lymph fluid in the body’s tissues, causing swelling. It can affect any part of the body, but usually occurs in the arms and legs.  

The condition is usually caused by a malfunctioning lymphatic system, with symptoms that can be quite severe. Read on to find out more about lymphedema, causes, and symptoms.  

The lymphatic system in our body 

lymphatic system lymphedema

The lymphatic system is a network of glands and channels in our bodies that help fight against infection and remove excess fluids. Lymph fluid is a protein-rich fluid found in lymph vessels.  

It removes toxic substances like bacteria, waste, and viruses by bringing them to your lymph nodes, which then filter the fluid to flush out impurities and toxins from your body.  

When the lymphatic system is not working properly, it could be due to underlying causes such as an internal damage or blockage.  

Lymphedema: Causes, Symptoms & Treatment

How do I know if I have lymphedema?

signs and symptoms lymphedema

There are two types of lymphedemas – primary and secondary.  

Secondary lymphedema is induced by a disease or condition that has damaged your lymph nodes or vessels. Secondary lymphedema may be caused by:  

  • Cancer surgery 
  • Radiation therapy  
  • Inflammation e.g., eczema  
  • Obesity   
  • Parasitic infections  
  • Deep vein thrombosis  
  • Immobility  

Primary lymphedema is caused by genetic factors, and occurs because the lymph nodes are not fully developed or are missing. It is less common than secondary lymphedema.  

Symptoms of lymphedema include swelling in your arms or legs, and skin tightness. It develops gradually over time and can extend to your fingers and toes. There may even be redness or inflammation of the swollen area.  

Stages of lymphedema  

stages of primary lymphedema

There are 4 stages in lymphedema:  

  • Stage 1 – Soft swelling due to abnormal flow in lymphatic system  
  • Stage 2 – Accumulation of fluid. Swelling may go away when you elevate the affected limb.  
  • Stage 3 – Permanent swelling that does not go away. There is thickening or scarring of the skin.  
  • Stage – Elephantiasis (large deformed limb) can be seen. Skin thickens, with wart like growth and extensive swelling.  

The swelling will appear soft and fluid at first. Over time, it may become denser, and even make your skin look grainy. You may also experience heaviness, pain, or a limited range of motion in the affected limb, preventing you from carrying out your daily activities. Such symptoms may eventually lead to complications such as infection, or even cancer.  

Hence, you should consult a doctor as soon as possible if you see any early symptoms of lymphedema.   

What are my treatment options for lymphedema? 

The ideal treatment option for lymphedema when conservative management fails is lymphedema surgery. Conservative management such as lymphedema therapy may control the symptoms for some individuals. 

treatment options lymphedema

However, when the condition is unresponsive to these forms of treatment, this is an indication for surgery. 

Before treatment, your doctor will first conduct a thorough assessment to diagnose and ascertain the stage of lymphedema.  

A thorough investigation into your medical history will be conducted, along with imaging tests to diagnose the problem. A lymphoscintigraphy which is a scan that detects blockages or missing lymph vessels, may be carried out. It is done via injecting radioactive material. Other tests include MRI, CT scans, and ultrasound.  

Management of lymphedema through surgery 

There are 4 types of lymphedema surgery.  

liposuction in lymphedema treatment

Liposuction – When lymphatic fluid spills into the surrounding tissues, this causes inflammation, stimulating fat stem cells to grow. Liposuction can help to remove this extra fat. This is usually an outpatient procedure with short downtime. 

Lymphaticovenous anastomosis (LVA) – Microsurgical equipment and techniques are used by the surgeon to reroute your lymphatic system. This is done to bypass damaged nodes and connect lymphatic channels directly to your veins. Recovery period for this outpatient surgery is typically a few days.  

image of lymph node
Image of a lymph node. Retrieved from https://pubs.rsna.org/doi/10.1148/rg.2020190118.

Vascularized lymph node transfer – A group of lymph nodes is transferred from a healthy part of your body to the affected area. This results in rewiring of the lymphatic system. This is an inpatient procedure, and recovery takes a few days.  

Charles procedure (skin grafts) – Affected tissue is removed, and is used as skin grafts to repair the affected area. This procedure requires extensive care of the surgical site, and recovery period can be as long as one month.  

elephantiasis lymphedema extremity
Image of lymphedema stage 3. Retrieved from https://www.polarisplasticsurgery.com/articles/excisional-lymphedema-surgery.

Currently there is no known full recovery for lymphedema. However, these treatment options will significantly reduce the symptoms, such as lower body swelling. 

Lymphedema surgery is progressive and effective, thanks to advancements in medical technology, and allows for better management of lymphedema. Post-surgery, patients can expect to see significant reduction in symptoms and limb weight, and a better quality of life.  

Other than surgery, how is lymphedema managed?  

There are complementary management options to bring lymphedema under control. This includes:  

  • Bandaging and compression garments: This moves fluid out of the affected limb and prevents fluid buildup.  
  • Proper skincare: It is important to keep your skin in good condition, in order to minimize any chances of infection, such as cellulitis.  
  • Adequate nutrition: Choose a diet that is rich in protein and stay hydrated to avoid lymphatic overload. Avoid sodium, excess calories, fats, soy foods, sweeteners, fried foods, and alcohol.  
  • Active lifestyle, exercises: Regular exercise is also important to ensure fluid flows smoothly through the lymphatic system, as the system does not have a central pump, such as the heart. Having an active lifestyle will help to keep symptoms of lymphedema at bay.  
lymphedema surgery treatment
  • Lymphatic drainage (manual, massage, or both): Lymphatic drainage helps to stimulate the flow of fluid in the lymphatic system. At the same time, it helps to reduce swelling. A specialist therapist can carry out a lymphatic drainage massage to move fluid from swollen areas into working lymph nodes, where the fluid will be drained. Your therapist may also teach you manual lymphatic drainage exercises, which are easy to carry out at home.  

Conclusion  

Lymphedema is a complicated condition that is difficult to treat, with life-threatening symptoms. It is recommended to not take it lightly and to seek early intervention to prevent complications from arising.  

It is also of utmost importance to consult an experienced plastic surgeon who has expert knowledge in lymphedema therapy in Singapore. He will be able to curate a proper treatment plan to manage your lymphedema, as diagnosis and treatment outcomes will vary from patient to patient.