06/07/2025
π¬ Connective Tissue Abnormalities in Lipedema
𧱠Structural Changes
β’ Thickened fibrotic septa divide fat lobules.
β’ Dense extracellular matrix (ECM) with excess collagen types I & III.
β’ Loss of tissue elasticity and reduced skin recoil.
π§ Fluid Retention
β’ ECM contains excess hyaluronic acid and proteoglycans, which hold water.
β’ Lymphatic drainage is impaired due to stiffened connective tissue β swelling and heaviness.
π©Έ Capillary Fragility
β’ Fragile capillaries lead to easy bruising with minor pressure or trauma.
π Chronic Inflammation & Tissue Remodeling
β’ Elevated matrix metalloproteinases (MMP-2, MMP-9) degrade collagen and alter ECM.
β’ Ongoing fibrosis and low-grade inflammation contribute to disease progression.
π‘ Clinical Implications
β’ Fat is resistant to weight loss through diet or exercise.
β’ Symptoms include pain, swelling, heaviness, and sensitivity.
β’ Compression, manual lymphatic drainage (MLD), and liposuction help manage symptoms but do not reverse ECM fibrosis.
