The structure of the fatty tissue in the subcutis changes when lipedema occurs. On the one hand, the lymph vessels are unable to remove water properly, which eventually leads to chronic lymphedema. On the other hand, fibrosis (increase in connective tissue) and scarring of the subcutaneous adipose tissue occur. These scars can then be felt under the skin.
Background knowledge: Function of the lymph vessels in the body
The task of the lymphatic system is to collect lymph fluids from all parts of the body. It consists of the finest capillaries that converge into thicker vessels and, unlike the blood vessel system, is not a circulatory system.
The lymph vessels complement the body’s blood vessel system and transport body fluids, blood cells and nutrients (fats) that are secreted by the cells. The fine lymph capillary tissue water (so-called lymph) is absorbed and passes into the larger lymphatic vessels and finally into the blood vessel system of the upper vena cava. The lymphatic system thus forms a drainage system for the human tissue. The lymph vessels have valves that transport the lymph fluid through the body with their own muscle power. The lymph fluid is produced by pressing blood fluid from the arteries as interstitial fluid into the tissue and supplying the cells there with nutrients. This fluid is then removed via the lymph vessel system. If necessary, the lymph vessels can work faster and absorb and transport more fluid.
In lipedema patients, the permeability of the blood vessel capillaries is disturbed, resulting in increased fluid release into the connective tissue. The fat cells of the subcutis absorb this fluid and exert increased pressure on the vascular system, creating a vicious circle and releasing even more fluid from the blood vessels. The lymph vessels are compressed and can therefore transport less fluid away. This results in water accumulation in the tissue, a so-called edema.
Summary of the function of the lymphatic system:
- Arteries release fluid into the tissue to supply cells with nutrients
- Part of this liquid is absorbed and transported by the lymph capillaries
- The lymph system removes body fluids, blood cells and lipids and serves as a drainage system
- The lymph system returns the lymph fluid to the bloodstream