{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T09:09:11Z","timestamp":1778922551643,"version":"3.51.4"},"reference-count":13,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Phlebology"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lipedema is a chronic and progressive disorder of subcutaneous adipose tissue that predominantly affects women and is frequently misdiagnosed as obesity, lymphedema, or venous disease. Increasing evidence indicates that lipedema represents a systemic vascular\u2013lymphatic\u2013inflammatory disorder rather than a cosmetic or metabolic condition. Delayed diagnosis often results in progressive fibrosis, lymphatic dysfunction, chronic pain, and functional impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This review aims to present a structured, clinically applicable framework for the diagnosis and multimodal management of lipedema within phlebology practice, with an emphasis on stage-specific assessment and integrated therapeutic strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A narrative clinical review of peer-reviewed literature in phlebology, vascular medicine, lymphatic disorders, and adipose tissue pathology was conducted. Diagnostic criteria, clinical staging, and differential diagnostic features were synthesized into a practical, stage-based framework. A multilayer therapeutic approach targeting inflammation, lymphatic function, adipose tissue pathology, extracellular matrix remodeling, and post-treatment rehabilitation is proposed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Accurate diagnosis of lipedema relies primarily on clinical evaluation, including pain assessment, tissue palpation, characteristic fat distribution, and exclusion of lymphedema and simple obesity. Early-stage identification enables effective intervention focused on inflammation control and lymphatic unloading, potentially preventing irreversible fibrosis. Advanced stages require targeted adipose tissue interventions, fibrosis management, and structured rehabilitation to preserve mobility and quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lipedema should be recognized as a systemic vascular\u2013lymphatic\u2013inflammatory disorder within phlebology practice. Early diagnosis and implementation of a structured, stage-specific multimodal treatment framework may significantly alter disease progression and reduce the risk of long-term disability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02683555261451571","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T08:16:26Z","timestamp":1778487386000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Modern approaches to the diagnosis and multimodal management of lipedema: A phlebology-oriented clinical framework"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7158-0289","authenticated-orcid":false,"given":"Fariba","family":"Hendesi","sequence":"first","affiliation":[{"name":"Erfan Hospital"},{"name":"Department of Phlebology and Venous Medicine, Tehran, Iran"},{"name":"Department of Vein and Lipedema Practice"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"issue":"12","key":"e_1_3_7_2_2","first-page":"983","article-title":"Lipedema: an overview of its diagnosis, treatment and future challenges","volume":"13","author":"Forner-Cordero I","year":"2012","unstructured":"Forner-Cordero I, Szolnoky G, Forner-Cordero A, et al. Lipedema: an overview of its diagnosis, treatment and future challenges. Obes Rev 2012; 13(12): 983\u2013991.","journal-title":"Obes Rev"},{"issue":"1","key":"e_1_3_7_3_2","first-page":"1","article-title":"Rare adipose disorders (RADs) and their symptoms","volume":"44","author":"Herbst KL","year":"2020","unstructured":"Herbst KL. Rare adipose disorders (RADs) and their symptoms. Int J Obes 2020; 44(1): 1\u201311.","journal-title":"Int J Obes"},{"issue":"1","key":"e_1_3_7_4_2","first-page":"17","article-title":"Lipedema: a frequently misdiagnosed and misunderstood fatty deposition syndrome","volume":"5","author":"Child AH","year":"2010","unstructured":"Child AH. Lipedema: a frequently misdiagnosed and misunderstood fatty deposition syndrome. J Lymphoedema 2010; 5(1): 17\u201328.","journal-title":"J Lymphoedema"},{"issue":"5","key":"e_1_3_7_5_2","first-page":"184","article-title":"Lipedema of the legs: a syndrome characterized by fat legs and edema","volume":"26","author":"Wold LE","year":"1951","unstructured":"Wold LE, Hines EAJr, Allen EV. Lipedema of the legs: a syndrome characterized by fat legs and edema. Mayo Clin Proc 1951; 26(5): 184\u2013187.","journal-title":"Mayo Clin Proc"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2009.09413.x"},{"issue":"5","key":"e_1_3_7_7_2","first-page":"701","article-title":"Lipedema: molecular pathophysiology, diagnosis, and clinical treatment strategies","volume":"6","author":"Torre YS","year":"2018","unstructured":"Torre YS, Wadeea R, Rosas V, et al. Lipedema: molecular pathophysiology, diagnosis, and clinical treatment strategies. J Vasc Surg Venous Lymphat Disord 2018; 6(5): 701\u2013709.","journal-title":"J Vasc Surg Venous Lymphat Disord"},{"issue":"3","key":"e_1_3_7_8_2","first-page":"222","article-title":"Lipedema: a clinical review","volume":"44","author":"Dadras M","year":"2017","unstructured":"Dadras M, Mallinger PJ, Corterier CC, et al. Lipedema: a clinical review. Arch Plast Surg 2017; 44(3): 222\u2013231.","journal-title":"Arch Plast Surg"},{"issue":"4","key":"e_1_3_7_9_2","first-page":"312","article-title":"The role of lymphatic therapy in lipedema management","volume":"40","author":"Haun MM","year":"2021","unstructured":"Haun MM, O\u2019Brien M. The role of lymphatic therapy in lipedema management. Int Angiol 2021; 40(4): 312\u2013318.","journal-title":"Int Angiol"},{"issue":"3","key":"e_1_3_7_10_2","first-page":"479","article-title":"Genetics and epigenetics of lipedema: a comprehensive review","volume":"12","author":"Paolacci S","year":"2022","unstructured":"Paolacci S, Precone V, Chiurazzi P. Genetics and epigenetics of lipedema: a comprehensive review. J Pers Med 2022; 12(3): 479.","journal-title":"J Pers Med"},{"issue":"10","key":"e_1_3_7_11_2","first-page":"718","article-title":"Treatment of lipedema using a lymph-sparing liposuction technique","volume":"35","author":"Rapprich S","year":"2020","unstructured":"Rapprich S, Dingler A, Podda M, et al. Treatment of lipedema using a lymph-sparing liposuction technique. Phlebology 2020; 35(10): 718\u2013725.","journal-title":"Phlebology"},{"issue":"2","key":"e_1_3_7_12_2","first-page":"91","article-title":"Lipedema: Misdiagnosis and emerging therapies","volume":"88","author":"Cleveland Clinic","year":"2021","unstructured":"Cleveland Clinic. Lipedema: Misdiagnosis and emerging therapies. Cleve Clin J Med 2021; 88(2): 91\u201398.","journal-title":"Cleve Clin J Med"},{"issue":"5","key":"e_1_3_7_13_2","first-page":"1012","article-title":"Lipedema: clinical updates and staging considerations","volume":"97","author":"Mayo Clinic Staff","year":"2022","unstructured":"Mayo Clinic Staff. Lipedema: clinical updates and staging considerations. Mayo Clin Proc 2022; 97(5): 1012\u20131020.","journal-title":"Mayo Clin Proc"},{"issue":"11","key":"e_1_3_7_14_2","first-page":"S1","article-title":"Lipoedema: a paradigm shift and consensus","volume":"29","author":"Lipoedema UK Big Survey Working Group","year":"2020","unstructured":"Lipoedema UK Big Survey Working Group. Lipoedema: a paradigm shift and consensus. J Wound Care 2020; 29(Sup11b): S1\u2013S51.","journal-title":"J Wound Care"}],"container-title":["Phlebology: The Journal of Venous Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02683555261451571","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02683555261451571","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02683555261451571","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T08:16:36Z","timestamp":1778919396000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02683555261451571"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,11]]},"references-count":13,"alternative-id":["10.1177\/02683555261451571"],"URL":"https:\/\/doi.org\/10.1177\/02683555261451571","relation":{},"ISSN":["0268-3555","1758-1125"],"issn-type":[{"value":"0268-3555","type":"print"},{"value":"1758-1125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,11]]},"article-number":"02683555261451571"}}