Lipedema:A common though often unrecognized condition

Lipedema is a chronic disorder primarily affecting women,characterized by abnormal fat deposition in the extremities,leading to pain,mobility issues,and psychological distress.These fat deposits are clear-cut and spare hands and feet.Often misdiagnosed as lymphedema,its prevalence remains uncertain due to a lack of universally accepted diagnostic criteria and difficulty in differentiating it from obesity or lymphedema.Genetic factors and hormonal influences are likely related to the pathophysiology of the disease,though the specific causes remain unknown.Imaging techniques may aid evaluation,but no definitive test exists,and diagnosis is made clinically.Conservative treatments such as lifestyle modifications and compression garments are considered first-line treatments,while surgical options such as liposuction and lipectomy are reserved for severe or refractory cases.Psychological support may be recommended,given lipedema’s impact on quality of life and self-esteem.This review aims to present the current understanding of this condition,including challenges in diagnosis,current guideline recommendations for clinical care,and associated comorbid conditions.

Testing the leanocentric locking-point theory by in silico partial lipectomy

Background:The lipostatic set-point theory,ascribing fat mass homeostasis to leptin mediated central feedback regulation targeting the body9s fat storage,has caused a variety of conundrums.We recently proposed a leanocentric locking-point theory and the corresponding mathematical model,which not only resolve these conundrums but also provide valuable insights into weight control and health assessment.This paper aims to further test the leanocentric theory.Methods:Partial lipectomy is a touchstone to test both the leanocentric and lipostatic theories.Here we perform in silico lipectomy by using a mathematical model embodying the leanocentric theory to simulate the long-term body fat change after removing some fat cells in the body.Results:The mathematical modeling uncovers a phenomenon called post-surgical fat loss,which was well-documented in real partial lipectomy surgeries;thus,the phenomenon can serve as an empirical support to the leanocentric theory.On the other hand,the leanocentric theory,but not the lipostatic theory,can well explain the post-surgical fat loss.Conclusions:The leanocentric locking-point theory is a promising theory and deserves further testing.Partial lipectomy surgeries are beneficial to obese patients for quite a long period.

Clinical applications of the jugal lipectomy technique:case reports

The adipose body of cheek is the tissue located in the buccal space. In the past, the partial removal of this tissue, called jugal lipectomy, was indicated to fill defects resulting from buccosinusal communications and/or maxillary resections. Recently, such technique became popular in facial aesthetics as it gives patients the feel of a more delicate face, in which the zygomatic bone appears to be more prominent due to the reduction in the volume of the cheeks. However, many professionals are unaware of how to establish the correct diagnosis of facial volume alterations, as well as in performing and treating the complications that may arise from jugal lipectomy. The aim of this paper is to present three clinical cases with different applications of jugal lipectomy, discussing some relevant aspects of surgical planning that involve the request for imaging exams and a previous study of this tissue's anatomical features.

Diagnostic and surgical challenges of progressive neck and upper back painless masses in Madelung’s disease: A case report and review of literature

BACKGROUND Madelung’s disease(MD)is a chronic alcoholism-associated metabolic syndrome characterized by symmetrical subcutaneous deposition of adipose tissue in the head,neck,shoulders,back,trunk,and nerve roots of the upper and lower limbs.It is relatively rare in Asian individuals and is prone to misdiagnosis.Herein,we report a case of a patient with MD who had undergone surgical management at our hospital,and we discuss the pathogenesis,diagnosis,and treatment of MD.CASE SUMMARY We report a case of MD in a 65-year-old man of Han descent.The patient had multiple,painless progressive masses for more than five years in the neck and more than 30 years in the upper back.Because of neck mobility limitations and progressive cosmetic deformities caused by the masses,he was admitted to our hospital.He drank approximately 500 mL of liquor per day and smoked heavily for more than 30 years.Contrast-enhanced computed tomography of the neck and chest documented abundant unencapsulated,subcutaneous fatty deposits.We prepared a staged operation plan.The patient was diagnosed with MD;he was advised to abstain from alcohol and was followed up regularly.After a 3-month follow-up,no recurrence of fat accumulation was found in the surgical areas.CONCLUSION This report presents a case of surgical treatment for MD to improve clinicians'understanding of the disease.

Correction of Congenital Symmastia with Macromastia： Report of a Rare Case and Devised Treatment Algorithm

INTRODUCTIONSymmastia is defined as the medial confluence of both breasts or unification of the breasts by soft tissue on the sternum rendering them inseparable. It was first described in the plastic surgery literature by Spence et al. in 1984. Two forms of symmastia exist; acquired and congenital,Acquired symmastia is a very common condition that results as an iatrogenic complication of over-dissecting a pocket, or using implants with a diameter that is too large in proportion to the chest wall during breast augmentation or reconstruction.