News
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Why You Should Address Fibrosis in Your Lymphedema Therapy for Optimal Results
Lymphedema (also spelled as lymphoedema) doesn’t always stop at swelling. For many patients, fibrosis— the thickening or scarring of connective tissue— plays a crucial role in determining the course of treatment. Therapists who recognize and treat fibrosis, including incorporating targeted compression garments into their lymphedema (lymphoedema) treatment, can transform patient outcomes and offer more effective and lasting relief. Whether you're a patient or a therapist, understanding how fibrosis impacts your lymphedema treatment journey could be the game-changer you need.
Fibrosis: A Common Challenge in Lymphedema Treatment
Fibrosis occurs as a natural part of the body’s healing process. However, when it’s combined with lymphedema, it can complicate both management and recovery. Fibrosis can exacerbate lymphedema by restricting fluid movement, reducing tissue flexibility, and increasing tissue density. As the tissue becomes thicker and scarred, standard treatments like manual lymphatic drainage and compression garments may become less effective if they don’t also specifically target fibrosis.
There are multiple kinds of fibrosis that can affect lymphedema treatment. While lymphostatic fibrosis is the most relevant when treating the inflammatory processes that cause lymphedema, patients can also experience surgical scarring and radiation-induced fibrosis.
Fibrosis is common in lymphedema patients. In fact, it can play a role in nearly every lymphedema patient’s journey. As Karen Ashforth, MS, OTR/L, CLT-LANA, explains: “Lymphostatic fibrosis is present in all forms of lymphedema. In fact, the stages of lymphedema are defined by the progression of lymphostatic fibrosis… this means every lymphedema patient is also a fibrosis patient.”
Given this, it's clear that recognizing and treating fibrosis early is essential to preventing its progression alongside lymphedema. Common treatment strategies for lymphedema include massage, skin care, exercise, medication, and compression therapy. Fibrosis treatment is commonly incorporated as part of compression therapy.
Compression Therapy Helps Both Fibrosis and Lymphedema
Compression therapy is one of the cornerstones of lymphedema treatment, and it offers significant benefits for both fibrosis and lymphedema.
- Improves circulation: Good circulation plays a critical role in treating fibrosis. Compression therapy works by improving lymphatic circulation and helping to soften tissues, which in turn helps alleviate the symptoms of both lymphedema and fibrosis. Compression is a key component of Complete Decongestive Therapy (CDT), one of the most effective treatments for lymphedema care.
- Creates softer, smoother tissue: Fibrosis, in particular, responds well to combining textured materials with pressure during lymphedema therapy. This is called micromassage compression. It improves circulation to facilitate better healing, as well as improving skin texture to create softer and smoother tissue.
- Uses different types of compression for different needs: The type of external pressure used depends on the patient’s individual therapeutic needs. The most common options include compression garments, Velcro wraps, bandaging, and pump compression. Each provides varying levels of compression to address specific patient conditions and comfort levels. The optimal compression pressure and duration of treatment will vary for everyone, highlighting the need for personalized treatment plans.
Use The Opportunity To Treat Fibrosis and Lymphedema Together
Addressing fibrosis and lymphedema simultaneously can improve patient outcomes significantly. As Karen Ashforth points out in the seminar quoted above, if you're already using compression garments with your patients and not addressing fibrosis, you're missing an opportunity to enhance the healing process. Combining the two treatments can reduce discomfort, improve circulation, and accelerate healing.
An important solution for this combined treatment is anti-fibrotic compression garments. Fibrosis responds well to combining textured materials with pressure during lymphedema therapy, so therapeutic recovery garments have been developed specifically for addressing both conditions and making patients’ lives more comfortable. Anti-fibrotic garments combine compression with textured or quilted fabrics (also known as micromassage compression therapy) to actively treat fibrosis and help create softer, smoother tissue.
Compression Garments For Comfort, Healing, and Quality of Life
Compression garments - such as compression bras, camisoles, t-shirts, vests, shirts, and bodysuits - provide mild compression. Their purpose is to provide a comfortable solution that can be worn for long periods of time, both day and night. This approach has proven effective in reducing swelling, improving lymphatic function, and preventing the progression of lymphedema as well as the progression of fibrosis.
Wear Ease compression garments offer advanced solutions designed for patient comfort and healing. Our therapeutic recovery garments support the combined treatment of fibrosis and lymphedema, and include:
- Cutting-edge designs for better outcomes: Wear Ease compression garments are crafted using innovative fabrics and techniques that provide immediate relief from pain while promoting long-term healing. By improving circulation, reducing swelling, and improving skin texture, these garments facilitate the healing process and help patients achieve a better quality of life.
- Our new Karena anti-fibrotic micromassage bra: Specifically designed for post-surgical patients, the Karena bra features a textured lining that softens scars and radiation-induced fibrosis. This micromassage bra offers comfortable compression therapy that gets meaningful results and is great for promoting healing.
- Our 790 Compression Bra: Designed to provide mild compression that offers immediate relief from lymphedema symptoms, this bra can even be worn home from the hospital after surgery.
- Anti-fibrotic pads can also be used with other Wear Ease compression garments, including our Wear Ease compression camisole, to target specific areas affected by swelling and fibrosis. These can help reduce swelling and facilitate healing.
Walking The Path To Healing
By making fibrosis treatment a regular part of your lymphedema therapy protocols, you can offer your patients greater comfort and a more comprehensive path to healing.
Want to know more? Register for Karen Ashforth’s webinar, “Lymphedema and Fibrosis Compression Treatment for the Breast and Torso”. Karen offers a detailed review of the relationship between lymphedema and fibrosis as well as various types of treatment. This seminar is also eligible for Lymphology Association of North America (LANA) continuing education credit.
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A Holistic Approach to Lipedema Management
Lipedema is a poorly understood disorder that primarily affects females. It is characterized by excessive and disproportionate fat, usually in the lower body, pain/heightened sensitivity, and other unique skin and tissue changes. A holistic and individualized approach to healing and management of lipedema symptoms can optimize outcomes for people affected by this condition.
Lipedema affects all facets of life and can have an impact on everyone involved in the life of someone with lipedema. Because there is such a variety of presentations of lipedema in conjunction with each person’s particular situation, such as other social, economic, cultural, and physical influences on health, individualizing treatment and support is crucial.
For these reasons, a holistic approach can be very important. Although five different aspects of the holistic approach are described here, it is important to note that there is a great deal of overlap between each aspect. We are not made up of individual compartments but are an integrated whole.
Physical Aspect
The physical aspect of the holistic model focuses on reducing or eliminating the physical symptoms of lipedema and their consequences. This may include reducing pain, improving or regaining mobility, increasing tolerance to physical activity and movement, and managing weight. It may be necessary to address other health conditions, such as obesity or hypothyroidism, to lessen the impact these may have on lipedema symptoms and quality of life (Ghods et al., 2020).
Effective interventions for managing the physical aspects can include: Complete Decongestive Therapy (CDT) provided by a certified lymphedema therapist, aquatic activity, compression garments, pneumatic pumps, and proven nutrition strategies such as low carb and ketogenic diets (Keith et al., 2021; Jeziorek et al., 2023).
Mental/Psychological Aspect
The mental and psychological aspects of the holistic model can focus on remedying mental health issues, such as depression and anxiety, common comorbidities of lipedema (Alwardat et al., 2020). Intervention should also focus on providing education and increasing awareness about lipedema as a disease. Individuals want to understand lipedema and its care to better understand the condition and to learn how to manage it. Educating both patients and healthcare providers about lipedema will ensure an accurate and timely diagnosis as well as appropriate referrals for treatment. Understanding the condition, its symptoms, and treatment options is the first step toward effective management.
Interventions that address the mental/psychological aspect may include seeking care from a counselor, psychologist, or other mental health practitioner to learn strategies for dealing with depression, anxiety, post-traumatic stress disorder, or panic attacks. Programs may be in-person or virtual and can be one-on-one or in groups. Attending educational workshops, seminars, conferences, and webinars about lipedema or other chronic conditions can improve one’s ability to cope with the challenges of the condition.
Emotional Aspect
Because individuals with lipedema are dealing with a chronic condition that can be disfiguring, they may isolate themselves from others. Limited outside help can increase the challenge of dealing with the day-to-day needs that arise from a diagnosis of lipedema and increase the emotional burden. This may result in feeling completely overwhelmed and developing a sense of hopelessness. Even more so, these feelings can be compounded by experiencing anti-fat bias, widespread in healthcare, which can give rise to long-lasting feelings of shame, blame, and guilt (Seo, 2014).
Similar to intervention strategies used in the Mental/Psychological Aspect, individuals may seek care from a mental health practitioner to help with developing a healthy mindset for dealing with a complex and challenging chronic condition like lipedema. A crucial part of addressing the emotional aspect is to achieve a balance between adherence to self-care activities and having a life outside of managing lipedema (Dudek et al., 2016). Peer-to-peer support can help the individual with lipedema to not feel so alone. Knowledgeable practitioners can help those with lipedema to restore and build feelings of self-compassion, acceptance, and understanding (Dudek et al., 2021).
Spiritual Aspect
Individuals with lipedema may begin to feel that their condition defines them, causing them to disconnect with others and themselves. This can foster feelings of separateness, worthlessness, and despair. Without a sense of purpose and connection to the world, all of the self-care necessary for managing lipedema symptoms can seem fruitless.
Spiritual wellness begins with an inner knowing that we are naturally resourceful, creative, and already whole. Insight into one’s self allows an expansion of that knowing to include others, creating a network of awareness and understanding. Dr. Matthew Carmody, Medical Advisor for Lipedema Simplified, reminds us, “the wisdom is within each of us.”
The spiritual aspect of the holistic approach urges self-reflection, life balance, and the development of a sense of meaning and purpose. This might be achieved by spending time alone or with others in nature, practicing quiet time or meditation, or doing activities that promote a sense of flow (losing oneself while immersed in an activity) (Csikszentmihalyi et al., 2018). Some may feel a deep connection to the world when birdwatching, stargazing, or knitting a sweater; others may feel a strong link to the greater good by volunteering to be part of a lipedema research study.
Social Aspect
Until they learn about lipedema, most individuals with this condition believe that they alone have an unusual form of obesity that does not respond to traditional weight loss attempts. Even after diagnosis, constantly explaining their condition to friends and family can become burdensome.
The social aspect of the holistic approach recognizes the importance of community. Receiving support and understanding from peers can be a significant part of the healing and growth process. Feelings of isolation are replaced with a deep and often lasting connection to a larger community.
Lipedema Simplified’s Lipedema Tribe is one such community and has become a place to go for resources, information, guidance, and acceptance. Members can share and support others without having to explain: other Tribe members just know.
ConclusionThe holistic approach describes a model where care is concerned with more than the physical side of lipedema management, but also addresses other aspects and looks at the person as a connected whole. A guiding principle is that those with lipedema are not destined to be victims of their own disease, but rather that they have agency and power within their own story.
Lipedema Simplified Heart to Heart Virtual Event ConferenceYour Holistic Roadmap to Living Well with Lipedema and Lymphedemaon September 27, 28 and 29, 2024Patients, caregivers, clinicians, researchers, and vendors are encouraged to join this highly interactive event to gain new insight into life with lipedema, lymphedema, and other lymphatic disorders.Thank you, Wear Ease, Our Gold Sponsor!References
Alwardat, Nuha, et al. (2020). The effect of lipedema on health-related quality of life and psychological status: a narrative review of the literature. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 25, 851-856.
Csikszentmihalyi, M. et al. (2018). Flow theory: Optimizing elite performance in the creative realm.
Dudek, J. et al. (2016). Quality of life in women with lipoedema: a contextual behavioral approach. Quality of Life Research. 25, 401-408.
Dudek, J. et al. (2021) Quality of life, its factors, and sociodemographic characteristics of Polish women with lipedema. BMC Women's Health, 21(1), 1-9.
Ghods, Mojtaba, et al. (2020). Disease progression and comorbidities in lipedema patients: A 10‐year retrospective analysis. Dermatologic Therapy, 33(6), e14534.
Jeziorek, et al. (2023). The effect of a low-carbohydrate high-fat diet on laboratory parameters in women with lipedema in comparison to overweight/obese women. Nutrients, 15(11), 2619.
Keith, L., et al. (2021) Ketogenic diet as a potential intervention for lipedema. Medical Hypotheses, 146, 110435.
Seo, C. (2014). You mean it's not my fault: Learning about lipedema, a fat disorder. Narrative Inquiry in Bioethics 4(2), E6-E9.
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Wear Ease Anti-Fibrotic Compression Garments for the Breast and Torso
Andrea Shirt 960/962
Anti-Fibrotic Axilla Pads!
- Compression Shirt
- Sewn in Quilted Axilla Pad
- Best for lumpectomy or bilateral mastectomy
- No prostheses pockets
- Options:
- 960: Both Pads
- 960R: Right
- 960L: Left
- 962: No Pads
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Katy T, 918 & Axilla Pad, 305
Anti-Fibrotic Axilla Pads!
- Compression T-Shirt
- Treats Thorax/Axilla
- Axilla pocket for removeable quilted pad
- No prostheses pockets
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Karena Bra, 770
Entire Garment Provides Anti-Fibrotic Treatment!
- Textured micromassage fabric
- Thorax/Axilla compression
- Chest pockets for prostheses
- Bust cups included
- Adjustable straps
Karena Bra Effects-
Comfortable - Covers wide area
- Good compression
- No binding
- Easy to put on/take off
- Decreased pain
- Decreased Swelling
- Decreased tissue hardness
- Improved skin texture
- Improved scar/skin appearance
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Wear Ease Anti-Fibrotic Sternum/Genital Pad, 309
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L&R Anti-Fibrotic SwellSpots™ + Wear Ease Compression Bras/Camisoles
Curved Pad SP-01 Breast Pad SP-09 Circular Pad SP-06 
Link to SP-01 Link to SP-09 Link to SP-06 Kidney Pad SP-08 Lateral Pad SP-16-A Full Bra Pad SP-16-B 
Link to SP-08 Link to SP-16-A Link to SP-16-B ____________________________________________________________
*disclaimer: please speak with your therapist, doctor or oncology team regarding any medical concerns, as this is not personalized treatment, but rather general education
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Crisscross Shaper, Style 970, A Summertime Garment
Our Crisscross Shaper is designed with care and precision for women who have undergone breast surgery or experience lymphedema in the torso. Our Compression Camisole is more than just a garment; it's a blend of comfort, support, and elegance, meticulously crafted to meet the unique needs of its wearer.
Key Features of Our Crisscross Shaper (Compression Camisole):
- Targeted Compression: Offering gentle yet effective compression around the underarm, back, and abdomen areas, this camisole is engineered to provide the support you need while facilitating a smoother recovery process and managing lymphedema symptoms with ease.
- Surplice Neckline: Elegance meets functionality with our beautifully designed surplice neckline. This feature not only adds a touch of grace to your wardrobe but also ensures easy wear and comfort, making it a seamless addition to your daily attire.
- A Pretty Alternative: Understanding the importance of feeling good while on your recovery journey, our camisole serves as a gorgeous alternative to a compression bra. It's designed to uplift your spirits and confidence every time you wear it.
- Pocketed for Prostheses: Catering to the post-surgery needs of our wearers, this camisole comes with thoughtfully integrated pockets to securely hold breast prostheses, ensuring you feel comfortable and supported throughout the day.
- UPF 50+ for Sun Protection: We go the extra mile to protect your sensitive skin, especially in areas affected by surgery or treatment. Our fabric boasts UPF 50+ sun protection, shielding you from harmful UV rays and offering peace of mind during outdoor activities.
Who It's For:
This camisole is specially designed for women who have had breast surgery or those dealing with lymphedema in the torso. Whether you're on the path to recovery or seeking everyday support and protection, our Crisscross Shaper offers a blend of therapeutic benefits and graceful design to accompany you every step of the way.
Discover the perfect blend of support, protection, and elegance with our Crisscross Shaper. Experience the comfort and confidence it brings into your life, making it the ideal companion on your journey to wellness and recovery.
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A good defense: Get to know this immune system hero by DEBORAH HERLAX ENOS
The lymphatic system (LS) is often called the
body’s unsung hero because it works hard to
keep us healthy, but most of us don’t know
much about it.
It wasn’t until my oncologist stressed the need
to take care of my LS to avoid lymphedema that
I began researching its importance. If someone
has lymphedema, their LS cannot sufficiently
drain the lymph fluid and swelling occurs, most
often in the arms and legs.
According to Dr. Gerald M. Lemole, author of
the book
Lymph & Longevity
(Scribner, 2021; not
available at Costco), the better your LS runs, the
better your body runs. The LS is the second line
of defense—after skin—against foreign invaders,
such as viruses and bacteria.
Josh Axe, a chiropractor and nutritionist,
explains that “the LS—which consists of nodes
and lymph vessels—is a significant part of your
immune system. Its main jobs include
defending against illnesses and infections and
helping the body eliminate waste and
abnormal cells.”
He adds that “the spleen and thymus are a part
of the LS,” as well as the tonsils and adenoids,
which “help trap pathogens before they can
cause infections.”
According to Axe, the LS:
● Removes harmful bacteria and pathogens from the body
● Produces immune cells
● Removes excess fluids from body tissues and reduces swelling/inflammation.
According to Lemole, the lymphatic system doesn’t have a central engine or pump like the heart,
which pumps blood throughout the circulatory system. Instead, the LS works through pressure,
meaning your lymph fluid primarily moves when you do. When you don’t move, it doesn’t move
much, either.
Increased circulation, including increased blood flow and the flow of lymph fluid, is critical for
removing waste from the body. So, get up and move every hour. Take a short walk around your
house or add some stretches while sitting at your desk.
Another tip: Stay hydrated, but avoid sugary drinks and excess alcohol. The body needs plenty of
water for blood flow and lymphatic drainage.
These simple changes can make a significant difference in your lymphatic system and your
overall health.