BACKGROUND
Lipedema is a chronic adipose tissue disorder associated with pain, tissue fibrosis, and functional impairment. Evidence supporting nutritional strategies and adjunctive local treatments remains limited.
CASE REPORT
A 47-year-old woman with stage 3/type III lipedema and obesity underwent an individualized ketogenic, carbohydrate-restricted, normoprotein dietary phase for 7 months. This was followed by a 4-month local intervention phase including 4 monthly sessions of multipuncture administration of autologous platelet-rich plasma after ex vivo photothermal biomodulation with blue light (467 nm, 2 J/cm², 37°C, 10 min). Body composition was assessed by bioelectrical impedance analysis, fat thickness by ultrasonography, pain by visual analog scale, and patient-reported global aesthetic improvement at the final visit. Over 11 months, body weight decreased from 103.4 to 72.0 kg, body mass index from 37.1 to 25.8 kg/m², fat mass from 47.2 to 23.2 kg, and visceral fat level from 12 to 6. Subcutaneous, preperitoneal, and omental fat thickness also decreased. Pain decreased from 9/10 at baseline to 5/10 at final assessment; patient-reported global aesthetic improvement was 5/5, and no adverse events were documented.
CONCLUSIONS
Most objective changes occurred during the dietary phase. During the local intervention phase, the diet continued to be modified, and body weight decreased further, confounding attribution of second-phase outcomes specifically to photothermal biomodulated platelet-rich plasma. Pain was not assessed at the end of the dietary phase. Therefore, the independent contribution of photothermal biomodulated platelet-rich plasma to second-phase outcomes cannot be determined. This case should be interpreted as a descriptive report rather than as evidence of efficacy, mechanism, or additive benefit.

Keywords: Lipedema; Low-Level Light Therapy; Platelet-Rich Plasma; Ultrasonography