Stages of lipedema: how the disease progresses
If you suffer from painful, disproportionately distributed fat deposits on your legs and/or arms, lipedema could be the cause. Lipedema is a chronic condition that can be divided into different stages.
These lipoedema stages serve purely to describe the fat distribution disorder and do NOT provide any information about how severe the pain is. Even a supposedly low stage can be accompanied by considerable discomfort, while a higher stage can be associated with less pain. The varying severity of the symptoms has also led medical associations to refrain from using the lipoedema stages as an indication for surgery.
For this reason, individual consultation is always crucial in order to develop the right treatment approach for each individual patient.
Contents:
- Basics of lipedema stages: What is lipedema?
- The 3 stages of lipoedema at a glance
- The 4 types of lipedema within the stages of lipedema
- How are the different stages of lipedema treated?
- Diagnosis and treatment of lipedema stages at LipoClinic Dr. Heck
- FAQ - Frequently asked questions about the stages of lipoedema
Basics of lipedema stages: What is lipedema?
The lipoedema is a chronic disease that almost exclusively affects women. It is a fat distribution disorder in which there is a symmetrical and painful increase in subcutaneous fatty tissue, particularly on the legs, but also on the hips, buttocks and arms.
Although an estimated 3.8 million women in Germany suffer from it, the condition is still little known. Many sufferers do not even know that they have lipoedema and attribute the lipoedema symptoms to obesity or lack of exercise. Doctors also often fail to recognize the condition or confuse it with lymphoedema or simple obesity.
However, lipoedema is more than just an aesthetic impairment. The fat distribution disorder is accompanied by pain, feelings of tightness and restricted movement and can significantly reduce quality of life. This makes it all the more important to recognize the signs of the lipoedema stages at an early stage and to put yourself in the hands of an experienced specialist.
The 3 stages of lipedema at a glance
For the sake of completeness, we have listed the stage classification as it was used in the past and as it is still used in part by health insurance companies today. However, it should be emphasized once again that the stage of lipedema does NOT allow any conclusions to be drawn about pain/symptoms.
Lipedema stage 1
In lipoedema stage 1often referred to as the initial stage of lipoedema, the skin is still smooth but the subcutaneous fatty tissue is already thickened. You may already feel painful, pressure-sensitive fat pads on your legs or arms. This early stage is often mistaken for being overweight. This makes it all the more important to make the correct diagnosis promptly so that you can start conservative treatment at an early stage.
Lipedema stage 2
The lipoedema stage 2 is characterized by an increasingly uneven, wavy skin surface. Nodular structures in the subcutaneous fatty tissue are now palpable. The legs are clearly thickened and are in disharmony with the slim upper body. The pressure on the lymph vessels increases, which can lead to feelings of tension, heaviness and oedema.
Lipedema stage 3
In advanced lipoedema stage 3 the tissue feels coarse and hard. The skin surface is coarse-knotted and large, overhanging fat flaps, so-called “dewlaps”, form. The increase in circumference on the arms and legs is now very pronounced. Pain and restricted movement continue to increase and put a strain on the joints and spine.
The 4 types of lipedema within the stages of lipedema
In addition to the classification into different stages of lipoedema, the fat distribution disorder can also be divided into four types. This classification is based on which areas of the body are affected by lipoedema.
- Type 1: The subcutaneous fat accumulates mainly around the buttocks and hips. The result is what is known as “saddlebags.”
- Type 2: Lipedema extends to the knees. More fat accumulates on the insides of the knees.
- Type 3: The disease extends from the hips to the ankles. The feet are not affected.
- Type 4: The lipedema now also affects the arms. Wrists and hands are not affected.
Just as with the stages of lipedema, it is important to know which type you have in order to choose the right lipedema treatment.
How are the different stages of lipedema treated?
The lipoedema diagnosis requires the trained eye and the targeted anamnesis and examination of an experienced doctor. Only an early and correct diagnosis can ensure that you receive the optimal treatment for your lipoedema stage.
As the symptoms of lipoedema are independent of the stages, liposuction can also be the treatment of choice at an early stage. Patients who show few external changes are often not taken seriously by inexperienced doctors. It is therefore all the more important to consult a doctor with experience in diagnosing lipoedema. Only then can an individual lipoedema treatment can be created.
Diagnosis and treatment of lipedema stages at LipoClinic Dr. Heck!
As a pioneer in the surgical treatment of lipedema, LipoClinic Dr. Heck is a world leader with over 2500 successful operations every year. Our specialized team guarantees safe and effective long-term treatment of lipoedema using clinically proven and scientifically documented surgical standards.
Liposuction can be useful even at stage 1 to slow down the progression of the disease and alleviate symptoms. In the advanced stages of lipedema (stages 2 and 3), surgical treatment is often the only way to reduce the massive fat deposits, alleviate pain, and significantly improve quality of life.
In a personal consultation, we will be happy to inform you in detail about the possibilities of liposuction and create an individual treatment plan for you.
Would you like to learn more about our holistic approach or join one of the LipoTalks with other people affected? Then simply contact us now contact to us now!
FAQ - Frequently asked questions about the stages of lipoedema
What are the different stages of lipoedema?
Lipoedema is divided into three stages, which describe the visual and structural condition of the fatty tissue. However, these stages say nothing about the intensity of the pain. Severe discomfort can also occur at a low stage.
Are all stages of lipedema the same?
No, the course of the disease is individual. Some sufferers remain at an early stage for a long time, while the disease progresses more quickly in others. Factors such as hormonal changes or lack of treatment can influence the course of the disease.
Can I recognize for myself what stage of lipoedema I am in?
Patients usually find it difficult to classify the stages as they are often not visually clear. Only an experienced doctor can correctly classify the tissue structure, skin changes and symptoms. A professional diagnosis is therefore necessary.
Are there differences between the stages of lipedema in the arms and legs?
The staging generally applies to both body regions. However, lipoedema on the arms is usually less pronounced or appears later. A precise medical examination helps to determine the individual severity.
Does the stage of lipedema play a role in the approval for surgery?
Medical societies are explicitly opposed to making an indication for surgery based on the stage alone. What counts is the individual symptoms – such as pain, restricted movement or quality of life.
Draco (2025): Lipedema: Diagnosis, clinical picture, therapy. > Open source
Funke, S., Kuhlmann, C., Taha S. et al. (2023): In search of evidence: a systematic review of the pathology of lipedema. > Open source
Reviewed by Dr. med. Thomas Witte
Dr. Thomas Witte is Medical Director of LipoClinic Dr. Heck and a specialist in plastic and aesthetic surgery. With decades of surgical experience and a deep understanding of the individual needs of lipoedema patients, he is one of the leading experts in this field. His focus is on holistic, safe and empathetic care – always with the aim of restoring quality of life.
Dr. med. Thomas Witte
Medical Director
Specialist in plastic and aesthetic surgery
Specialist in surgery and hand surgeon
