Lipedema stage 3: symptoms, treatment and cost coverage

Many women know it: Despite regular exercise and a conscious diet, they simply do not lose weight, but – quite the opposite – continue to gain weight uncontrollably and disproportionately. They experience tension pains in the arms and legs, even when completely at rest, and even the smallest tasks in everyday life are difficult. It is possible that they already have stage 3 lipedema. In order for those affected to be able to alleviate their daily complaints in the best possible way, a targeted treatment is necessary – which is first preceded by a clear diagnosis.

We at LIPOCURA® would like to finally give our patients new self-confidence and a pain-free life. We understand the special situation of lipedema fighters and always take them seriously. In the following, we explain the special features of lipedema stage 3 and present suitable treatment options.

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What is stage 3 lipedema?

Stage 3 lipedema is the most advanced form of chronic fat distribution disorder. Lipedema is a disease in which – almost exclusively in women – disproportionate fat distribution occurs in certain regions of the body. It usually affects the legs and almost always the arms as well. In stage 3, the lipedema is already very pronounced and there are clear changes in the appearance as well as sometimes massive complaints such as pain and feelings of tension. Often it is a mixed form: patients think it is obesity and in reality it is lipedema. This explains why weight loss is not successful.

In the third stage, lipedema is usually manifested by very hardened subcutaneous tissue and considerable fat flaps, which in turn restrict movement and can cause chafing and inflammation in the skin folds. In addition, self-confidence suffers in many sufferers, in some cases to the point of social isolation and severe depression. As the disease is still quite unknown in society, many lipedema fighters encounter a lack of understanding for their situation, as lipedema is confused with obesity.

Lipedema stage 3 – images

The appearance and symptoms of lipedema can vary from patient to patient. In the advanced stage, lipedema means significant restrictions for those affected.

This is what stage 3 lipedema can look like:

Ursachen und Unterschiede Lipödem Stadium 1 und 2

Causes and difference to lipedema stages 1 and 2

The exact causes of lipedema are not yet fully understood. However, it is assumed that hormonal changes, genetic factors, a microangiopathy and a disturbed fat metabolism regulation play a role. What is certain, however, is that lipedema is not caused by a lack of exercise or a poor diet. These factors can only contribute to the further worsening of the disease. If you are overfed at the same time, so that you have a mixed form of obesity and lipedema, it is possible to reduce the diet-related fat. However, this is much more difficult for these patients than in the case of pure obesity.

Compared to stage 1 or 2 lipedema, stage 3 lipedema already involves more extensive fat deposits, some of which have already been transformed into fibrous tissue (which can no longer be suctioned off). The affected areas of the body may be greatly enlarged and so-called fat bulges may form. The total weight and the shifted leg axis caused by the fat deposits on the inside of the legs lead to premature wear and tear of the joints. As a result, arthrosis develops. The disproportionate distribution of fatty tissue is clearly visible, especially on the extremities.

Symptoms of stage 3 lipedema

Lipedema is a progressive fat distribution disorder. This means that the symptoms also increase with time and changing stage. In stage 3, symptoms include:

  • Large fat deposits: The legs or arms are greatly enlarged and have disproportionate fat distribution. Often the affected regions are heavier than the rest of the body. The hands and feet are proportionally very slim.
  • Hardened tissue: The subcutaneous fatty tissue is clearly hardened and sensitive to pressure.
  • Fat bulges: The fat flaps hang down on the inner sides of the upper arms and thighs and can put additional strain on the joints due to their weight. Chafing, chafed areas, fungal infections and inflammation are also common side effects.
  • Tightness and pain: The skin can be tight and sensitive. Affected people often complain of pain, both to the touch and at rest, as well as a feeling of coldness when standing or walking for long periods of time.
  • Lymphoedema: Secondary lymphoedema usually occurs due to the heavy weight.

In the third stage, adapted treatment is absolutely necessary.

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Patient experience – This is what stage 3 lipedema looks like

The experiences of our patients with stage 3 lipedema can vary greatly from person to person. Some sufferers report severe restrictions in everyday life, both physically and psychologically. The appearance of the legs or arms can cause considerable stress and affect self-confidence. However, a pattern can usually be recognised here. But take a look for yourself:

At LIPOCURA®, our top priority is to give you, the person affected, a new zest for life by means of holistic lipedema treatment. Our treatment concept is specially tailored to your needs in order to achieve optimal results. Many of our patients have already gained increased self-confidence through our holistic care and have been able to significantly alleviate or even completely eliminate their symptoms. We always strive to help you live a full and happy life, despite the challenges of stage 3 lipedema.

Take a look at the patient story of LIPOCURA® patient Diana. She came to us with stage 2-3 lipedema and tells us about her experiences with the disease.

Patient story Diana

The diagnosis of stage 3 lipedema

The diagnosis of advanced stage 3 lipedema can usually be made relatively easily by a medical specialist who specialises in lipedema and often has the additional title of phlebologist and lymphologist. In particular, a specialist in phlebology (vein doctor) or a specialist who specialises in lipedema have the necessary knowledge and experience to make an accurate diagnosis.

Diagnosis of stage 3 lipedema is usually made by the following procedures:

The diagnostic interview usually begins with questions about existing symptoms and possible previous illnesses. It is determined whether you experience pain, feelings of tension or increased sensations of pressure and cold. Information about other lipedema cases in your family can also be helpful.

A specialist can often make a probable diagnosis of stage 3 lipedema just by looking at the lipedema-typical areas with disproportionate fat deposits, clearly hanging skin flaps and thickened joints.

The pressure and the sensitivity to touch can be measured with a pinch test. Furthermore, the subcutaneous fatty tissue structure can be determined by palpation. In third-stage lipedema, the hardened subcutaneous fat tissue can be clearly palpated.

Behandlung eines Lipödems in Stadium 3

Treatment of very advanced lipedema

Conservative therapy can help relieve symptoms and slow the progression of stage 3 lipedema – but it cannot be prevented. Through physical therapies such as

  • manual lymphatic drainage,
  • Compression therapy and
  • Exercise therapy

can improve the lymph flow and reduce the symptoms somewhat. An adapted diet can also have a supportive effect. However, you should be aware that conservative therapy alone is often not sufficient to effectively treat lipedema in advanced stages. Also, the aesthetic appearance cannot be changed in this way. In such cases, liposuction can be considered as an effective surgical option.

In advanced stage 3 of lipedema, severe discomfort often occurs, which means that conventional conservative therapy measures often reach their limits. In such cases, liposuction can be considered as a possible solution. Liposuction for lipedema is currently the only method to completely remove diseased fatty tissue in the long term. This means that lipedema surgery is also a solution for adjusting the contours of the body and thus giving patients new self-confidence in an aesthetic sense as well.

In some cases, liposuction can even achieve complete freedom from symptoms. Our experienced LIPODOCs perform liposuction on lipedema patients in all stages and are at your disposal with their specialist knowledge and experience. We understand the distressing effects of stage 3 lipedema and are committed to helping you achieve an improved quality of life. If obesity is present, we will support you in the first step of trying to lose weight with a special diet, which can also be successful with lipedema.

Find out more about liposuction on our services page and in a personal consultation in our specialist centres.

What happens if lipedema is left untreated?

If stage 3 lipedema is left untreated, symptoms may continue to worsen. The fat deposits can continue to increase, which can lead to an even greater impairment of body shape and mobility. The pain and tightness may increase, and there is an increased risk of developing lipolymphoedema, infections and other complications. In addition, untreated lipedema can have a significant impact on the psychological well-being of those affected, as it can lead to a negative body image, low self-esteem and social isolation.

Living with stage 3 lipedema

Living with stage 3 lipedema can be challenging, but you are not alone. There is now a large lipedema community that offers advice, tips and tricks, shares experiences and celebrates joint successes.

You can incorporate the following tips into your everyday life:

  • Diet and exercise:
    To manage the symptoms of stage 3 lipedema, a healthy lifestyle with a balanced diet and regular physical activity is very important. Eat nutrient-rich, low-carbohydrate foods and avoid alcohol and nicotine. Relieving sports such as swimming or aqua gymnastics have a positive effect on the joints.
  • Be aware of temperature fluctuations:
    Extreme temperatures can have a negative effect on the symptoms of stage 3 lipedema. It is therefore advisable to avoid both intense heat and extreme cold.
  • Compression:
    An effective measure to alleviate the symptoms of very advanced lipedema is the regular wearing of suitable compression garments. The pressure that the compression garment exerts on the tissue can counteract swelling. Be sure to wear the compression garment regularly and ensure that it fits correctly to get the best possible effect.

Learn more about living with lipedema here!

Will the costs of lipedema surgery be covered?

The cost of liposuction to treat stage 3 lipedema can depend on a number of factors, including the type of surgery and individual health insurance. In a decision from 2020, liposuction for stage 3 lipedema became a health insurance benefit for a limited period of time. This means that the chances are very good that the costs will be covered. However, very precise guidelines and all requirements, such as the advanced stage and at least 6 months of conservative therapy without significant relief of symptoms, must be met. The BMI, for example, must also be below 35.

It is advisable to contact the health insurance company in advance and obtain information on cost coverage. In some cases, cost sharing by the patient may also be required.


Lipedema stage 3 – Your consultation with LIPOCURA®.

You are not alone! At LIPOCURA® we welcome women every day who want to fight lipedema. We are happy to help these sufferers – and therefore also you – on your way to a new carefree life. Our lipedema specialists look forward to welcoming you for a personal consultation at one of our numerous locations throughout Germany. Make an appointment now.

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LIPOCURA® Frankfurt - Eterno Health


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