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For many affected individuals, the diagnosis of lipedema is the first step on the road to recovery—and at the same time, it raises many questions and uncertainties. It is important to us to support our patients professionally, empathetically, and comprehensively from the very beginning.
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Dr Katrin Lossagk is a highly specialised lipedema expert and founding member and medical director of LIPOCURA®. Research into the clinical picture and a holistic treatment approach are particularly close to her heart.
Dr. med. Katrin Lossagk
Medical director Specialist for plastic and aesthetic surgery
Table of contents
The diagnosis begins with a detailed medical history. Often, lipedema can be suspected based on a patient’s medical history, especially if similar conditions have already occurred in the family. We take plenty of time to get to know you and your medical history in order to gain a thorough understanding of your condition. On this basis, we can focus on where you need help. Learn more about the definition of lipedema.
The medical history is followed by a physical examination. The affected areas are inspected and palpated. A typical indication is the symmetrical occurrence of fat accumulation on the arms or legs. The lipedema pinch test is a simple but effective means of initial assessment: if there is a significantly increased sensitivity to pain on the outside of the thighs compared to the inside, this may indicate lipedema.
Palpation often reveals hardened or nodular structures in the subcutaneous fatty tissue that are characteristic of lipedema. Increased sensitivity to pressure and a tendency to bruise also support the clinical assessment.
The 3D body analysis with the MyLIPOAvatar complements specialist medical diagnostics by providing a precise digital representation of the body. Unlike individual photos or circumference measurements, the 3D body scan provides a holistic view of proportions, contours, and abnormalities. This allows the current findings to be clearly documented and better contextualized. The scan does not replace a medical diagnosis but provides an additional basis for consultation, follow-up monitoring, and treatment planning.
Lipedema must be clearly distinguished from other similar conditions:
An examination by an experienced specialist is essential for a definitive diagnosis of lipedema. Nevertheless, measuring the waist-to-hip ratio provides those affected with useful initial guidance, as it takes fat distribution into account and can therefore provide meaningful indications of a pathological fat distribution disorder.
Ultrasound examination cannot clearly distinguish lipedema from healthy fatty tissue, but it does provide valuable additional information. That is why we at LIPOCURA® use sonography specifically to supplement clinical examination in order to objectively assess the density and structure of fatty tissue. In patients with lipedema, ultrasound often reveals a wavy, nodular structure comparable to so-called “fat tissue granules.” These findings help us plan the subsequent therapy.
Another important component is the standardized measurement of tissue thickness in the subcutaneous fat tissue (subcutis) and the overlying skin layer (cutis). This sonographic assessment makes it possible to objectively determine the extent of fat tissue proliferation and better classify the severity of lipedema.
At LIPOCURA®, we use the classification system developed by Marshall and Sehwahn-Schreiber, which distinguishes between the following stages:
These measurements are not only diagnostically relevant for us, but also serve as the basis for individualized and precise treatment planning.
Stemmer sign is used to detect lymphedema. It involves attempting to lift a skin fold above the second and third toes. If this fold is thickened, difficult to lift, or cannot be lifted due to tissue hardening, Stemmers’ sign is positive and indicates lymphedema.
A negative result does not rule out lymphedema, but it can reduce suspicion—especially in combination with other findings.
In practice, the test is used as part of an overall picture—not as the sole basis for a decision.
If preliminary findings are already available or there are uncertainties, it may be advisable to seek a second opinion from an experienced specialist. It is important to us that our patients can rely on an accurate diagnosis as the basis for the best possible treatment.
As founders of EuSoLip, we offer you a professional assessment based on the latest, Europe-wide coordinated quality standards.
For many patients, a Lipedema diagnosis is far more than a medical classification. It can significantly alleviate years of uncertainty, self-doubt, and the feeling that their symptoms have not been taken seriously. When the symptoms are finally named and understood correctly, patients often gain clarity for the first time about what is really causing the changes in their bodies.
This is precisely why an early diagnosis is so important. It provides the foundation for beginning appropriate treatment promptly and preventing the condition from worsening further. The earlier typical signs are assessed by a specialist, the better the symptoms can be evaluated and the next treatment steps planned.
Would you like to have your symptoms assessed, or would you like a second opinion regarding an existing diagnosis? The specialists at LIPOCURA® are here to listen and will take you and your symptoms seriously. You are welcome to schedule an appointment at our clinic.
NOTE: Lipedema is a serious condition that can, of course, affect not only women but also transgender, non-binary, and intersex people. All patients are welcome at our specialist centers.
The diagnosis is made through a clinical examination that looks for typical symptoms such as symmetrical fat accumulation, pressure pain, and a tendency to develop hematomas. In addition, a pinch test and, if necessary, imaging procedures can be used to rule out other diseases.
It is possible for lipedema and lymphedema to occur simultaneously, which is then referred to as lipo-lymphedema. Lipedema that remains untreated for a long period of time can lead to lymphedema, which is why early detection and treatment tailored to the individual affected are extremely important. In addition, lipedema is often misdiagnosed as lymphedema due to its relative obscurity.
Lipedema and lymphedema are both tissue disorders that can cause swelling. Despite their similar names and the frequent risk of confusion, they differ in their causes and signs.
Ideally, lipedema is diagnosed by specialists with experience in this condition. These include phlebologists, lymphologists, and specialists in plastic and aesthetic surgery with relevant expertise. Dermatologists and angiologists can also provide a well-founded initial assessment. What matters most is that the treating physician has extensive experience in the differential diagnosis of fat distribution disorders, as also recommended by the current guideline.
At present, there is no specific blood test or imaging procedure that can definitively confirm lipedema. According to a review article in PubMed Central, the diagnosis remains primarily clinical. However, ultrasound can be used as an additional tool to measure tissue thickness and to rule out associated conditions such as lymphedema. MRI is also being discussed in research, but so far it has not become established as a standard procedure in routine diagnostics.
In lipedema, the main feature is a pathological increase in fatty tissue, whereas lymphedema is primarily characterised by impaired lymphatic drainage, resulting in swelling. One key distinguishing feature is that in lipedema the hands and feet usually remain slim, while in lymphedema these areas may also be affected. In addition, lipedema always occurs symmetrically, whereas lymphedema can also appear on only one side. In advanced stages, lipedema can develop into what is known as lipo-lymphedema, where both conditions occur together. A precise differential diagnosis by a specialised physician is therefore essential.
Back to life – Anna
From Anna – a patient at LIPOCURA®
A Milestone in Lipedema Treatment: LIPLEG Study Published in…
A Milestone in Lipedema Treatment: LIPLEG Study Published in “The Lancet”
From Dr. med. Katrin Lossagk
Preparation for lipedema surgery
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