Lipoedema treatment – relieving symptoms, strengthening quality of life Taking pain seriously, understanding treatment: personal consultation and water-jet-assisted liposuction (WAL) at Park-Klinik Birkenwerder near Berlin.

Lipoedema is a chronic, usually painful disorder of the subcutaneous fatty tissue. Typical is an increase in fatty tissue, often on both sides, that is conspicuous in relation to the trunk, on the legs and possibly the arms. Hands and feet are usually spared. The condition mainly affects women. The course varies from person to person; changes may be noticed, among other things, in the context of hormonal changes, for example during puberty or after pregnancy.

Lipoedema is not the same as ordinary excess weight or lymphoedema. Other causes of swelling, pain and changes in circumference must also be ruled out. Not every unequal body proportion automatically means lipoedema.

Several typical features may point to lipoedema. The following checklist does not replace a medical diagnosis, but it helps to organise symptoms for an examination:

• Legs or arms look conspicuously voluminous in relation to the waist and upper body.
• The changes often affect both sides; hands and feet are usually not affected.
• The tissue hurts when pressed or touched.
• The legs feel heavy or tight, especially after standing for a long time.
• Bruises appear comparatively easily.
• Walking or standing for longer periods, or certain movements, become difficult.
• Clothing, boots or sleeves fit poorly in the affected regions.
• Symptoms or changes in circumference were noticed, for example, during a hormonal change.
• Similar symptoms may occur in the family.

Not all points have to apply. Bruising, dimples, a feeling of coldness or the absence of weight loss in particular are not proof on their own. What matters is the whole picture of pain, distribution pattern and clinical findings.

In the past, lipoedema was often described in three stages according to the appearance of the skin and tissue: stage I with a rather smooth skin surface and fine tissue structure, stage II with more marked unevenness and nodules, and stage III with pronounced tissue enlargement and larger skin-fat folds. Terms such as involvement of the hips, thighs, lower legs or arms also describe the affected regions.

These visual classifications are not equivalent to the extent of pain or the need for treatment. Current medical assessment is based largely on symptoms, functional limitations and the individual findings. We therefore do not use the former “five types” of the previous LipoKlinik website as a binding diagnostic classification.

Lipoedema treatment takes into account your symptoms, your everyday life, accompanying conditions and previous therapies. Conservative measures can reduce pain and support mobility. These include suitable exercise – such as swimming, water exercise, walking or cycling –, individually fitted compression, self-management and, where appropriate, weight management in the case of additional excess weight. Manual lymphatic drainage can be a useful addition where indicated, but is not necessary for every patient.

If considerable symptoms remain despite suitable conservative treatment, liposuction may be considered. It is intended to reduce the affected portions of fatty tissue and above all to relieve symptoms. It does not replace every other therapy, is not primarily intended for weight loss and is not a guaranteed cure.

Often the focus is on the thighs and lower legs, the inner knees, the hips or the arms. Not all affected regions have to be treated in one session. With larger treatment volumes, a staged operation can make medical sense. Together we clarify which symptoms are in the foreground and which treatment steps are appropriate.

After a larger reduction of fatty tissue the question often arises of how the skin will retract. In addition to WAL, a minimally invasive laser treatment to support tissue tightening can be considered in selected cases. The procedure works with controlled heat energy. Whether your individual skin condition is suitable is something we assess in the consultation.

An additional laser treatment is not a necessary standard therapy for lipoedema and cannot guarantee any particular degree of tightening. Benefits, limits, thermal risks and additional costs are discussed separately. As a guide for the additional laser tightening we state from 1.500 €. More on the page laser tightening.