{"id":20934,"date":"2025-08-12T15:40:22","date_gmt":"2025-08-12T15:40:22","guid":{"rendered":"https:\/\/venaziel.de\/lipedema-center\/lipoedema-diagnosis-how-to-recognize-the-disease-early-and-avoid-misdiagnosis\/"},"modified":"2026-04-10T17:03:46","modified_gmt":"2026-04-10T17:03:46","slug":"lipoedemdiagnose","status":"publish","type":"page","link":"https:\/\/venaziel.de\/en\/lipoedemzentrum\/lipoedemdiagnose\/","title":{"rendered":"Lipoedema diagnosis: How to recognize the disease early &#8211; and avoid misdiagnosis"},"content":{"rendered":"<h2><b>True stories: Patients live with uncertainty for a long time<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Many lipoedema patients have a long <\/span><b>long odyssey<\/b><span style=\"font-weight: 400;\">  behind them. They sense that something is wrong with their body \u2013 their legs are painful and disproportionately strong \u2013 but they often receive no clear answer for years. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Lipoedema is often mistaken for <\/span><b>overweight<\/b><span style=\"font-weight: 400;\">  or dismissed as a lymphatic problem. Such <\/span><b>Misdiagnoses<\/b><span style=\"font-weight: 400;\">  lead to those affected living with uncertainty and self-doubt for a long time. During this time, many try in vain to lose weight or follow other advice that, in the case of a real lipedema, <\/span><b>bring no relief<\/b><span style=\"font-weight: 400;\"> bring.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">They only learn about the actual clinical picture years later <\/span><i><span style=\"font-weight: 400;\">lipedema<\/span><\/i><span style=\"font-weight: 400;\">  \u2013 and are often relieved to finally have an explanation for their agonizing symptoms. The realization of suffering from a real (and treatable) disease can be psychologically relieving and the starting point for effective therapy.<\/span><\/p>\n<h3><b>What you will learn in this article \u2013 incl. Delineations &amp; clinical procedures<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">In this guide, our specialist explains <\/span><b>how you can recognize lipedema at an early stage<\/b><span style=\"font-weight: 400;\"> and why a quick <\/span><b>diagnosis<\/b><span style=\"font-weight: 400;\">  is so important. Among other things, you will learn:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Typical symptoms and signs:<\/b><span style=\"font-weight: 400;\"> Which symptoms and changes indicate lipoedema.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Differentiation from other diseases:<\/b><span style=\"font-weight: 400;\"> How lipedema differs from normal obesity or lymphedema &#8211; and how you can avoid misdiagnosis <\/span><b>avoid misdiagnosis<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Medical diagnostic procedures:<\/b><span style=\"font-weight: 400;\"> What steps the doctor takes to diagnose <\/span><i><span style=\"font-weight: 400;\">lipoedema diagnosis<\/span><\/i><span style=\"font-weight: 400;\"> (medical history, physical examination and further tests if necessary).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>No snap judgment:<\/b><span style=\"font-weight: 400;\"> Why the BMI or the scales alone are not enough to diagnose lipoedema and why specialist doctors (phlebologists\/lymphologists) are often the best address.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">With this knowledge, you are well prepared to <\/span><b>recognize the early warning signs<\/b><span style=\"font-weight: 400;\">  and to ask the right questions to the doctor if necessary. This is because lipoedema is an independent disease with clear characteristics &#8211; the sooner it is recognized, the better the symptoms can be alleviated.<\/span><\/p>\n<h2><b>Recognizing lipoedema &#8211; What are the typical signs?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">How do you recognize lipedema? There are  <\/span><b>several typical signs<\/b><span style=\"font-weight: 400;\">, which occur together. Each patient is individual, but the following symptoms occur particularly frequently (and often in combination) with lipedema. Important: Not every symptom alone immediately means lipedema \u2013 but the <\/span><b>A combination of the following features<\/b><span style=\"font-weight: 400;\"> is a clear indication.<\/span><\/p>\n<h3><b>Pain, tenderness and a feeling of tension<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">An <\/span><b>important alarm sign<\/b><span style=\"font-weight: 400;\"> of lipedema are <\/span><a href=\"https:\/\/www.phlebology.de\/patienten\/venenkrankheiten\/lipoedem\/#:~:text=,und%20bleibt%20deshalb%20lange%20unerkannt\" target=\"_blank\" rel=\"noopener\"><b>Pain in the legs<\/b><\/a><span style=\"font-weight: 400;\">  \u2013 something that does not occur with pure obesity. Typical is a <\/span><b>High sensitivity to pressure<\/b><span style=\"font-weight: 400;\">Even light touches or gentle pressure can hurt. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Many sufferers also describe a constant <\/span><b>feeling of tension<\/b><span style=\"font-weight: 400;\">  in the legs, as if the tissue is under pressure. This feeling of <\/span><i><span style=\"font-weight: 400;\">heavy, tense legs<\/span><\/i><span style=\"font-weight: 400;\"> often persists even after resting. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Without external influence, spontaneous <\/span><b>dull pain<\/b><span style=\"font-weight: 400;\">  occur, which often worsen in the evening or after prolonged standing and sitting. So if you notice that your legs <\/span><b>hurt disproportionately when touched<\/b><span style=\"font-weight: 400;\"> and feel constantly tense, you should pay attention.<\/span><\/p>\n<h3><b>Symmetrical fat distribution &#8211; legs, hips, arms if necessary<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Lipoedema can be recognized by the <\/span><b>characteristic distribution of fat<\/b><span style=\"font-weight: 400;\"> on the body. <\/span><b>Both halves of the body are equally affected<\/b><span style=\"font-weight: 400;\">: excessive fat is usually deposited on <\/span><i><span style=\"font-weight: 400;\">legs, hips and buttocks<\/span><\/i><span style=\"font-weight: 400;\"> and indeed <\/span><b>symmetrically<\/b><span style=\"font-weight: 400;\"> on both sides. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">The upper half of the body (waist, upper body) often remains slimmer in comparison. It is noticeable that <\/span><b>Hands and feet not affected by lipedema<\/b><span style=\"font-weight: 400;\">  are. The fat pads end at the wrists at the top and at the ankles at the bottom \u2013 a difference from lymphedema, in which the feet often swell as well. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">This often creates a disproportion in lipoedema patients. <\/span><b>disproportion<\/b><span style=\"font-weight: 400;\">: slim upper body, but strong legs (one also speaks of the <\/span><i><span style=\"font-weight: 400;\">&#8220;saddlebags phenomenon&#8221;<\/span><\/i><span style=\"font-weight: 400;\"> in the hip-thigh area).<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In some cases (about <\/span><a href=\"https:\/\/www.phlebology.de\/patienten\/venenkrankheiten\/lipoedem\/#:~:text=Suavenhosen,tritt%2C%20kommt%20nur%20selten%20vor\" target=\"_blank\" rel=\"noopener\"><b>30 % of those affected<\/b><\/a><span style=\"font-weight: 400;\">) the <\/span><b>arms<\/b><span style=\"font-weight: 400;\">  affected by lipedema. Then symmetrical fat deposits also appear on the upper and lower arms, while the hands and fingers remain slim. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">The symmetry is crucial: Both legs (and possibly both arms) are evenly thickened. This bilateral distribution and the sparing of hands and feet clearly distinguishes lipedema from other diseases. So if you <\/span><b>uniform fat pads<\/b><span style=\"font-weight: 400;\"> on the legs or arms that do not match the rest of the body could be an indication of lipoedema.<\/span><\/p>\n<h3><b>Hematomas and sensitivity &#8211; warning signs of the disease<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Another <\/span><b>warning signal<\/b><span style=\"font-weight: 400;\"> are <\/span><b>conspicuously frequent bruising<\/b><span style=\"font-weight: 400;\">  on legs or arms. Lipedema patients tend to <\/span><b>hematomas<\/b><span style=\"font-weight: 400;\"> (bruising) can develop. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">The small blood capillaries in the diseased fatty tissue are more fragile; even a slight bump \u2013 which you may not even consciously notice \u2013 can cause a visible bruise. So if you find that you <\/span><b>get bruises disproportionately often<\/b><span style=\"font-weight: 400;\"> on your legs without remembering an injury, you should be alert.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">At the same time, the skin in the affected areas is often <\/span><b>hypersensitive<\/b><span style=\"font-weight: 400;\">. Many sufferers report that even gentle touches or light pressure  <\/span><b>unpleasant or painful<\/b><span style=\"font-weight: 400;\"> are. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">This combination of <\/span><b>rapid bruising and high sensitivity to touch<\/b><span style=\"font-weight: 400;\">  is typical of lipedema. As a rule, these signs are not found in simple obesity. So, should you notice unexplained hematomas and your legs are sensitive to touch and painfully tense, this is a clear indication that a doctor should clarify. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">An early lipoedema diagnosis can confirm whether these warning signs are actually due to lipoedema &#8211; and helps to avoid misdiagnosis.<\/span><\/p>\n<h2><b>Medical diagnostic procedures for lipedema<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">The diagnosis of lipedema is primarily clinical \u2013 a special laboratory test or individual marker does not exist. Therefore, a detailed discussion with the patient and a careful physical examination are crucial. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Typical findings and simple clinical tests help to differentiate lipoedema from other diseases. <\/span><b>Imaging procedures<\/b><span style=\"font-weight: 400;\"> such as ultrasound, CT or MRI are only useful in certain cases, usually to rule out concomitant diseases.<\/span><\/p>\n<h3><b>Medical history &amp; consultation &#8211; focus on your complaints<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">At the beginning there is a detailed <\/span><b>anamnesis<\/b><span style=\"font-weight: 400;\">, in which the doctor asks about the medical history and current complaints. The discussion will include topics such as <\/span><b>since when<\/b><span style=\"font-weight: 400;\"> the changes have existed and whether there were any triggering factors &#8211; lipoedema often occurs for the first time during hormonal upheaval phases such as <\/span><b>puberty, pregnancy or the menopause<\/b><span style=\"font-weight: 400;\"> occurs. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">It is also important to know whether other <\/span><b>family members<\/b><span style=\"font-weight: 400;\">  (mother, grandmother) had similar fat distribution problems. A central topic is the <\/span><b>Symptoms<\/b><span style=\"font-weight: 400;\">Lipedema patients often report <\/span><b>pain, a feeling of pressure or heaviness<\/b><span style=\"font-weight: 400;\"> in the legs, sometimes spontaneous, sometimes when touched. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">The pain is categorized more precisely (e.g. dull aching or stabbing, pain scale) and the patient is asked whether <\/span><b>sensitivity to pressure<\/b><span style=\"font-weight: 400;\">  exists and how pronounced it is. Also a noticeable <\/span><b>Tendency to bruising<\/b><span style=\"font-weight: 400;\"> (hematomas) without adequate trauma is a typical sign that is asked about.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Another criterion in the conversation is the <\/span><b>distribution of the swellings<\/b><span style=\"font-weight: 400;\">If the fat pads occur <\/span><b>symmetrical<\/b><span style=\"font-weight: 400;\">  on both legs (and possibly arms)? Stay <\/span><b>Feet and hands<\/b><span style=\"font-weight: 400;\"> free? Lipedema almost always affects both legs (and often both arms) evenly, while the feet\/toes remain slim. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">In contrast to lymphoedema, for example, lipoedema symptoms do not <\/span><b>do not depend on the time of day or elevation<\/b><span style=\"font-weight: 400;\">  to or from \u2013 that is, the leg circumferences are not significantly different in the morning than in the evening. These details are asked in order to differentiate lipedema from venous or lymphatic edema. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">It is also asked whether the legs feel noticeably thinner in the morning and swell during the course of the day &#8211; an indication that would speak against lipedema and rather point to other types of edema.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The medical history also includes <\/span><b>Weight and nutritional history<\/b><span style=\"font-weight: 400;\">. The patient is asked whether  <\/span><b>overweight<\/b><span style=\"font-weight: 400;\"> is or has been in the past <\/span><b>Diets<\/b><span style=\"font-weight: 400;\">  were tried and with what success. Typically, lipoedema sufferers report that they  <\/span><i><span style=\"font-weight: 400;\">retain their disproportionately thick legs\/arms despite losing weight<\/span><\/i><span style=\"font-weight: 400;\">  \u2013 losing weight is extremely difficult in the lipedema areas. As a result, a disproportion between a slim upper body and strong legs often remains. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">This information helps to distinguish lipedema from pure obesity. In addition, the doctor inquires about the <\/span><b>Psychosocial stress level<\/b><span style=\"font-weight: 400;\">The unusual body shape and chronic pain often lead to psychological stress, self-esteem problems or social withdrawal. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Therefore, questions are asked about mood, possible depression or anxieties that go hand in hand with the body image. All of this information together \u2013 family predisposition, hormonal triggers, typical pain, tendency to hematomas, diet resistance and psychological effects \u2013 already provide important clues to lipedema in the conversation.<\/span><\/p>\n<h3><b>Physical examination &#8211; inspection &amp; palpation<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">The medical history is followed by a thorough <\/span><b>physical examination<\/b><span style=\"font-weight: 400;\">. First, general values are recorded: Blood pressure, pulse and body measurements (weight, height) to calculate the  <\/span><b>BMI<\/b><span style=\"font-weight: 400;\"> and measurement of the <\/span><b>waist-to-hip or waist-to-height ratio<\/b><span style=\"font-weight: 400;\">to assess possible overweight and fat distribution. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Lipoedema patients usually show a clear <\/span><b>difference<\/b><span style=\"font-weight: 400;\"> between a slim upper body and voluminous legs\/hips &#8211; the proportions appear <\/span><b>dysproportional<\/b><span style=\"font-weight: 400;\">. The doctor pays attention to the  <\/span><b>Examination<\/b><span style=\"font-weight: 400;\"> (observation) in particular on this disproportionate fat accumulation in the extremities. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">An abrupt transition at the ankles and wrists is often noticeable. <\/span><b>Feet and hands are slender<\/b><span style=\"font-weight: 400;\">while the tissue directly above is more extensive (so-called <\/span><b>collar phenomenon<\/b><span style=\"font-weight: 400;\">). This sharp end of the fat increase at the ankles is characteristic of lipedema.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Also the <\/span><b>skin surface<\/b><span style=\"font-weight: 400;\">  is examined closely. Often shows a <\/span><b>finely knotted structure of the skin<\/b><span style=\"font-weight: 400;\"> &#8211; colloquially <\/span><b>Orange peel skin (cellulite)<\/b><span style=\"font-weight: 400;\">  \u2013 especially in early stages. In advanced stages, the dents can <\/span><b>become coarser<\/b><span style=\"font-weight: 400;\"> and resemble a <\/span><b>mattress pattern<\/b><span style=\"font-weight: 400;\"> reminiscent of a mattress pattern. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">With increasing fat accumulation <\/span><b>bulges or lobes<\/b><span style=\"font-weight: 400;\">  arise, e.g. on the insides of the thighs or knees. The skin over the lipedema area is often rather <\/span><b>cool<\/b><span style=\"font-weight: 400;\"> and pale (no overheating) and shows fine bluish veins <\/span><b>veins (spider veins\/telangiectasia)<\/b><span style=\"font-weight: 400;\">. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">A very important sign is the <\/span><b>Tendency to hematomas<\/b><span style=\"font-weight: 400;\">: Even minor bumps lead to bruises in lipedema patients. This is due to the increased fragility of the capillaries in the diseased fatty tissue. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">The presence of numerous hematoma spots on the legs or arms thus supports the suspected diagnosis of lipedema. In contrast, skin inflammations, hardening or open areas typically do not occur in pure lipedema <\/span><i><span style=\"font-weight: 400;\">not<\/span><\/i><span style=\"font-weight: 400;\"> If it does, secondary lymphoedema may already be involved.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The next step is <\/span><b>palpation<\/b><span style=\"font-weight: 400;\">, i.e. palpating the affected areas. In lipedema, the subcutaneous fatty tissue usually feels <\/span><b>soft to doughy<\/b><span style=\"font-weight: 400;\"> often with fine <\/span><b>nodular structures<\/b><span style=\"font-weight: 400;\">  under the skin. Patients sometimes describe the palpable feeling as if <\/span><i><span style=\"font-weight: 400;\">&#8220;little polystyrene balls&#8221;<\/span><\/i><span style=\"font-weight: 400;\"> can be felt under the surface of the skin. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">By pressing gently, the examiner can determine whether and where <\/span><b>pressure pain<\/b><span style=\"font-weight: 400;\">  be triggered. A simple <\/span><b>Pinch test<\/b><span style=\"font-weight: 400;\"> (take the skin between two fingers and pinch lightly) tests the sensitivity to touch: in the lipoedema area, even light pinching is extremely uncomfortable or even painful for the patient. <\/span><b>unpleasant to painful<\/b><span style=\"font-weight: 400;\">while it causes no pain in unaffected areas of the body. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">This reaction to the pinch test underpins the diagnosis of lipedema. In addition, the <\/span><b>Circumferences of the extremities<\/b><span style=\"font-weight: 400;\">  are measured at defined points (e.g. on the ankle, calf, knee, thigh). Such measurements serve, on the one hand, to <\/span><b>extent<\/b><span style=\"font-weight: 400;\"> of adipose tissue proliferation objectively, and on the other hand as a <\/span><b>comparative value<\/b><span style=\"font-weight: 400;\"> for the assessment of progress (e.g. whether therapies cause a reduction in circumference).<\/span><\/p>\n<h3><b>The Daumentest &amp; Stemmer sign &#8211; the most important differential tests<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Certain clinical tests help to distinguish lipedema from lymphedema or other edematous conditions. The two most important are the <\/span><b>Stemmer sign<\/b><span style=\"font-weight: 400;\"> and the <\/span><b>thumb test<\/b><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In the <\/span><b>Stemmer test<\/b><span style=\"font-weight: 400;\"> the examiner attempts to <\/span><b>back of the toe<\/b><span style=\"font-weight: 400;\"> (usually on the second toe) a small <\/span><b>skin fold<\/b><span style=\"font-weight: 400;\">  to lift. Is this <\/span><i><span style=\"font-weight: 400;\">possible<\/span><\/i><span style=\"font-weight: 400;\">the Stemmer sign is considered <\/span><b>negative<\/b><span style=\"font-weight: 400;\">. With lipoedema, the skin over the toes can typically still be lifted &#8211; the feet are not affected by lipoedema.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">However, if the test is <\/span><i><span style=\"font-weight: 400;\">positive<\/span><\/i><span style=\"font-weight: 400;\">no skin fold can be seen, this is a strong indication of lymphedema. <\/span><b>lymphoedema<\/b><span style=\"font-weight: 400;\">. In lymphoedema, fluid accumulates in the tissue of the toes and the back of the foot, causing the skin there to thicken and tighten so that a fold cannot be felt.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">A positive Stemmer&#8217;s sign is a classic feature of lymphoedema, whereas lipoedema <\/span><b>no<\/b><span style=\"font-weight: 400;\"> such a skin sign on the toes (Stemmer negative). <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">However, a negative Stemmer test does not always completely rule out an incipient lymphedema \u2013 in early stages, the skin may still be liftable. Therefore, the overall picture of the findings is always considered.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The <\/span><b>daumen test<\/b><span style=\"font-weight: 400;\"> checks whether in the tissue <\/span><b>water edema<\/b><span style=\"font-weight: 400;\">  available. In this case, the thumb is used to press on the swollen area for about 10 seconds and it is observed whether a <\/span><b>dent<\/b><span style=\"font-weight: 400;\"> remains (so-called <\/span><b>Godet sign<\/b><span style=\"font-weight: 400;\"> or <\/span><i><span style=\"font-weight: 400;\">pitting edema<\/span><\/i><span style=\"font-weight: 400;\">). <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">In the case of lipoedema, this test is <\/span><b>negative<\/b><span style=\"font-weight: 400;\"> &#8211; which means that the depressed area bounces back immediately, leaving no permanent <\/span><b>no permanent indentation remains<\/b><span style=\"font-weight: 400;\">. The lipedema tissue contains hardly any free fluid in the early stages, so no water is displaced from the pressure area. In contrast, the thumb test is often <\/span><b>positive<\/b><span style=\"font-weight: 400;\">: The pressure leaves a visible dent <\/span><b>dent that remains for a few seconds<\/b><span style=\"font-weight: 400;\">. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">This is a sign that there is fluid in the tissue that moves to the side due to the pressure and only gradually flows back. A positive Godet sign would therefore <\/span><i><span style=\"font-weight: 400;\">against<\/span><\/i><span style=\"font-weight: 400;\"> pure lipedema and rather indicate lymphedema or venous edema.<\/span><\/p>\n<p> <span style=\"font-weight: 400;\"> To summarize: <\/span><b>Stemmer and thumb tests are negative in lipedema<\/b><span style=\"font-weight: 400;\">, positive in lymphedema. These simple clinical tests are among the most important differential diagnoses in lipedema diagnostics.<\/span><\/p>\n<h3><b>Imaging procedures &#8211; when ultrasound, CT or MRI are useful<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">As lipoedema is primarily a clinical diagnosis <\/span><b>Imaging examinations<\/b><span style=\"font-weight: 400;\">  not routinely required. There is no specific imaging \u201cproof\u201d of lipedema, but in certain situations, devices can be consulted to rule out other causes or to detect concomitant diseases. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Most commonly used is <\/span><b>sonography (ultrasound)<\/b><span style=\"font-weight: 400;\">  used. A simple ultrasound can be used to check whether <\/span><b>venous problems<\/b><span style=\"font-weight: 400;\"> are present &#8211; e.g. <\/span><b>varicose veins or deep vein thrombosis<\/b><span style=\"font-weight: 400;\">which can cause <\/span><b>venous leg edema<\/b><span style=\"font-weight: 400;\">  could cause. In fact, chronic venous diseases and lipedema are not uncommon together, so the venous condition should be checked by duplex sonography. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">A duplex ultrasound examination can show whether the venous valves are intact or whether venous reflux (chronic venous insufficiency) contributes to the swelling. Under certain circumstances, it hides <\/span><b>under the guise of lipoedema<\/b><span style=\"font-weight: 400;\"> even a post-thrombotic syndrome &#8211; the ultrasound would reveal this.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Furthermore, a high-resolution <\/span><b>soft tissue ultrasound<\/b><span style=\"font-weight: 400;\">  represent the subcutaneous fatty tissue. Typically, lipedema shows a <\/span><b>uniform thickening<\/b><span style=\"font-weight: 400;\"> of the subcutis with a finely <\/span><b>striped echo structure<\/b><span style=\"font-weight: 400;\"> &#8211; often as <\/span><i><span style=\"font-weight: 400;\">&#8220;snow flurry&#8221;<\/span><\/i><span style=\"font-weight: 400;\">-pattern &#8211; as well as <\/span><b>echo-rich septa<\/b><span style=\"font-weight: 400;\"> (connective tissue strands) and no large fluid clefts. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">However, this ultrasound image is not clear in every patient and overlaps with findings in obesity, so that ultrasound alone cannot confirm the diagnosis.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">However, an important area of application is the differentiation from <\/span><b>lymphoedema<\/b><span style=\"font-weight: 400;\">If there are pockets of fluid in the tissue or thickened layers of skin, this could indicate lymphoedema. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">In the case of pure lipedema <\/span><b>no<\/b><span style=\"font-weight: 400;\"> larger free fluid accumulations in the sonography &#8211; which again confirms that it is primarily a fat distribution disorder and not a classic edema. <\/span><i><span style=\"font-weight: 400;\">not classic oedema<\/span><\/i><span style=\"font-weight: 400;\"> is involved.<\/span><\/p>\n<p><b>Advanced imaging<\/b><span style=\"font-weight: 400;\"> such as <\/span><b>computed tomography (CT)<\/b><span style=\"font-weight: 400;\"> or <\/span><b>magnetic resonance imaging (MRI)<\/b><span style=\"font-weight: 400;\">  are only necessary in special cases. For example, an MRI examination can be helpful if there is an atypical course or if there is a suspicion of other tissue changes (such as unusually hardened nodules that one wants to differentiate from tumors). <\/span><\/p>\n<p><span style=\"font-weight: 400;\">As a rule, CT\/MRI are used for <\/span><b>differential diagnosis<\/b><span style=\"font-weight: 400;\">, in order to rule out serious other diseases \u2013 such as liposarcomas (malignant fatty tissue tumors) or generalized edema as a result of organ diseases. For the <\/span><b>Confirmation of the lipoedema diagnosis<\/b><span style=\"font-weight: 400;\"> these more complex procedures are usually not necessary. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">If the findings are unclear, a <\/span><b>lymphoscintigraphy<\/b><span style=\"font-weight: 400;\"> can also be considered to assess the function of the lymphatic drainage &#8211; this is particularly relevant if a combined lipo-lymphedema finding is assumed. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Overall, however, the following applies: In most cases, lipedema can be recognized through anamnesis, clinical examination and the simple tests mentioned. Apparatus diagnostics are used in a targeted manner, <\/span><b>if the clinical findings leave doubt or comorbidities are present<\/b><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h2><b>Differential diagnosis &#8211; What is not lipedema?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Lipedema can easily be confused with other clinical pictures or occur together with them. Therefore, the <\/span><b>Differential diagnosis<\/b><span style=\"font-weight: 400;\"> crucial: The doctor must check whether the symptoms observed are actually due to lipoedema &#8211; or whether they are not due to <\/span><b>overweight (obesity)<\/b><span style=\"font-weight: 400;\">a <\/span><b>lymphoedema<\/b><span style=\"font-weight: 400;\"> or even just <\/span><b>cosmetic cellulite<\/b><span style=\"font-weight: 400;\">  available. The most important differentiations are described below.<\/span><\/p>\n<h3><b>Lipedema vs. lymphedema &#8211; foot involvement &amp; Stemmer&#8217;s sign<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Lymphoedema is swelling due to impaired lymphatic drainage. <\/span><b>lymphatic drainage<\/b><span style=\"font-weight: 400;\">, which can occur e.g. after lymph node removals or due to congenital malformations. Compared to lipedema, it shows some clear differences. <\/span><\/p>\n<p><b>Clinically important<\/b><span style=\"font-weight: 400;\"> are above all the <\/span><b>Affected feet\/toes<\/b><span style=\"font-weight: 400;\"> and the already mentioned <\/span><b>Stemmer&#8217;s sign<\/b><span style=\"font-weight: 400;\">. <\/span><b>With lipoedema<\/b><span style=\"font-weight: 400;\"> the swellings are <\/span><i><span style=\"font-weight: 400;\">limited to the legs (and possibly arms)<\/span><\/i><span style=\"font-weight: 400;\">, <\/span><b>Feet and toes are left out<\/b><span style=\"font-weight: 400;\">. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Typically, lipedema ends abruptly above the ankles, so that the feet and back of the foot are free of edema and relatively slim (kink at the ankle). <\/span><b>With lymphoedema<\/b><span style=\"font-weight: 400;\"> on the other hand, the accumulation of fluid often extends to the foot: swelling of the back of the foot and toes occurs. <\/span><b>the back of the foot and the toes<\/b><span style=\"font-weight: 400;\">recognizable, for example, by a <\/span><b>bacon folds above the toes<\/b><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Therefore, in lymphoedema the <\/span><b>Stemmer&#8217;s sign is usually positive<\/b><span style=\"font-weight: 400;\">  \u2013 the thickened toe skin cannot be lifted. The Stemmer sign is <\/span><b>negative<\/b><span style=\"font-weight: 400;\">as the skin of the toes can be gripped normally.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Another difference is the <\/span><b>Body side and symmetry<\/b><span style=\"font-weight: 400;\">Lipedema always occurs <\/span><b>always occurs symmetrically<\/b><span style=\"font-weight: 400;\"> on both legs (or arms); lymphedema, on the other hand, often affects <\/span><b>only one side<\/b><span style=\"font-weight: 400;\"> or is at least asymmetrical. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">For example, primary leg lymphoedema would typically show one leg significantly more swollen than the other, whereas in lipoedema both legs are relatively evenly enlarged.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">In addition, the <\/span><b>pain<\/b><span style=\"font-weight: 400;\"> different: <\/span><b>Pressure pain<\/b><span style=\"font-weight: 400;\"> is a leading symptom of lipoedema &#8211; even slight pressure hurts &#8211; whereas pure lymphoedema is usually <\/span><b>not painful<\/b><span style=\"font-weight: 400;\">  reacts to pressure. Patients with lymphedema complain more of a feeling of tension or heaviness, but not of the pressure sensitivity as with lipedema.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The <\/span><b>thumb test<\/b><span style=\"font-weight: 400;\"> also behaves differently: In lipedema, no permanent dent can be pressed with the thumb (negative Godet), in lymphedema &#8211; at least in the early stages, as long as the tissue is still soft &#8211; a dent persists longer. <\/span><b>dent remains longer<\/b><span style=\"font-weight: 400;\"> (positive Godet). <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">In advanced stages, lymphoedema becomes hard and fibrotic, and it is no longer possible to press a dent; however, in the beginning, pitting oedema is characteristic.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">With regard to the <\/span><b>skin changes<\/b><span style=\"font-weight: 400;\"> the following applies: lipoedema patients tend to suffer from haematomas, but <\/span><b>inflammations or infections<\/b><span style=\"font-weight: 400;\"> in the swollen areas are rare.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Lymphoedema, on the other hand, damages the skin barrier in the long term and often leads to <\/span><b>hardening of the skin<\/b><span style=\"font-weight: 400;\"> and an increased risk of infections such as erysipelas (erysipelas).<\/span><\/p>\n<p> <span style=\"font-weight: 400;\"> Visible changes such as <\/span><b>papillomatosis, hyperkeratosis or barky skin<\/b><span style=\"font-weight: 400;\"> are found in lymphoedema that has been present for a long time, but not in lipoedema. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Taken together, all these features usually allow a clear distinction to be made: <\/span><b>Lipoedema shows symmetrical, pressure-painful fat pads with recessed feet (Stemmer negative)<\/b><span style=\"font-weight: 400;\">while <\/span><b>lymphoedema is asymmetrical, rather painless, with coarse swellings down to the toes (Stemmer positive)<\/b><span style=\"font-weight: 400;\"> is associated.<\/span><\/p>\n<h3><b>Lipedema vs. obesity &#8211; fat distribution &amp; effect of diets<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">At first glance <\/span><b>lipedema<\/b><span style=\"font-weight: 400;\"> and <\/span><b>general overweight (obesity)<\/b><span style=\"font-weight: 400;\">  appear similar \u2013 both are associated with increased fatty tissue and often a larger body circumference. In fact, the clinical pictures can also occur in combination. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Nevertheless, there are important differences: In the case of pure <\/span><b>obesity<\/b><span style=\"font-weight: 400;\"> the <\/span><b>fat is usually proportional to the whole body<\/b><span style=\"font-weight: 400;\">  including the trunk, abdomen and extremities. At the  <\/span><b>lipedema<\/b><span style=\"font-weight: 400;\"> on the other hand, the <\/span><b>proportions are inharmonious<\/b><span style=\"font-weight: 400;\">Especially <\/span><b>legs, hips and possibly arms<\/b><span style=\"font-weight: 400;\"> store excessive fat, while the upper body <\/span><b>upper body remains comparatively slim.<\/b><span style=\"font-weight: 400;\"> remains comparatively slim. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">The patient&#8217;s upper body often appears two dress sizes smaller than the lower body region &#8211; a significant disproportion that does not occur with obesity alone.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Another distinguishing criterion is the <\/span><b>symptoms and tissue characteristics.<\/b> <b>Lipoedema patients<\/b><span style=\"font-weight: 400;\"> suffer from <\/span><b>painful legs<\/b><span style=\"font-weight: 400;\"> and very easily get <\/span><b>bruises<\/b><span style=\"font-weight: 400;\">even with small bumps. <\/span> <\/p>\n<p><b>Overweight people without lipedema<\/b><span style=\"font-weight: 400;\"> on the other hand, usually have <\/span><b>no pain<\/b><span style=\"font-weight: 400;\">  in their fat pads and also no unusual tendency to hematomas. Fatty tissue caused purely by obesity is soft and insensitive to pressure; it primarily causes mechanical problems (stress on the joints, etc.), but no spontaneous pain in the tissue. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">This difference &#8211; <\/span><b>painfulness<\/b><span style=\"font-weight: 400;\"> vs. <\/span><b>freedom from discomfort<\/b><span style=\"font-weight: 400;\">  \u2013 is essential for differentiation. Experts also emphasize that lipedema <\/span><i><span style=\"font-weight: 400;\">is not<\/span><\/i><span style=\"font-weight: 400;\"> is not the result of a poor diet or obesity and will not disappear simply by losing weight.<\/span><\/p>\n<p><b>Diet and exercise<\/b><span style=\"font-weight: 400;\"> therefore play a role in the differential diagnosis: in the case of obesity, a reduction in calories can lead to significant fat loss all over the body, whereas in the case of lipoedema, even the strictest diets hardly reduce the pathological increase in fat on the legs\/arms. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Many affected people frustratingly find that although they lose weight overall, the disproportionately thick legs or hips remain. This lack of success in the affected areas is typical of lipedema. Therefore, a <\/span><b>Therapy trial with weight loss<\/b><span style=\"font-weight: 400;\"> may be an indication: If the extremities remain unusually full despite a normalized BMI, this indicates lipoedema. <\/span> <\/p>\n<p><b>Obesity fat<\/b><span style=\"font-weight: 400;\"> on the other hand, melts away relatively evenly across the body under diet and exercise &#8211; in particular a reduction in the <\/span><b>abdominal circumference<\/b><span style=\"font-weight: 400;\"> is to be expected here, whereas with lipedema the <\/span><b>leg circumferences remain disproportionately high<\/b><span style=\"font-weight: 400;\">. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">However, it is important to note that lipoedema and obesity are often <\/span><b>combined<\/b><span style=\"font-weight: 400;\"> often occur in combination: A large proportion of lipoedema patients also develop obesity over the years. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">In such cases, both aspects must be treated &#8211; the obesity (e.g. through dietary changes, exercise, possibly bariatric surgery) <\/span><b>and<\/b><span style=\"font-weight: 400;\"> lipoedema (conservative therapies, liposuction if necessary). <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">To summarize: <\/span><b>Lipedema is characterized by a regional, painful increase in fat with diet resistance<\/b><span style=\"font-weight: 400;\">while <\/span><b>obesity leads to global obesity without localized pressure pain<\/b><span style=\"font-weight: 400;\"> leads to localized pressure pain.<\/span><\/p>\n<h3><b>Lipedema vs. cellulite &#8211; cosmetic effect vs. disease value<\/b><\/h3>\n<p><b>Cellulite<\/b><span style=\"font-weight: 400;\"> (orange peel skin) and lipedema are sometimes colloquially confused, as both are associated with <\/span><b>Dents in the skin<\/b><span style=\"font-weight: 400;\">  go hand in hand. However, cellulite refers to <\/span><b>not a clinical picture<\/b><span style=\"font-weight: 400;\">but a purely <\/span><b>cosmetic phenomenon<\/b><span style=\"font-weight: 400;\">  due to structural connective tissue weakness. The  <\/span><b>Skin surface<\/b><span style=\"font-weight: 400;\"> &#8211; especially on the thighs and buttocks &#8211; shows the typical wavy dimpling, especially when pinching or tightening, but cellulite does not cause any medical complaints. <\/span><b>no medical complaints<\/b><span style=\"font-weight: 400;\"> as a result. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">It can affect both slim and overweight women and causes no pain. <\/span><b>no pain<\/b><span style=\"font-weight: 400;\">. In contrast to this, lipedema is a  <\/span><b>chronic disease<\/b><span style=\"font-weight: 400;\">which is also often accompanied by cellulite-like skin dimples, but also causes serious symptoms.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The <\/span><b>main distinguishing feature<\/b><span style=\"font-weight: 400;\"> is again the <\/span><b>pain<\/b><span style=\"font-weight: 400;\">Lipoedema typically hurts (pain on pressure and touch, feeling of heaviness), <\/span><b>cellulite<\/b><span style=\"font-weight: 400;\"> on the other hand <\/span><i><span style=\"font-weight: 400;\">not<\/span><\/i><span style=\"font-weight: 400;\">  painful. In addition to the skin change, lipedema patients also have <\/span><b>Swelling<\/b><span style=\"font-weight: 400;\"> of the extremities, a feeling of tension and increased sensitivity &#8211; all of which are absent with pure cellulite. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">While in the case of cellulite the skin <\/span><b>unevenness<\/b><span style=\"font-weight: 400;\"> but remains soft and normally supplied with blood, the tissue in lipedema often feels <\/span><b>hardened<\/b><span style=\"font-weight: 400;\"> and there are real <\/span><b>fat nodules<\/b><span style=\"font-weight: 400;\">  before, which you can feel. Cellulite dents are caused by the protrusion of existing fat cells with weak connective tissue, whereas lipedema dents are caused by <\/span><i><span style=\"font-weight: 400;\">new<\/span><\/i><span style=\"font-weight: 400;\"> increased fat cells and edema &#8211; the skin is thickened and firmer as a result. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">After all, cellulite has no progression or complications: It remains an <\/span><i><span style=\"font-weight: 400;\">aesthetic skin appearance<\/span><\/i><span style=\"font-weight: 400;\">  and requires cosmetic treatments at most. Lipedema, on the other hand, is <\/span><b>progressive<\/b><span style=\"font-weight: 400;\"> (usually worsens over years without treatment) and can lead to considerable limitations. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">To summarize: <\/span><b>Cellulite<\/b><span style=\"font-weight: 400;\"> is usually <\/span><i><span style=\"font-weight: 400;\">only an optical problem<\/span><\/i><span style=\"font-weight: 400;\"> without disease value, whereas <\/span><b>lipoedema<\/b><span style=\"font-weight: 400;\">  represents a serious fat distribution disorder with pain symptoms. In case of doubt, the differentiation can easily be clarified by a specialist examination, since the <\/span><b>Accompanying symptoms<\/b><span style=\"font-weight: 400;\"> (or their absence) clearly show what you are dealing with.<\/span><\/p>\n<h3><b>Lipedema vs. lipohypertrophy &#8211; lack of pain, aesthetic phenomenon<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">The term <\/span><b>lipohypertrophy<\/b><span style=\"font-weight: 400;\"> refers to a congenital <\/span><b>disproportionate fat distribution anomaly<\/b><span style=\"font-weight: 400;\">  on legs and\/or arms, which occurs mainly in women. Externally, it can look very similar to lipedema, as there is also an increased accumulation of fat on the lower and upper thighs (and possibly arms) \u2013 often also symmetrical and genetically familial. <\/span><\/p>\n<p><b>The decisive difference<\/b><span style=\"font-weight: 400;\">  lies in the symptoms: Lipohypertrophy lacks the pain and discomfort typical of lipedema. The fat pads are present and may be cosmetically disturbing, but they are <\/span><b>not painful under pressure<\/b><span style=\"font-weight: 400;\">there is <\/span><b>no tendency to hematomas<\/b><span style=\"font-weight: 400;\">  and no feeling of illness. Lipohypertrophy has <\/span><i><span style=\"font-weight: 400;\">no disease value<\/span><\/i><span style=\"font-weight: 400;\"> in the narrower sense, but is considered a <\/span><b>normal variant<\/b><span style=\"font-weight: 400;\"> of fat distribution. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">In the medical literature, it is described as a benign phenomenon without pathological changes. Basically, it is \u201c<\/span><b>Strong legs without pain<\/b><span style=\"font-weight: 400;\">&#8220;.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Differentiation is important for the doctor: <\/span><b>If all clinical symptoms are absent, but the legs are disproportionately thick<\/b><span style=\"font-weight: 400;\">, one speaks more of lipohypertrophy than of lipedema. Sometimes this is also called <\/span><b>Lipedema stage 0<\/b><span style=\"font-weight: 400;\"> is called &#8211; it is, so to speak, a <\/span><i><span style=\"font-weight: 400;\">preliminary stage<\/span><\/i><span style=\"font-weight: 400;\">in which a fat distribution disorder is present but does not (yet) cause any pain. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">In some cases, lipohypertrophy can &#8220;transition&#8221; into lipedema in the course of life, e.g. if hormonal changes occur or edema and pain are added.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">However, as long as <\/span><b>no pain, no edema formation and no functional impairment<\/b><span style=\"font-weight: 400;\">  the diagnosis of lipohypertrophy remains. The  <\/span><b>Therapy<\/b><span style=\"font-weight: 400;\"> is primarily cosmetic\/conservative (weight optimization, compression garments if required) &#8211; more invasive measures such as liposuction are generally only considered in cases of painful lipoedema, not in cases of mere lipohypertrophy. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">In summary: <\/span><b>Lipohypertrophy looks like lipoedema, but does not hurt.<\/b><span style=\"font-weight: 400;\"> It is an aesthetic increase in fat without any accompanying pathological symptoms and therefore <\/span><i><span style=\"font-weight: 400;\">by definition<\/span><\/i><span style=\"font-weight: 400;\"> not lipoedema by definition.<\/span><\/p>\n<h2><b>Precise demarcation in everyday life &#8211; how patients recognize this<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Many affected people wonder whether their symptoms are due to lipedema or \u201conly\u201d to being overweight or other causes. Since lipedema often comes with <\/span><b>obesity<\/b><span style=\"font-weight: 400;\"> (overweight) or also a <\/span><b>lymphoedema<\/b><span style=\"font-weight: 400;\"> it is important to know the typical signs of the disease. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">In everyday life, patients can pay particular attention to the following characteristics in order to distinguish lipoedema from other problems:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Symmetrical fat deposits on the legs and\/or arms:<\/b><span style=\"font-weight: 400;\"> In lipedema, fat is deposited disproportionately on both legs (and possibly arms), while feet and hands are typically <\/span><i><span style=\"font-weight: 400;\">not<\/span><\/i><span style=\"font-weight: 400;\">  are affected. This leads to noticeable proportions \u2013 narrow waist, but strong legs (\u201criding breeches\u201d). With general overweight, on the other hand, the fatty tissue is usually distributed more evenly throughout the body.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Heavy, painful legs throughout the day:<\/b><span style=\"font-weight: 400;\"> Lipoedema patients often report that their legs and arms swell during the day and become increasingly heavy. Pain, feelings of tension and heaviness increase towards the evening. Elevating the legs often brings little relief. Normal excess weight does not usually cause such pronounced pain or swelling.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Pressure pain and a tendency to bruise:<\/b><span style=\"font-weight: 400;\">  An essential distinguishing feature is that with lipedema, even slight pressure on the skin hurts and hematomas (bruises) can occur very quickly. In obese people without lipedema, such pressure pain does not exist, and bruises do not occur more frequently.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Diet and exercise have little effect:<\/b><span style=\"font-weight: 400;\">  Unusually for lipedema, the increased fat pads can hardly be reduced by calorie reduction or sport. Anyone who is only overweight will usually become thinner everywhere on the body by losing weight \u2013 with lipedema, on the other hand, the affected areas remain disproportionately thick. This circumstance frustrates many affected people and often leads to the misconception that weight loss is \u201chopeless anyway\u201d.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">A simple <\/span><b>self-test<\/b><span style=\"font-weight: 400;\"> is the so-called <\/span><b>pinch test<\/b><span style=\"font-weight: 400;\">This involves gently pinching the skin at various points on the leg with your thumb and forefinger. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Typically, healthy or only overweight people feel a slightly stronger pain on the inside of the thighs than on the outside. With lipedema it is <\/span><i><span style=\"font-weight: 400;\">vice versa<\/span><\/i><span style=\"font-weight: 400;\"> &#8211; in this case, the outer side usually hurts much more, as there is more abnormal fatty tissue there. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">If even a slight pinch on the outer side of the thigh hurts a lot, there is a high <\/span><b>high probability of lipoedema<\/b><span style=\"font-weight: 400;\">. Small, nodular indurations under the skin may also be palpable.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Important: If the pinch test is inconspicuous, this does not rule out early lipoedema with certainty &#8211; the sensation of pain is individual and can be influenced by regular complaints.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Overall, however <\/span><b>persistent pressure pain in the legs\/arms, which gets worse when touched, is a warning signal<\/b><span style=\"font-weight: 400;\">that speaks for lipoedema in this form.<\/span><\/p>\n<p><b>Conclusion:<\/b><span style=\"font-weight: 400;\">  Those affected can pay particular attention to the symptoms mentioned in everyday life. If symmetrical fat pads (with slim feet), increasing swelling and pain in the course of the day, an unusually large number of bruises and therapy resistance to diet\/sport occur together, there is a strong suspicion of lipedema. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">In such cases, it is important to seek medical advice early \u2013 ideally from a specialist who is familiar with the clinical picture. An early <\/span><b>Diagnosis<\/b><span style=\"font-weight: 400;\"> is crucial, as untreated lipoedema progresses and can severely impair quality of life.<\/span><\/p>\n<h3><b>Questions you should ask your doctor<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Preparing well for the doctor&#8217;s appointment helps to clarify all the important points. Here are some <\/span><b>Questions<\/b><span style=\"font-weight: 400;\">that you should ask your doctor if you suspect or have been diagnosed with lipoedema:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><i><span style=\"font-weight: 400;\">Are my symptoms definitely lipoedema, or are there possibly other or additional conditions (e.g. lymphoedema or venous insufficiency)?<\/span><\/i><span style=\"font-weight: 400;\"> &#8211; Important to <\/span><b>mixed disease<\/b><span style=\"font-weight: 400;\"> (such as lipo-lymphoedema) and to plan the correct treatment.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><i><span style=\"font-weight: 400;\">At what <\/span><\/i><b><i>stage<\/i><\/b><i><span style=\"font-weight: 400;\"> is my lipoedema at?<\/span><\/i><span style=\"font-weight: 400;\"> &#8211; Ask for the doctor&#8217;s assessment of the progression of the disease (stage I-IV) and which areas of the body are affected. This is important as treatment recommendations often depend on the stage.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><i><span style=\"font-weight: 400;\">Which <\/span><\/i><b><i>therapy options<\/i><\/b><i><span style=\"font-weight: 400;\"> are possible for me?<\/span><\/i><span style=\"font-weight: 400;\"> &#8211; Let us explain to you which <\/span><b>conservative measures<\/b><span style=\"font-weight: 400;\"> (such as manual lymphatic drainage, compression therapy, exercise therapy) are useful and whether a <\/span><b>surgical therapy<\/b><span style=\"font-weight: 400;\">  (liposuction) is recommended. Ask about the advantages and disadvantages of the methods in your specific case.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><i><span style=\"font-weight: 400;\">If the planned therapy is covered by <\/span><\/i><b><i>health insurance<\/i><\/b><i><span style=\"font-weight: 400;\"> covered?<\/span><\/i><span style=\"font-weight: 400;\"> &#8211; Ask about the costs at an early stage. In Germany, conservative therapies (compression stockings, lymphatic drainage) are generally covered by health insurance.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Liposuctions are generally not covered by health insurance, except for stage 3. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><i><span style=\"font-weight: 400;\">What can I do myself in everyday life to positively influence the course of the disease?<\/span><\/i><span style=\"font-weight: 400;\"> &#8211; Your doctor can give you tips on <\/span><b>exercise<\/b><span style=\"font-weight: 400;\"> (such as gentle sports like swimming or cycling), about <\/span><b>diet<\/b><span style=\"font-weight: 400;\">  (anti-inflammatory diet, weight management) and skin care. Use the conversation to clarify uncertainties regarding sport or diet with lipedema.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><i><span style=\"font-weight: 400;\">What will happen in the long term and what are the <\/span><\/i><b><i>check-up appointments<\/i><\/b><i><span style=\"font-weight: 400;\"> look like?<\/span><\/i><span style=\"font-weight: 400;\">  \u2013 Ask how often you should come for check-ups and how you can recognize a progression of the disease. Also clarify whether the doctor can refer you to specialists or whether further treatment in a <\/span><b>Lipedema Center<\/b><span style=\"font-weight: 400;\"> would be useful.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">These questions help to get a comprehensive picture and to make an informed decision about the next steps together with the doctor.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Don&#8217;t hesitate to have the answers written down if necessary or to take someone with you to the interview &#8211; this can be very helpful, especially if you have a lot of information.<\/span><\/p>\n<h3><b>How to prepare for your appointment &#8211; tips from the VenaZiel Lipedema Center<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Our experience at the VenaZiel Lipedema Center shows that patients who are <\/span><b>are well prepared<\/b><span style=\"font-weight: 400;\">  go to the appointment, benefit more from the conversation. Here are some practical tips that we recommend to optimally prepare for a doctor&#8217;s appointment on the topic of lipedema:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Document symptoms:<\/b><span style=\"font-weight: 400;\"> Make a note of your symptoms in advance. How long have you had pain or swelling? In which situations (e.g. after standing for a long time, in the evening) do they occur in particular? This information will help the doctor to get a clear picture of your medical history.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Create a list of questions:<\/b><span style=\"font-weight: 400;\"> Write down all the questions that concern you &#8211; e.g. about treatment options, prognosis, everyday life (see list above). This way, you won&#8217;t forget anything during the appointment and will receive answers to all important points.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Bring documents with you:<\/b><span style=\"font-weight: 400;\"> If available, take relevant medical documents with you. This includes, for example, previous findings or <\/span><b>doctor&#8217;s letters<\/b><span style=\"font-weight: 400;\">especially if you have already had a <\/span><b>vein examination<\/b><span style=\"font-weight: 400;\"> (Doppler\/duplex ultrasound) has already been carried out or a lipoedema diagnosis has already been made by a doctor. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">These documents (as well as a possible allergy pass) can provide the treating doctor with valuable information. Although this is not absolutely necessary for an initial examination, it is very helpful.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Suitable clothing:<\/b><span style=\"font-weight: 400;\"> Choose comfortable, easily removable clothing for the appointment. Shorts or a skirt, for example, are recommended so that your legs can be examined without any problems. You should wear compression stockings <\/span><b>before<\/b><span style=\"font-weight: 400;\"> compression stockings before the examination &#8211; so plan to arrive a little earlier if you need time to change beforehand.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Be honest and open:<\/b><span style=\"font-weight: 400;\">  Tell the doctor openly about your complaints and previous measures. Mention, for example, if you have not seen any improvement despite diet and sport \u2013 this underlines the suspicion of lipedema. Do not hesitate to talk about <\/span><b>pain<\/b><span style=\"font-weight: 400;\">, <\/span><b>psychological stress<\/b><span style=\"font-weight: 400;\">  or restrictions in everyday life. The more complete the picture, the better we can help you.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Consider accompaniment:<\/b><span style=\"font-weight: 400;\">  If necessary, it can be useful to take a trusted person to the appointment. Especially if you are nervous or have many questions, a companion can support you and later recap the information discussed with you.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">These tips from our center are intended to help you use the doctor&#8217;s appointment effectively. Our goal is that <\/span><b>Your concerns are heard<\/b><span style=\"font-weight: 400;\">  and you receive all the information you need. Because a well-prepared conversation is the first step to successful treatment.<\/span><\/p>\n<h2><b>Who makes the diagnosis &#8211; and who is the specialist?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">The diagnosis <\/span><b>lipedema<\/b><span style=\"font-weight: 400;\"> is ideally made by a<\/span><i><span style=\"font-weight: 400;\">m **Specialist<\/span><\/i><span style=\"font-weight: 400;\">doctor** who has a lot of experience with this clinical picture. Unfortunately, not all doctors are familiar with the fat distribution disorder \u2013 which is why many patients only receive a correct diagnosis after a true doctor odyssey. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Often, lipedema is initially dismissed as pure overweight and patients are sent home with the advice that they should do more sport or lose weight. Such misdiagnoses cost valuable time and lead to frustration for those affected. It is all the more important to find the \u201cright\u201d doctor or the right point of contact early on.<\/span><\/p>\n<p><b>Specialists<\/b><span style=\"font-weight: 400;\">  for lipedema usually recognize the disease at first glance and can safely distinguish it from obesity or lymphedema. These specialists include in particular <\/span><b>lymphologists<\/b><span style=\"font-weight: 400;\">, <\/span><b>phlebologists<\/b><span style=\"font-weight: 400;\">, vascular physicians and specialists in plastic surgery. In the following, we will explain the role these and other specialist areas play in diagnosis and therapy.<\/span><\/p>\n<h3><b>Phlebologists, vascular &amp; lymph specialists<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">If lipoedema is suspected, a practice for <\/span><b>lymphology<\/b><span style=\"font-weight: 400;\"> or <\/span><b>phlebology<\/b><span style=\"font-weight: 400;\"> is often the best address. <\/span><b>Lymphologists<\/b><span style=\"font-weight: 400;\"> are doctors<\/span><i><span style=\"font-weight: 400;\">who specialize in diseases of the lymphatic system &#8211; and this includes lipoedema. <\/span><\/i> <\/p>\n<p><i><span style=\"font-weight: 400;\">These are usually specialists in the field of <\/span><\/i><b><i>dermatology<\/i><\/b><i><span style=\"font-weight: 400;\"> (dermatologists), <\/span><\/i><b><i>angiology<\/i><\/b><i><span style=\"font-weight: 400;\"> (vascular internists) or <\/span><\/i><b><i>internal medicine<\/i><\/b><i><span style=\"font-weight: 400;\">who have completed additional training in lymphology. <\/span><\/i> <\/p>\n<p><i><span style=\"font-weight: 400;\">Thanks to this expertise, they can often recognize lipedema based on the typical body shape and complaints and differentiate it from other diseases. A thorough clinical examination (anamnesis, inspection, palpation of the subcutaneous fatty tissue) then confirms the diagnosis. <\/span><\/i><\/p>\n<p><i><span style=\"font-weight: 400;\">Modern lymphologists<\/span><\/i><span style=\"font-weight: 400;\">use a gentle palpation test instead of the pinch test used in the past. <\/span><b>palpation test<\/b><span style=\"font-weight: 400;\"> in which the skin is checked for painful indurations.<\/span><\/p>\n<p><b>Phlebologists<\/b><span style=\"font-weight: 400;\">  are specialists in venereology who deal with venous diseases (e.g. varicose veins, CVI). Many phlebologists<\/span><i><span style=\"font-weight: 400;\">are also familiar with lymphoedema and lipoedema or work with lymphologists.<\/span><\/i><span style=\"font-weight: 400;\">inside together. Since lipedema and venous diseases can cause similar symptoms (swelling, heavy legs), a phlebological clarification is often useful. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">In specialized vein centers \u2013 such as our VenaZiel center \u2013 lipedema diagnostics are part of the range of services offered. Frequently, it is also diagnosed using <\/span><b>ultrasound<\/b><span style=\"font-weight: 400;\"> checks whether there are additional venous circulatory disorders or whether the condition is purely <\/span><a href=\"https:\/\/venaziel.de\/en\/lymphodem-vs-lipodem\/#:~:text=Die%20Diagnose%20von%20Lymph%C3%B6dem%2C%20Lip%C3%B6dem,Verfahren%20wie%20Ultraschall%20oder\"><span style=\"font-weight: 400;\">lipoedema<\/span><\/a><span style=\"font-weight: 400;\">. For example, accompanying leg edema due to venous insufficiency can be ruled out before treatment begins.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Among <\/span><b>vascular specialists<\/b><span style=\"font-weight: 400;\"> we understand here above all <\/span><b>angiologists<\/b><span style=\"font-weight: 400;\"> (internal medicine vascular specialists) and <\/span><b>vascular surgeons<\/b><span style=\"font-weight: 400;\">. These specialists can also recognize lipedema, especially if they have lymphological training. However, lipedema is not treated purely from a vascular surgery perspective, as it is not a primary \u201cblood vessel disease\u201d \u2013 nevertheless, vascular specialists are important to <\/span><b>other causes<\/b><span style=\"font-weight: 400;\"> of leg swelling (e.g. deep vein thrombosis, arterial circulatory disorders, etc.). <\/span> <\/p>\n<p><b>In short:<\/b><span style=\"font-weight: 400;\"> An interdisciplinary team from phlebology, angiology and lymphology offers the best conditions for a reliable diagnosis and individual treatment planning for lipoedema.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Also worth mentioning are <\/span><b>Specialists for plastic and aesthetic surgery<\/b><span style=\"font-weight: 400;\">, who specialize in lipedema. They come into play especially when considering <\/span><b>Liposuction<\/b><span style=\"font-weight: 400;\">  (liposuction) as a therapy. Many plastic surgeons perform lipedema surgeries; some work in their own lipedema clinics or cooperate with lymphologists for holistic care. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">It is important to choose a surgeon who has experience with lipoedema patients &#8211; this is not purely cosmetic liposuction, but a medical procedure that must be performed carefully and completely. Indications of good expertise can be, for example, certificates, further training in the field of lymphology or positive patient reports.<\/span><\/p>\n<h3><b>GPs &amp; dermatosurgery: what are their roles?<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Yours<\/span><i><span style=\"font-weight: 400;\">e **Doctor<\/span><\/i><span style=\"font-weight: 400;\">in** is often the first point of contact, especially when it is still unclear what is behind the complaints. General practitioners<\/span><i><span style=\"font-weight: 400;\">We know your medical history and can clarify other causes of weight gain or swelling &#8211; such as hormonal problems (thyroid), side effects of medication or general lifestyle factors.  <\/span><\/i><\/p>\n<p><i><span style=\"font-weight: 400;\">However, many general practitioners are not familiar with the specific picture of lipedema. Therefore, lipedema is easily overlooked by the general practitioner or mistaken for obesity. <\/span><\/i><b><i>Their role<\/i><\/b><i><span style=\"font-weight: 400;\"> is to issue a referral to a specialist in the event of suspicion. <\/span><\/i> <\/p>\n<p><i><span style=\"font-weight: 400;\">Do not hesitate to contact your<\/span><\/i><span style=\"font-weight: 400;\">e family doctor<\/span><i><span style=\"font-weight: 400;\">directly about your suspected lipoedema and ask for a specialist consultation (with a phlebologist\/lymphologist) if your family doctor is unsure. <\/span><\/i> <\/p>\n<p><i><span style=\"font-weight: 400;\">However, some GPs are also involved in this area themselves &#8211; especially doctors<\/span><\/i><span style=\"font-weight: 400;\">with the additional qualification <\/span><i><span style=\"font-weight: 400;\">phlebology<\/span><\/i><span style=\"font-weight: 400;\"> could already make the correct diagnosis in the GP practice.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Under <\/span><b>dermatosurgery<\/b><span style=\"font-weight: 400;\"> refers to the surgical activity of dermatologists<\/span><i><span style=\"font-weight: 400;\">for example in the areas of <\/span><\/i><b><i>liposuction<\/i><\/b><i><span style=\"font-weight: 400;\">  and skin tightening. In relation to lipedema, dermatosurgery plays an important role, because the technique of liposuction was originally developed in dermatology (by Dr. Jeffrey Klein). Dermatologists<\/span><\/i><span style=\"font-weight: 400;\">This means that surgeons with additional surgical training can perform liposuctions and treat many lipoedema patients, often in specialized practices or clinics.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">This is sometimes also referred to as <\/span><i><span style=\"font-weight: 400;\">cooperative centers<\/span><\/i><span style=\"font-weight: 400;\">in which dermatologists (for diagnosis and conservative therapy) and dermatosurgeons or plastic surgeons (for surgical therapy) work hand in hand. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">The role of dermatosurgery therefore lies primarily in the <\/span><b>surgical treatment<\/b><span style=\"font-weight: 400;\">For example, if liposuction is indicated after a diagnosis has been made, a doctor who is experienced in dermatosurgery can perform the procedure. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Dermatologists are also involved in <\/span><b>aftercare<\/b><span style=\"font-weight: 400;\"> important &#8211; for example in wound healing, scar treatment or skin care after an operation.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To summarize: The family doctor takes over the <\/span><b>basic care<\/b><span style=\"font-weight: 400;\"> and the recognition of suspicious symptoms, while dermatosurgery specialists or plastic surgeons perform the specialized procedures. <\/span><b>interventions<\/b><span style=\"font-weight: 400;\"> perform. Both should be networked with lymph\/phlebology experts as much as possible so that the patient receives comprehensive care.<\/span><\/p>\n<h3><b>When is it worth taking a second look at the Lipedema Center?<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Precisely because not all doctors are familiar with lipoedema, it can be very useful to get a <\/span><b>second opinion<\/b><span style=\"font-weight: 400;\"> in a specialized lipedema center. But when is such a \u201csecond look\u201d advisable?<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Uncertainty in the diagnosis:<\/b><span style=\"font-weight: 400;\">  If you feel that your complaints have not been properly classified or the doctor is unsure, you should seek a second opinion. An experienced lipedema specialist often recognizes the clinical picture immediately and can clarify doubtful cases. <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Especially if you have been told &#8220;you just need to lose weight&#8221;, but you still suspect lipoedema, a visit to a specialist center is advisable.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>No improvement under therapy:<\/b><span style=\"font-weight: 400;\"> Even if you have already been diagnosed and are wearing compression stockings or receiving lymphatic drainage, for example, but do not feel any improvement, a lipedema center can help. The treatment plan will be <\/span><b>reviewed and optimized<\/b><span style=\"font-weight: 400;\"> &#8211; there may be new approaches or the indication for liposuction should be reassessed.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Planning an operation:<\/b><span style=\"font-weight: 400;\"> If lipoedema liposuction is on the cards, it is worth going to a specialized center or clinic that frequently performs such procedures. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Specialized surgeons can explain the procedure, have experience with gentle techniques (e.g. water jet-assisted or vibrating liposuction) and know what to look for in lipedema patients. A second opinion before a major operation gives you security and confidence in the decision.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Dissatisfaction with the previous doctor:<\/b><span style=\"font-weight: 400;\">  If you do not feel sufficiently informed or taken seriously, changing doctors is absolutely legitimate. Different statements from different doctors can be unsettling \u2013 in this case, you can certainly consult a third specialist. It is important that you feel in good hands and that the new doctor takes time for you.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">In a <\/span><b>Lipedema Center<\/b><span style=\"font-weight: 400;\">  like VenaZiel, various expertises are bundled: lymphology, phlebology, nutritional advice, physiotherapy and surgery work hand in hand. Thus, a patient can be assessed holistically there. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">A &#8220;second look&#8221; often brings new insights &#8211; be it a <\/span><b>more precise diagnosis<\/b><span style=\"font-weight: 400;\"> (e.g. recognition of mixed forms such as lipo-lymphedema) or an extended range of treatment options that the first practitioner may not have been able to identify.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In summary, a second opinion is always worthwhile if you are not fully satisfied with the first diagnosis\/therapy. <\/span><b>not fully satisfied<\/b><span style=\"font-weight: 400;\"> are, or simply want certainty. Do not hesitate to exercise this right. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">The guidelines and experts expressly recommend seeking detailed advice and, if necessary, a <\/span><b>second opinion<\/b><span style=\"font-weight: 400;\"> obtain. After all, it is about your health and quality of life \u2013 and these are at the heart of every good medical care.<\/span><\/p>\n<p>&nbsp;<\/p>\n<h2><b>The typical diagnostic procedure in your clinic<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Many patients with lipedema already have a long history of suffering behind them. Not infrequently, the fat distribution disorder was falsely identified as <\/span><b>overweight<\/b><span style=\"font-weight: 400;\"> or other illness. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">At your specialized clinic, we take care to avoid such <\/span><b>misdiagnoses<\/b><span style=\"font-weight: 400;\"> to avoid. So that you know exactly what to expect, we explain here step by step the typical course of the <\/span><b>Lipedema diagnosis<\/b><span style=\"font-weight: 400;\"> &#8211; from the first <\/span><b>diagnostic interview<\/b><span style=\"font-weight: 400;\"> to the documentation of the <\/span><b>findings<\/b><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h3><b>Initial consultation &amp; anamnesis<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">It all starts with an empathetic <\/span><b>initial consultation<\/b><span style=\"font-weight: 400;\"> with a detailed <\/span><b>anamnesis<\/b><span style=\"font-weight: 400;\">. Your doctor will take plenty of time for you: you can talk about your symptoms in peace and ask all your questions.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">The important thing is <\/span><b>when<\/b><span style=\"font-weight: 400;\"> and <\/span><b>how<\/b><span style=\"font-weight: 400;\"> the symptoms began &#8211; for example during puberty or after pregnancy, as this is typical for lipoedema. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Likewise, you will be asked about your family history: Perhaps your mother or grandmother has similar problems? Since lipedema often occurs in families, this information is valuable.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Do not be afraid to talk about <\/span><b>pain<\/b><span style=\"font-weight: 400;\">, your everyday feelings and any emotional burdens. Lipedema can be very stressful, and your treatment team knows that. Therefore, part of the diagnostic interview is that we discuss your <\/span><b>life situation<\/b><span style=\"font-weight: 400;\"> and possible psychological stress &#8211; this is the only way to get a complete picture. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">All this information flows into your medical history and helps us to plan the next steps of the diagnostics in a targeted manner. Often our patients fill out a questionnaire about their medical history in advance so that we can prepare optimally. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">In the initial consultation itself, we will then go through your answers together, clarify any uncertainties and listen to you carefully.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In short: In this phase, the focus is on <\/span><b>listening and understanding<\/b><span style=\"font-weight: 400;\">  in the foreground. You are the expert for your own body \u2013 the more accurately you describe your symptoms, the better the doctor can get a picture. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Typical signs of lipoedema are, for example, pressure-sensitive, painful legs that swell during the course of the day and a <\/span><b>A tendency to bruise<\/b><span style=\"font-weight: 400;\">  without recognizable cause. All this is recorded in the conversation. At the end of the anamnesis, your doctor already has an initial suspicion \u2013 and you yourself have the good feeling of being taken seriously.<\/span><\/p>\n<h3><b>Examinations &amp; tests &#8211; what happens per session<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">The interview is followed by a physical <\/span><b>examination<\/b><span style=\"font-weight: 400;\">. Your doctor will take a close look at your affected areas of the body (usually legs, sometimes arms). He pays attention to the image typical of lipedema: a <\/span><b>symmetrical increase in fat<\/b><span style=\"font-weight: 400;\"> on both legs or arms, often with a slender trunk and slender feet or <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">hands. The  <\/span><b>Distribution pattern<\/b><span style=\"font-weight: 400;\"> differs from normal obesity &#8211; in lipedema, the fat pads usually end abruptly at the ankles, so that the feet remain normally slim (this is referred to as &#8220;collar formation&#8221;). <\/span><i><span style=\"font-weight: 400;\">&#8220;collar formation&#8221;<\/span><\/i><span style=\"font-weight: 400;\">).<\/span><\/p>\n<p><i><span style=\"font-weight: 400;\">Legs of women with different figures &#8211; with lipoedema, the legs and hips are often affected, while the feet and upper body remain slimmer.<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400;\">The inspection is followed by <\/span><b>palpation (palpation)<\/b><span style=\"font-weight: 400;\">  to. Your doctor uses his hands to check the texture of your subcutaneous fatty tissue. Early on, typical abnormalities appear: The skin may feel as if there are small nodules or <\/span><b>polystyrene beads<\/b><span style=\"font-weight: 400;\"> underneath. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">An important part of the examination is the <\/span><b>pinch test<\/b><span style=\"font-weight: 400;\">: Here, the skin on the outside of the thigh is carefully pinched. In lipedema patients, this test is usually significantly <\/span><b>more painful<\/b><span style=\"font-weight: 400;\"> than at a comparable point in unaffected areas. This means that if you pinch an area of lipoedema, it hurts excessively, whereas pinching the abdomen or the inside of the legs, for example, causes fewer problems. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">This different sensation of pain is a strong indication of lipedema. The  <\/span><b>Sensitivity to pressure<\/b><span style=\"font-weight: 400;\"> is checked overall, e.g. whether even slight pressure with the finger on the legs is uncomfortable.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Thorough diagnostics often include <\/span><b>further tests<\/b><span style=\"font-weight: 400;\">  within the same session. Your doctor will measure your <\/span><b>Body circumference<\/b><span style=\"font-weight: 400;\"> \u2013 typically circumference measurements on legs, hips and waist. This allows, on the one hand, to record the extent of the fat distribution disorder, and on the other hand, a <\/span><b>Differentiation from obesity<\/b><span style=\"font-weight: 400;\"> to make. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">For example, a comparison of waist circumference and leg circumference shows whether there is a disproportionate fat distribution. In addition, your <\/span><b>Weight and your height<\/b><span style=\"font-weight: 400;\"> are recorded to calculate your BMI &#8211; this also helps to rule out other causes for your figure.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If necessary <\/span><b>Devices and imaging procedures<\/b><span style=\"font-weight: 400;\"> are used. Very often a <\/span><b>Ultrasound examination (sonography)<\/b><span style=\"font-weight: 400;\"> of the legs. This enables the doctor to determine, for example, whether <\/span><b>varicose veins or venous insufficiency<\/b><span style=\"font-weight: 400;\"> that could contribute to swelling. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Although lipoedema cannot be &#8220;seen&#8221; directly on ultrasound, this examination is important in order to <\/span><b>other causes<\/b><span style=\"font-weight: 400;\"> swollen legs (such as a <\/span><b>venous disease<\/b><span style=\"font-weight: 400;\">) can be ruled out. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Ultrasound can also be used to roughly assess how thick the layer of fat under the skin is, which gives an indication of the <\/span><b>lipoedema stage<\/b><span style=\"font-weight: 400;\"> can give an indication of the stage of lipoedema. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">In some cases, our clinic also uses more modern techniques &#8211; for example 3D body scanners or <\/span><b>bioimpedance analysis<\/b><span style=\"font-weight: 400;\"> \u2013 to measure your body composition exactly. Such objective measurements help later to check the success of the therapy.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If necessary, we will arrange for additional <\/span><b>laboratory tests<\/b><span style=\"font-weight: 400;\">. For example, a blood sample can  <\/span><b>Thyroid function, liver and kidney values<\/b><span style=\"font-weight: 400;\"> etc. are checked. Why? Certain internal problems (e.g. an underactive thyroid) can promote edema or be associated with lipedema. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Your doctor wants to make sure that no such <\/span><b>underlying disease<\/b><span style=\"font-weight: 400;\"> is overlooked. All these tests \u2013 physical examination, ultrasound, laboratory \u2013 can usually be carried out in one appointment. So you don&#8217;t have to come extra for every step. At the end of the examination, you usually know very well where you stand.<\/span><\/p>\n<h3><b>Securing results &#8211; documentation, progress, findings<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">After all examinations have been completed, the next step is the careful <\/span><b>documentation<\/b><span style=\"font-weight: 400;\"> of the results. Your doctor will <\/span><b>Findings<\/b><span style=\"font-weight: 400;\"> note: from your anamnesis data to the results of the pinch test to measurement results such as circumference measurements. In specialized centers, <\/span><b>Photos<\/b><span style=\"font-weight: 400;\"> or 3D scans are often made to record the initial findings. Such visual reference material can be valuable later to objectively assess changes. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">All the data together make up your <\/span><b>medical report<\/b><span style=\"font-weight: 400;\">which clearly states whether lipedema is present and if so, in which <\/span><b>stage<\/b><span style=\"font-weight: 400;\">. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Lipoedema is usually divided into <\/span><b>three stages<\/b><span style=\"font-weight: 400;\"> (some experts even speak of four stages) &#8211; so your doctor will look at your skin condition and palpation findings and classify you accordingly. <\/span> <\/p>\n<p><b>Important:  <\/b><span style=\"font-weight: 400;\">The stage classification primarily describes the changes in the tissue (e.g. smooth skin vs. nodule formation), but does not automatically say anything about the severity of your symptoms. Even in an early stage, someone can have severe pain. Nevertheless, the stage documentation helps with the <\/span><b>Therapy planning<\/b><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In the final consultation, the doctor will <\/span><b>diagnosis of lipedema<\/b><span style=\"font-weight: 400;\"> discuss with you \u2013 if it has been confirmed \u2013 and explain all the findings to you. So you will know exactly what we have found out. Don&#8217;t worry: Of course you can ask further questions. Our concern is that you understand your disease. This also includes an outlook: The doctor will explain to you how the <\/span><b>Further procedure<\/b><span style=\"font-weight: 400;\"> may look like. In addition, <\/span><b>Progress observations<\/b><span style=\"font-weight: 400;\"> are planned: That is, we record which controls or measurements are useful in the future. For example, we note your current leg circumferences in order to be able to compare them at later appointments. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">This allows us to see objectively whether, for example, a therapy is working or whether the lipoedema is progressing. If necessary, a next appointment for a <\/span><b>follow-up<\/b><span style=\"font-weight: 400;\"> if necessary &#8211; especially if conservative measures are to be tried first.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">At the end of the diagnosis, you as a patient have a solid basis on which the treatment can build. All important points are now in black and white in your file. With this clear finding in mind, your doctor can develop a <\/span><b>individual treatment plan<\/b><span style=\"font-weight: 400;\"> for you. <\/span> <\/p>\n<p><b>Thanks to the thorough diagnosis, you now know exactly where you stand &#8211; and together we can tackle the next steps.<\/b> <i><span style=\"font-weight: 400;\">You can read more about the possible forms of treatment for lipoedema in our further guide on conservative and surgical treatment options.<\/span><\/i><\/p>\n<h2><b>Diagnosis confirmed &#8211; and now what?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">The diagnosis <\/span><i><span style=\"font-weight: 400;\">lipoedema<\/span><\/i><span style=\"font-weight: 400;\"> has been made &#8211; you may feel relieved to finally have some certainty and at the same time worried about what will happen next. <\/span> <\/p>\n<p><b>The important thing is:<\/b><span style=\"font-weight: 400;\"> You are not alone with this finding. <\/span><b>What happens now?<\/b><span style=\"font-weight: 400;\"> <\/span><\/p>\n<p><span style=\"font-weight: 400;\">In your specialized clinic, you will not simply be sent home after the diagnosis, but will be comprehensively informed about the next steps. In the following, we explain what happens immediately after confirmation of the diagnosis.<\/span><\/p>\n<h3><b>Step 1: Exclude differential diagnoses<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Before the actual therapy begins, your doctor will make sure that only <\/span><b>only the lipoedema<\/b><span style=\"font-weight: 400;\"> behind your complaints \u2013 and no other or additional disease. The elimination of <\/span><b>Differential diagnoses<\/b><span style=\"font-weight: 400;\"> is crucial in order to avoid incorrect treatment. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Although possible other causes were already considered during the diagnosis, but now you look at it again specifically. Typical diseases that can resemble a lipedema are:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Lymphoedema:<\/b><span style=\"font-weight: 400;\"> Here, tissue fluid accumulates in the arms or legs, usually on one side or unevenly. In contrast to lipoedema, lymphoedema often also affects feet\/toes &#8211; recognizable by the positive <\/span><i><span style=\"font-weight: 400;\">Stemmer&#8217;s sign<\/span><\/i><span style=\"font-weight: 400;\"> (the skin above the toes cannot be lifted). <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Lipoedema, on the other hand, leaves the feet free; the Stemmer&#8217;s sign is negative (skin fold can be lifted). Lymphoedema also causes a feeling of tightness rather than pain. Your doctor will carefully check for signs such as these.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">If necessary, lymphatic scintigraphy can be used to test lymphatic function in order to rule out lymphoedema. <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><b>Important to know: <\/b><span style=\"font-weight: 400;\">Both diseases can also occur <\/span><b>occur simultaneously<\/b><span style=\"font-weight: 400;\"> occur at the same time (so-called lipolymphedema). If lymphoedema is present alongside lipoedema, this will be included in the treatment plan.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Lipohypertrophy:<\/b><span style=\"font-weight: 400;\"> This refers to a purely <\/span><b>aesthetic fat distribution disorder<\/b><span style=\"font-weight: 400;\"> without disease value. Similar to lipedema, increased fat occurs on the legs and hips (often in puberty), <\/span><b>but<\/b><span style=\"font-weight: 400;\">There is no pain <\/span><b>no pain, no bruises and no swelling<\/b><span style=\"font-weight: 400;\">. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Lipohypertrophy is easily confused with lipedema, but is actually \u201conly\u201d a figure variant. However, it can develop into a lipedema over the years.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">In your case, the doctor has recognized from the medical history and examination that pain and tenderness are present &#8211; this rules out pure lipohypertrophy.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Obesity (overweight):<\/b><span style=\"font-weight: 400;\"> Severe obesity can lead to similar fat gain, but usually all over the body (especially the abdomen) and not as disproportionately on the legs\/hips. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Crucial: <\/span><b>Lipedema fat is resistant to diet<\/b><span style=\"font-weight: 400;\"> \u2013 that is, even with weight loss, the affected areas remain disproportionately thick. In obesity, on the other hand, a change in diet would reduce the fat in all areas. Your doctor has probably determined your BMI and measured the ratio of waist to hip to distinguish between general obesity and lipedema. <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Often, lipedema patients also have mild obesity; then both problems are addressed. It is important to <\/span><b>Consequential risks<\/b><span style=\"font-weight: 400;\"> of being overweight (e.g. high cholesterol or sugar levels) &#8211; therefore cholesterol, blood sugar etc. were tested in the laboratory if necessary.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Venous diseases:<\/b><span style=\"font-weight: 400;\"> Varicose veins or chronic venous insufficiency can also cause <\/span><b>Swelling and feelings of heaviness<\/b><span style=\"font-weight: 400;\"> cause in the legs. Therefore, a look at the <\/span><b>Veins<\/b><span style=\"font-weight: 400;\">. Your phlebologist may have detected a  <\/span><i><span style=\"font-weight: 400;\">Vein check<\/span><\/i><span style=\"font-weight: 400;\"> made. This excludes that your complaints primarily originate from a venous disease. <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">If varicose veins are found, they can be treated in parallel \u2013 because untreated varicose veins would reduce the therapeutic success in lipedema (they increase swelling and pain). Therefore, all findings \u2013 lipedema and any concomitant diseases \u2013 are taken into account in your treatment plan.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">After all these differential diagnoses <\/span><b>checked off<\/b><span style=\"font-weight: 400;\"> are, you can be sure: The main cause of your complaints is actually the lipedema. This clear foundation is important to now initiate the appropriate therapy steps.<\/span><\/p>\n<h3><b>Step 2: Treatment planning &#8211; conservative or surgical?<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Now the <\/span><b>therapy planning<\/b><span style=\"font-weight: 400;\">. Your doctor will discuss with you in detail which treatment paths are available. Basically, two approaches are available: a <\/span><b>conservative therapy<\/b><span style=\"font-weight: 400;\"> (without surgery) and a <\/span><b>surgical therapy<\/b><span style=\"font-weight: 400;\">. The plan will  <\/span><b>individually<\/b><span style=\"font-weight: 400;\"> tailored to you &#8211; depending on the severity of your lipoedema, your personal wishes and circumstances. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">It is often recommended to first exhaust all conservative options. These aim to <\/span><b>alleviate symptoms<\/b><span style=\"font-weight: 400;\"> and slow down the progression of the disease. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">If the conservative treatment does not bring the desired success or your lipedema is already far advanced (e.g. stage III), an operative measure can also be considered. Together with you, we weigh the benefits and risks of the options \u2013 <\/span><b>You<\/b><span style=\"font-weight: 400;\"> help decide which path is right for you.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">An overview of the two therapeutic approaches:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Conservative therapy:<\/b><span style=\"font-weight: 400;\">  This includes all non-surgical measures. Central is the <\/span><b>Complex physical decongestive therapy (CDT)<\/b><span style=\"font-weight: 400;\">, which combines various building blocks. Your doctor will in almost all cases <\/span><b>prescribe medical compression garments<\/b><span style=\"font-weight: 400;\"> for example, custom-made compression stockings or leggings. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">These exert pressure on the tissue and can thus reduce pain and reduce swelling. Important to know: Compression does not melt away the fat itself, but it shapes the extremities and prevents further fluid accumulation. <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Especially if a lymphedema is also involved, compression is indispensable. In addition, <\/span><b>Manual lymphatic drainage (MLD)<\/b><span style=\"font-weight: 400;\"> recommended. This is a gentle medical massage by specially trained physiotherapists who move congested lymph fluid towards the trunk. <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">You usually feel a relief afterwards because the pressure in the legs decreases. Other conservative measures include <\/span><b>Exercise therapy<\/b><span style=\"font-weight: 400;\"> (e.g. swimming, gymnastics in compression stockings) and skin care. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Also an <\/span><b>adapted diet<\/b><span style=\"font-weight: 400;\"> is also part of this: Although lipoedema cannot be &#8220;dieted away&#8221;, healthy eating habits help to control accompanying factors such as obesity or inflammation. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Your doctors will guide you in all of this \u2013 you will learn how you can actively help to improve your complaints. The conservative therapy requires some patience and cooperation at the beginning, but in most cases it forms the <\/span><b>Basis of the treatment<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Surgical therapy:<\/b><span style=\"font-weight: 400;\"> If the lipedema is very pronounced or the non-surgical measures have not brought enough relief, a <\/span><a href=\"https:\/\/venaziel.de\/en\/venenzentrum-leistungen\/lipodem\/\"><b>liposuction<\/b><span style=\"font-weight: 400;\"> (liposuction)<\/span><\/a><span style=\"font-weight: 400;\"> can be considered. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">In this process, excess, pathologically altered fatty tissue is permanently removed in a surgical procedure. D<\/span><span style=\"font-weight: 400;\">Liposuction for lipedema is performed in specialized centers and usually in several sessions. <\/span><b>several sessions<\/b><span style=\"font-weight: 400;\">as only a certain amount of fat can be removed per operation. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Modern techniques such as vibration-assisted or water jet-assisted liposuction are used, sometimes also ultrasound methods (e.g. VASER). The goal of the surgery is to <\/span><b>reduce fat deposits<\/b><span style=\"font-weight: 400;\"> and thus reduce pressure pain and movement problems. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Many patients report a significant improvement in their quality of life after successful liposuction &#8211; their proportions finally fit together better and, above all, the daily pain subsides.  <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Nevertheless, liposuction is not an easy step. Your doctor will advise you in detail (if necessary, you will receive a separate clarification interview with the surgeon). <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">It is also important that conservative measures are continued after liposuction. <\/span><i><span style=\"font-weight: 400;\">continued<\/span><\/i><span style=\"font-weight: 400;\"> e.g. temporarily more intensive lymphatic drainage and permanent compression to maintain the result. An operation <\/span><b>supplements<\/b><span style=\"font-weight: 400;\"> conservative therapy, but does not replace it completely.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Your individual therapy plan can consist of a combination of these approaches. For example, many patients start with <\/span><b>conservative therapy<\/b><span style=\"font-weight: 400;\">and if the symptoms do not improve sufficiently, the decision is made to undergo liposuction. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">In other cases, it is clear from the outset that an operation makes sense \u2013 then, of course, conservative treatment is still carried out until the surgery date in order to prepare your legs in the best possible way. Your treatment team will advise you comprehensively on which strategy is best for you. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">We are guided by current medical guidelines, but also by your personal goals and wishes.<\/span><\/p>\n<h3><b>Step 3: First steps at the VenaZiel Lipedema Center &#8211; individual recommendations<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">After the diagnosis and the joint therapy planning, we will not leave you alone. In the <\/span><b>VenaZiel Lipedema Center<\/b><span style=\"font-weight: 400;\"> now the first steps of your treatment begin specifically. Everything will be <\/span><b>individual<\/b><span style=\"font-weight: 400;\"> tailored to you so that you are optimally cared for. What can you expect directly?<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Detailed final consultation:<\/b><span style=\"font-weight: 400;\"> First of all, your doctor will sit down with you again and explain <\/span><b>the next steps in detail<\/b><span style=\"font-weight: 400;\">. You will have the opportunity to ask any unanswered questions.  <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">During this consultation, the results of the diagnosis (your findings) will be explained to you in an understandable way and the planned treatment will be discussed point by point.  <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">The aim is for you to know exactly what happens next and why.  <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">This personal consultation is very important to us &#8211; you should go home with a clear plan and a good feeling.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Tailor-made advice &amp; planning:<\/b><span style=\"font-weight: 400;\"> This is followed by the concrete <\/span><b>therapy organization<\/b><span style=\"font-weight: 400;\">. Together with you we create a<\/span> <a href=\"https:\/\/venaziel.de\/en\/venenzentrum-leistungen\/lipodem\/\"> <b>customized therapy plan<\/b><\/a><span style=\"font-weight: 400;\">. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">This means: We determine which conservative measures you will receive and in which order. For example, the supply with <\/span><b>compression garments<\/b><span style=\"font-weight: 400;\"> arranged. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Our specialists take your <\/span><b>measurements<\/b><span style=\"font-weight: 400;\"> and help you choose the right compression class and materials so that your stockings\/trousers fit perfectly. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">You will be given detailed advice on how to put them on, when to wear them and how to care for them &#8211; all step by step and without haste.  <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">If <\/span><b>manual lymphatic drainage<\/b><span style=\"font-weight: 400;\"> is part of the plan, you will receive a prescription for it. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">If other specialists need to be involved &#8211; such as a vascular surgeon for a large number of varicose veins or an endocrinologist for hormonal issues &#8211; we will also coordinate these referrals for you.  <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><b>Surgical steps<\/b><span style=\"font-weight: 400;\"> (e.g. liposuction) are also planned together: You will learn how to prepare for the operation, what you need to consider post-operatively and what support is available during rehabilitation.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Individual everyday tips:<\/b><span style=\"font-weight: 400;\"> A major focus of our center is to prepare you for everyday life with lipedema. <\/span><b>everyday life with lipoedema<\/b><span style=\"font-weight: 400;\"> to equip. You will receive <\/span><b>practical tips and recommendations<\/b><span style=\"font-weight: 400;\">how you can help to alleviate the situation yourself &#8211; always adapted to your personal situation. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">This includes, for example, advice on <\/span><b>exercise<\/b><span style=\"font-weight: 400;\"> (&#8220;Exercise as often as possible, activities that are easy on the joints such as swimming or cycling are ideal &#8211; even with compression stockings on&#8221;), on <\/span><b>diet<\/b><span style=\"font-weight: 400;\"> (an anti-inflammatory diet can be helpful, but crash diets are not effective) and on <\/span><b>skin care<\/b><span style=\"font-weight: 400;\"> (regular application of suitable lotions to protect your skin under compression).<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">We also provide you with strategies for dealing with any emotional stress: Don&#8217;t be afraid to accept support &#8211; be it through exchanges in self-help groups or, if necessary, through psychological counseling.  <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">All these tips should help you to cope better in everyday life and actively contribute to the success of your therapy.  <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Of course, you will receive this advice in writing or in the form of leaflets so that you can read everything at home at your leisure.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Aftercare and follow-up:<\/b><span style=\"font-weight: 400;\"> At VenaZiel, we understand lipedema therapy as a <\/span><b>continuous process<\/b><span style=\"font-weight: 400;\">. That&#8217;s why, right from the start, your  <\/span><b>Aftercare appointments<\/b><span style=\"font-weight: 400;\"> planned. Depending on the therapy plan, we arrange check-up examinations \u2013 initially perhaps every few months, later individually as needed. <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">In these appointments we review the <\/span><b>progress<\/b><span style=\"font-weight: 400;\">For example, we measure your circumferences again, ask about your current complaints and adjust the therapy if necessary. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Your <\/span><b>compression supply<\/b><span style=\"font-weight: 400;\"> is regularly checked and renewed if necessary (because over time the material can decrease or your dimensions can change). If you have had surgery, close follow-up checks take place to assess wound healing and the result of liposuction. And of course we are also available between appointments for questions. You should feel in good hands at all times.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">In summary: After your lipedema has been diagnosed, you will receive a clear roadmap from us. You know which therapy steps are pending, get personal recommendations for everyday life and have fixed contact persons who accompany you. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">The journey may be long, but you&#8217;re not going it alone &#8211; your VenaZiel team is by your side.  <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><i><span style=\"font-weight: 400;\">You can also find out how to cope better with lipoedema in everyday life in our guide with practical everyday tips and lifestyle strategies.<\/span><\/i><\/p>\n<p>&nbsp;<\/p>\n<h2><b>What to do if the findings are unclear?<\/b><\/h2>\n<h3><b>Seek a second opinion or specialist at the lipedema center<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Many lipoedema patients only receive a correct diagnosis after many years &#8211; on average it can take up to <\/span><b>10 years<\/b><span style=\"font-weight: 400;\"> can pass before lipoedema is medically recognized. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">This is also due to the fact that doctors without specialist knowledge often misinterpret lipedema symptoms as mere obesity.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">It is therefore worth seeking a second opinion if the findings are unclear. <\/span><b>second opinion<\/b><span style=\"font-weight: 400;\"> and consult an experienced specialist or a lipedema center. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Such a specialist (such as a lymphologist, phlebologist or plastic surgeon with lipoedema expertise) knows the clinical picture and can assess the situation competently.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">An additional opinion creates certainty about the findings and strengthens confidence in the treatment decision &#8211; precisely because lipedema is often misdiagnosed, the view of a second expert helps to carefully weigh up all the options.<\/span><\/p>\n<h3><b>Self-tests &amp; screening tools &#8211; yes or no?<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">To date, there is no simple laboratory or imaging test that can clearly detect lipedema &#8211; even ultrasound examinations cannot provide direct evidence.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ultimately, only a medical examination by an experienced specialist (e.g. phlebologist or lymphologist) can provide clarity.  <\/span><b>Self-tests<\/b><span style=\"font-weight: 400;\"> or online screening tools can at best provide initial clues. An example is the <\/span><b>Pinch test<\/b><span style=\"font-weight: 400;\">This involves gently pinching the skin of the thighs (inside and outside). <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">If you feel a clear pain even with a slight pinch on the outside, this speaks with a high probability for a lipedema (because the increased fat cells press painfully on the nerve fibers). Digital questionnaires also ask about typical symptoms and give a rough orientation. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Please note, however, that such self-tests are <\/span><b>only an initial orientation<\/b><span style=\"font-weight: 400;\"> and cannot replace a medical diagnosis by a specialist <\/span><b>not replace<\/b><span style=\"font-weight: 400;\">. In any case, the final diagnosis should be made by an experienced doctor by means of a clinical examination.<\/span><\/p>\n<h3><b>When it makes sense to supplement imaging procedures (ultrasound, lymphoscintigraphy)<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">A clinical examination forms the basis of the diagnosis, but if necessary <\/span><b>imaging procedures<\/b><span style=\"font-weight: 400;\"> can be used to confirm the findings or rule out differential diagnoses. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">In particular the <\/span><b>ultrasound<\/b><span style=\"font-weight: 400;\"> helps to rule out other causes for the pain &#8211; for example, venous insufficiency or varicose veins can be detected in the sonogram and ruled out as the cause of the pain. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">In contrast, the fatty tissue itself does not look any different in lipoedema <\/span><b>does not look any different<\/b><span style=\"font-weight: 400;\"> than with normal obesity, so this method cannot make lipoedema directly visible.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A <\/span><b>lymphoscintigraphy<\/b><span style=\"font-weight: 400;\"> (visualization of lymphatic drainage using radioactive marker substances) is only carried out in special cases, for example if it is unclear whether there is also <\/span><b>lymphoedema<\/b><span style=\"font-weight: 400;\"> is also present. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">This procedure visualizes lymphatic drainage disorders in the extremities and is primarily used in cases of suspected chronic lymphoedema or a mixed form (lipoedema <\/span><i><span style=\"font-weight: 400;\">plus<\/span><\/i><span style=\"font-weight: 400;\"> lymphoedema, so-called <\/span><b>lipolymphedema<\/b><span style=\"font-weight: 400;\">) is used. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">In the case of pure lipedema, there is usually <\/span><b>no<\/b><span style=\"font-weight: 400;\">  Lymph congestion; studies even show that lymph transport may initially be normal or increased. Therefore, lymphoscintigraphy for lipedema diagnosis is <\/span><b>not routinely<\/b><span style=\"font-weight: 400;\"> but can provide helpful information in unclear borderline cases.<\/span><\/p>\n<h2><b>Conclusion &amp; next steps<\/b><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Overview:<\/b><span style=\"font-weight: 400;\"> After a clear diagnosis has been made, many sufferers feel great relief. This certainty about the cause of the symptoms is already <\/span><b>the first success<\/b><span style=\"font-weight: 400;\">because targeted treatment can now be planned.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Recommendation:<\/b><span style=\"font-weight: 400;\"> Make an appointment for an official diagnosis as soon as possible &#8211; ideally at a specialized lipedema center such as <\/span><b>VenaZiel<\/b><span style=\"font-weight: 400;\">. Modern procedures (e.g. high-resolution ultrasound or lymphoscintigraphy) are available there to make a precise diagnosis and rule out other diseases.  <\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Thanks to this expertise, you not only receive certainty, but also a customized treatment plan for the next steps.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Note:<\/b><span style=\"font-weight: 400;\">  Remember that the diagnosis is only the beginning. Based on the findings, the actual therapy can now begin \u2013 with the goal of alleviating your symptoms and your <\/span><b>quality of life<\/b><span style=\"font-weight: 400;\"> of life.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">With the support of experienced specialists (such as the VenaZiel team), you can continue on your path: from treatment to aftercare &#8211; for a more active and pain-free life again in the future.<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2><b>FAQ on lipoedema diagnosis<\/b><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>How is lipedema diagnosed?  <\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The diagnosis of lipoedema is made <\/span><b>by a combination of medical history, physical examination and, if necessary, imaging procedures, in particular ultrasound.<\/b><span style=\"font-weight: 400;\"> <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Doctors such as phlebologists, vascular specialists, dermatologists or plastic surgeons are responsible for making the diagnosis, as they have the necessary specialist knowledge and experience with the disease.  <\/span><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>How can I tell if I have lipedema?<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Lipoedema can be recognized by several signs, which typically include <\/span><b>symmetrical fat distribution on the legs and hips, pain and tenderness in the affected areas, and a tendency to bruise without an identifiable cause. <\/b> <\/p>\n<p><span style=\"font-weight: 400;\">Other indications may be heavy, aching legs that swell during the day and may also hurt at night, as well as a disproportionate figure with a slimmer upper body and increased fat deposits on the legs and\/or arms.  <\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>What are the first signs of lipoedema?<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">The first signs of lipoedema include a <\/span><b>symmetrical increase in fat on the legs and\/or arms, often extending to the ankles or wrists, while the hands and feet remain slim. <\/b> <\/p>\n<p><b>Other early symptoms include tenderness and pain in the affected areas, as well as an increased tendency to bruise.<\/b><span style=\"font-weight: 400;\"> A feeling of tension and heaviness in the limbs can also indicate lipoedema.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>What does the pain of lipoedema feel like?<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The pain associated with lipoedema is often described as a <\/span><b>described as a pressing feeling of tension that is comparable to sore muscles.<\/b><span style=\"font-weight: 400;\"> <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Those affected report touch sensitivity, so that even slight touches can cause pain. The pain can increase during the day and be exacerbated by prolonged standing or sitting. <\/span><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Where exactly do the legs hurt with lipoedema?<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Lipoedema causes pain mainly in the legs, although the intensity of pain can vary from person to person.  <\/span><b>Typically, the legs are affected, especially the thighs and lower legs, although the hips and buttocks are also often involved.<\/b><span style=\"font-weight: 400;\"> <\/span><\/p>\n<p><span style=\"font-weight: 400;\">The pain is often described as pressing, pulling or stabbing and can also occur with a light touch or without any external influence.  <\/span><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>How does lipoedema begin &#8211; where do the symptoms first appear?<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Lipoedema begins <\/span><b>typically begins with a symmetrical fat distribution disorder, which is usually seen on the legs and\/or arms.<\/b><span style=\"font-weight: 400;\"> is usually seen on the legs and\/or arms. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">The first symptoms are often pain, feelings of tension and increased touch sensitivity in the affected areas. Those affected often notice an increase in fatty tissue, especially on the hips, thighs, lower legs or arms, while hands and feet are usually not affected. <\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>What does stage 1 lipedema look like?<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Stage 1 lipoedema is characterized by a <\/span><b>uniform thickening of the subcutaneous tissue on the arms and legs, usually with a smooth skin surface, but which can show the first signs of &#8220;orange peel skin&#8221; or dents when pressure is applied or the skin is pushed together.<\/b><span style=\"font-weight: 400;\"> The fat structure is fine-knotted and those affected often report pain or tenderness in the affected areas. <\/span><span style=\"font-weight: 400;\">Further details on stage 1 lipoedema:<\/span><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Symmetrical fat distribution disorder<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Smooth skin<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Fine nodular fat structure<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Pain and sensitivity to pressure<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Tendency to bruising<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">No or little swelling<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Different body proportions<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li aria-level=\"2\"><span style=\"font-weight: 400;\">No change despite exercise and dieting<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>What is the difference between normal fat legs and lipoedema?<\/b><\/li>\n<\/ul>\n<p><b>Lipoedema is a fat distribution disorder that differs from normal thick legs as it is associated with pain, tenderness and a tendency to bruise.  <\/b><\/p>\n<p><span style=\"font-weight: 400;\">In addition, the distribution of fat in lipoedema is symmetrical and often disproportionate to the rest of the body, whereas fat legs are often caused by other factors such as obesity, lymphatic drainage disorders or vein problems.  <\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Can lipedema also occur at a normal body weight?<\/b><\/li>\n<\/ul>\n<p><b>Yes, lipoedema can also occur at a normal body weight or even if you are underweight.<\/b><span style=\"font-weight: 400;\"> It is a chronic fat distribution disorder that is not exclusively associated with being overweight. <\/span> <\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>How can I test myself to see if I have lipedema?<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">A self-administered test can give an indication of possible lipedema, but is not definitive.  <\/span><b>The lipedema pinch test can help by pinching the skin on the thighs and paying attention to pain sensitivity. A pinch that hurts more than on the inside could indicate a lipedema, as this is often the opposite in healthy people.<\/b><span style=\"font-weight: 400;\"> <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Other signs are rapid bruising, swelling that worsens in the evening, and an uneven skin texture with possibly nodular areas. A visit to the doctor is essential for a final diagnosis, as the symptoms can also occur in other diseases.<\/span><\/p>\n<p><b>Explanation of the pinch test:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The pinch test is carried out by pinching the skin on the thighs between the thumb and index finger.  <\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pay attention to whether you feel pain or an unpleasant feeling of pressure.  <\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">With lipoedema, sensitivity to pain is often greater on the outside of the thighs than on the inside, in contrast to healthy people.  <\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>How reliable is the Stemmer&#8217;s sign in distinguishing lymphoedema?<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The stemmer mark is a useful, but not completely <\/span><b>not completely reliable characteristic<\/b><span style=\"font-weight: 400;\"> for distinguishing lymphoedema from other swellings, especially lipoedema. <\/span> <span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">A positive Stemmer&#8217;s sign, i.e. the inability to lift a fold of skin in the affected area, indicates lymphoedema, but does not rule it out with certainty.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">A negative Stemmer&#8217;s sign, in which the skin fold is slightly raised, does not definitively rule out lymphoedema either, as it can also occur with lymphoedema.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>How long does the diagnostic process take if lipedema is suspected?<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The diagnostic process for suspected lipedema can vary, but <\/span><b>on average it takes about 10 years<\/b><span style=\"font-weight: 400;\">until a diagnosis is made. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">This is often because the symptoms can vary from woman to woman and lipoedema is not recognized by many doctors as a disease in its own right.  <\/span><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Which doctor diagnoses lipedema?<\/b><\/li>\n<\/ul>\n<p><b>A phlebologist (specialist in vein medicine), a lymphologist or a vascular specialist  <\/b><span style=\"font-weight: 400;\">can diagnose a lipedema. A dermatologist or a specialist in plastic and aesthetic surgery with a specialization in lipedema can also make the diagnosis. <\/span><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Can a gynecologist diagnose lipedema?<\/b><\/li>\n<\/ul>\n<p><b>A gynecologist can recognize signs of lipedema, but a definitive diagnosis should be made by a specialist, such as a phlebologist, lymphologist or vascular specialist.  <\/b><\/p>\n<p><span style=\"font-weight: 400;\">It is important to see a doctor who specializes in lipedema to ensure a correct diagnosis and treatment.  <\/span><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>When does the health insurance company officially recognize lipoedema?<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">A health insurance company officially recognizes lipoedema<\/span><b> if certain criteria are met, in particular stage III lipoedema and at least 6 months of unsuccessful conservative treatment. <\/b> <\/p>\n<p><span style=\"font-weight: 400;\">The body mass index (BMI) can also play a role, whereby a BMI over 35 often requires concomitant obesity treatment and a BMI over 40 can rule out surgery.  <\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Why is a lipedema diagnosis so important? A lipedema is more than just being overweight \u2013 it is a chronic, painful fat distribution disorder that almost exclusively affects women. The early lipedema diagnosis is extremely important, because only with a correct diagnosis can the treatment be initiated in a targeted manner. <\/p>\n<p>If a lipedema remains unrecognized, those affected often suffer unnecessarily long from pain and uncertainty, while incorrect treatments (e.g. strict diets) show no success. A correct and early diagnosis helps to avoid consequential damage and reduce the suffering.<\/p>\n","protected":false},"author":1,"featured_media":21350,"parent":20923,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-20934","page","type-page","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/pages\/20934","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/comments?post=20934"}],"version-history":[{"count":6,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/pages\/20934\/revisions"}],"predecessor-version":[{"id":46753,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/pages\/20934\/revisions\/46753"}],"up":[{"embeddable":true,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/pages\/20923"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/media\/21350"}],"wp:attachment":[{"href":"https:\/\/venaziel.de\/en\/wp-json\/wp\/v2\/media?parent=20934"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}