Diagnosis
of Lipedema

Self-Diagnosis of Lipedema

Are you wondering if you have lipedema ?

If you are wondering if you have lipedema, it is important to perform a self-diagnosis quickly. This condition can affect individuals regardless of their body mass index (BMI), making it difficult to determine lipedema based solely on the appearance of the lower and/or upper limbs, especially in cases of obesity.

Here are the signs that may indicate the presence of lipedema in your body :

An Unbalanced Body

Your lower and/or upper limbs have a volume and appearance different from the rest of your body.

Inability to Lose Weight

Despite your attempts to lose weight through diet and exercise, only certain parts of your body have responded. Your waist has become thin, but you have not noticed any positive changes in your lower/upper limbs despite your efforts.

Sensitivity to Touch and Pressure

This sensitivity can vary from person to person.

Vascular Fragility

Spontaneous appearance of bruises on the affected areas. The bruises are slow to heal and may leave marks.

Enlargement of Lower Limbs

The enlargement of tissues stops at the ankles, without affecting the feet. For the upper limbs, the tissue enlargement stops at the wrists, while the hands maintain a normal appearance.

You feel : A sensation of swelling and heaviness in the affected areas.

In some advanced cases of lipedema : Loss of mobility and muscle weakness, which can lead to difficulties in moving and an abnormal gait.

Self-diagnosing lipedema is a first step towards recovery.

Clinical Signs of Lipedema

A. Clinical Signs of Lipedema: How to Diagnose Them

The diagnosis of lipedema can be made by various healthcare professionals such as angiologists, general practitioners, or cosmetic surgeons. They will rely on a set of clinical signs specific to lipedema, obtained through questioning and physical examination. During this consultation, the doctor will ask you questions about your medical history and your symptoms related to lipedema.

B. Clinical Signs of Lipedema: The Clinical Examination.

During the physical examination, the doctor will first observe the visual appearance of your body. In individuals with lipedema, there is noticeable disproportion of the lower or upper limbs compared to the rest of the body, particularly with a waist that remains thin in contrast to the limbs. Joints such as the knees and ankles may become obscured in the lower limbs, while the elbows and wrists may be less defined and filled with fat in the upper limbs. However, the feet and hands are unaffected and maintain a normal appearance.

C. Clinical Signs of Lipedema: The “Column Legs” Appearance. From an overall view of the body, the lower limbs have the appearance of “columns.”

From an overall view of the body, the lower limbs may have the appearance of “columns.” A characteristic sign of lipedema is the symmetrical and bilateral involvement observed in the patient’s body. The healthcare professional will also examine the vascular system, visually noting the appearance of spider veins, which indicate vascular fragility, and may perform a Doppler ultrasound of the affected areas to get an overview of possible vascular issues.

Classification of Lipedema

Lipedema does not manifest the same way in all affected individuals. It can be classified into different stages (progression) and types (location).

The 4 Main Stages of Lipedema :

Lipedema can progress through four different phases. Without proper management, lipedema tends to worsen gradually. Here are the four main stages of lipedema :

The 4 Main Stages of Lipedema Severity :

The 4 Main Stages of Lipedema in Detail :

Stage I : Smooth skin surface, soft to the touch, uniform thickening of the hypodermis.
Stage II : Irregular skin surface, orange-peel appearance, nodules felt upon palpation.
Stage III : Hard skin surface, increased volumes, deformed limb appearance, functional impairment.
Stage IV : Lipo-lymphedema.

It is important not to confuse lipedema with lymphedema, which is an accumulation of lymph rather than fat. Several signs help differentiate these two conditions :

B. The 5 Types of Lipedema

The types of lipedema are determined based on the location of fat deposits and edema. There are five main categories of lipedema types :

• Type I Lipedema: Hips/Buttocks
• Type II Lipedema: From buttocks to knees (included)
• Type III Lipedema: From buttocks to ankles (included)
• Type IV Lipedema: Arms
• Type V Lipedema: Calves only

Complementary Lipedema Assessment: A Must-Do Before Surgery

During the first consultation with a plastic surgeon specializing in lipedema, several additional tests are required before considering surgery.

A. Complementary Lipedema Assessment: Venous Doppler Ultrasound

A Doppler ultrasound of the deep and superficial venous network will be performed to observe radiological signs in the patient. This study will evaluate venous circulation in the limbs, which is essential before aesthetic surgery with WAL liposuction. It will also help determine if surgical intervention for varicose veins is needed before WAL liposuction.

B. Complementary Lipedema Assessment: Lymphoscintigraphy for Advanced Stages

In advanced cases, particularly in advanced stage 2, stages 3, and 4 according to the medical classification of lipedema, Dr. Nicolas Zwillinger may request a lymphoscintigraphy, performed in nuclear medicine centers. This examination precisely analyzes the patient’s lymphatic condition and helps determine the lymphatic component that may be associated with the disease, explaining the enlarged limbs.

C. Complementary Lipedema Assessment: A Blood Test is Also Necessary

Before WAL liposuction, the plastic surgeon requires a pre-operative blood test to detect potential anemia or iron deficiencies. All these complementary results enable Dr. Nicolas Zwillinger and his team to plan a precise therapeutic strategy, ensuring the patient is treated comprehensively and safely.

It is recommended to visit the dedicated page on lipedema treatment to learn more about the available treatment options.