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Clinical picture cause of lipedema, medical examination

"More than
  just thick legs"

    Dr. med. Falk-Christian Heck


Guidelines of the
für Phlebologie



Often recognized during childhood, do the thighs and legs become visibly thicker during
. Even though it does not hurt yet – it bothers immensely! You don't know
where the fat so suddenly comes, but the hormones clearly play a big part of it.
A lack of exercise and wrong eating habits are truly not the cause for lipedema.
The frustration grows when regardless of exercise and a strict diet the fat keeps growing.
Where is science at today? The professional society of phlebology has this all
summed up into guidelines.


Stadium-1-des-lipoedems    Stage I
Smooth skin surface, subcutaneous
tissue thickened, fat structure fine-grained. Stage 1 can already cause pain.

Stadium-2-lipoedem   Stage II
Skin surface uneven,

Stadium-3-lipodem   Stage III
Tissue rougher and harder,
hard to eliminate, broad and
deformed fat-lobes.


"Just thick legs" is not quite right...
After several years, the legs cause pain. They are heavy, feel dense and
pressured after standing for an extended period of time.
At the age of 20 still in disbelieve, might be having difficulty at 40
standing for a whole day as a hair dresser. Pressure and sensitivity
in the legs and arms, might also cause disharmony with the Partner.
Lipedema can also change your gait-pattern from an orthopedic
perspective. The gait-pattern becomes more knock-kneed and causes
stress on the spine, the hip and knee joints.
However, lipedema has a much deeper impact on your personality.
Wounded femininity, discomfort in your own body, missing acceptance
and recognition of lipedema as a disease. Your friends, family and maybe
your doctor give you the blame for not being able to stick to your diet
until even you believe it.
Self-doubts are not a good foundation, for a young woman to develop
self-confidence, which negatively impacts every area of life:
Friendship’s, the relationship to your partner and your career.


The diagnosis "lipedema" arises from
the patient's history, the symptoms and
the visual observation.

The thick legs and arms since childhood,
that significantly increase during puberty
and pregnancy. Mother, grandmother or
aunts are possibly affected as well.
Heaviness, congestion, tension, pressure related pain and touch sensitivity are
certain evidence of lipedema.
The fat distribution is crucial:
From the hips downwards, the buttocks
and the outer, inner and front part of
the thighs.
The knees are hardly recognizable and
are immerged in a thick fat cushion.
The calves muscle tone is hardly visible,
they become column shaped.

Additionally, the ankles are often covered
in fat. However, the feet remain slim. The calves are tangibly filled with tissue water.
Similarly, fat can increasingly grow on the
upper and lower arms up to the wrists.
However, initially only certain body parts
can be affected. Only the thighs and calves.
The upper arms can "explosively" thicken
in a short period of time.
Recently bought tops, soon don't fit anymore.
Shaft boots might have never fitted.
A specialist in angiology, should especially
examine the veins and preclude a disease
of the lymph vessels.

Otherwise, no further examination is
necessary, certainly not an examination with contrast medium.