What Is Lipedema? | A Medical Overview by Dr Siafliakis

This article was written in collaboration with Dr Siafliakis of International Lipedema Surgical Center, a world-renowned Lipedema specialist and surgeon.

With decades of experience diagnosing and treating women with Lipedema, Dr Siafliakis generously partnered with us to share his expert insight into one of the most misunderstood conditions in women’s health. 

His goal? To raise awareness, promote early diagnosis, and offer clarity and compassion to those still searching for answers.

Understanding Lipedema: A Clinical Perspective

Lipedema is the most common fat distribution disorder in women – and yet it remains one of the least understood. It’s a chronic and progressive disease marked by a symmetrical build-up of painful, fibrotic fat, primarily affecting the legs, thighs, bum and arms. The condition is hormonally driven and typically develops or worsens during periods of hormonal instability such as puberty, pregnancy, or menopause.

Unlike general fat caused by obesity, Lipedema fat does not respond in the same way to standard weight-loss measures, including calorie reduction and exercise. This distinction is vital for early Lipedema diagnosis and effective management of the condition.

Lipedema Fat: Not Just Extra Weight

In my clinical experience, Lipedema fat behaves differently from ordinary fat. It is:

• Fibrotic and nodular
• Painful to the touch
• Resistant to metabolic changes
• Often associated with poor lymphatic flow and connective tissue dysfunction

This is why many patients report sudden and disproportionate enlargement of the lower body (and sometimes Lipedema in the arms) that cannot be explained by lifestyle factors alone.

Recognising Lipedema Symptoms

While the appearance of disproportionate fat is the hallmark, other signs often include:

• Lipedema pain and tenderness
• Easy bruising
• Cold limbs 
• Cuffing at the ankles or wrists (with feet and hands spared)
• Feelings of heaviness and tightness
• Emotional and psychological distress

As Lipedema progresses, patients may also experience limited mobility and resting pain.

Why Lipedema Is Commonly Misdiagnosed

Despite its prevalence, Lipedema is frequently mislabelled as lifestyle-related obesity. This misdiagnosis delays treatment and exacerbates patient suffering.

That’s why it’s essential to understand that a woman can have a healthy BMI and still suffer from severe Lipedema.

Diagnosing Lipedema: What I Look For

A correct diagnosis is clinical and based on the following criteria: 

• Patient history
• Symmetrical fat distribution sparing the hands and feet
• Palpation of tissue texture (often feels like rice grains or nodules)
• Pain response

Additional tools include ultrasound imaging and 3D body scanning.

Treatment Options: Managing a Lifelong Condition

Unfortunately, there is no cure for Lipedema at present, but treatments can significantly reduce symptoms and improve quality of life. These include:

Conservative Therapies

• Lipedema compression garments
• Massage for Lipedema known as manual lymphatic drainage 
• Low-impact exercise (e.g. swimming, rebounding, walking)
• Anti-inflammatory diet for Lipedema 
• Psychosocial support

Surgical Treatment

For patients with more advanced Lipedema or significant physical limitations, lymph-sparing liposuction (such as micro PAL, WAL or TAL Liposuction, parallel to the lymphessels direction) remains the gold standard. When performed correctly, it can:

• Reduce pain
• Improve mobility
• Halt Lipedema progression
• Significantly enhance daily function

Early Diagnosis Is Key

The earlier we intervene, the better the outcomes. Conservative treatments for Lipedema are most effective in the early stages, and surgery can be planned more precisely before severe tissue changes occur. That’s why it’s so important for medical professionals to spread the word about Lipedema symptoms and diagnosis.

So, What is Lipedema?

As someone who has dedicated their career to this field, I can say with confidence that Lipedema is real, it’s a progressive condition, and it deserves to be recognised in the medical field.

If you believe you may have Lipedema, I urge you to seek out a qualified Lipedema specialist who understands the condition. With the right treatment plan, there is hope.