Once the diagnosis of lipedema has been confirmed, the foundation for your journey into a new life without lipedema can be laid. After years of discomfort, something can now finally be done about your condition! Before an adequate therapy is initiated, the doctor must first determine the stage and severity of the lipedema.


There are three stages and four types of lipedema. Depending on  how advanced your lipedema is, we will choose the correct therapy for your diagnosis.

Stages of lipedema

In order to describe the structure of the tissue as well as the skin texture, lipedema is divided into three stages. The classification of the severity is based on the evaluation of the visible skin surface and on palpation finding. Although the skin surface appears very smooth in the first stage, those affected can already suffer from severe pain in the extremities, which makes long periods of walking and standing impossible. Therefore, the severity of the pain is not taken into account in the evaluation.

  • Stage I: Skin surface is smooth, subcutaneous fatty tissue is thickened. Fat structure is fine-knotted
  • Stage II: Skin surface is uneven. Usually dents and bumps are present. Fat structure is coarse knotted.
  • Stage III: Tissue becomes coarser and harder. The skin forms large-lobed pockets.

Differentiation of four lipedema types 

The stage of the lipedema is classified by the condition of the skin and of the surrounding tissue. Besides classifying lipedema by the stage, there is also a classification by type. Classification of lipedema by type is based on the affected body areas. 

  • Type 1: The subcutaneous fat is increased particularly in the area of the buttocks and hips. The consequence is the so-called ‘saddlebags‘.
  • Type 2: The lipedema has spread to the knees. There is an increased formation of fat on the knees’ inner side.
  • Type 3: The disease extends from the hips to the ankles.
  • Type 4: Lipedema now also affects the arms. The wrists are not affected.

At the beginning of the 2000s, Dr. Falk-Christian Heck first came into contact with a previously unknown disease – lipedema. The clinical picture of the affected women was met with neither acceptance nor understanding by the doctors. Even today, in many cases lipedema is still misdiagnosed as overweight or obesity (adiposity). The disease often remains undetected for a long time. Those affected suffer from shame, self-reproach and frustration.

As an experienced surgeon, Dr. Heck developed a completely new and sustainably effective surgical method, the lipedema surgery (lipo-decompression), which

  • stops the lipedema
  • is a pain-free surgery
  • eliminates the need for compression garments
  • improves the quality of life

These are still our goals today at the LipoClinic Dr. Heck GmbH!

We are here for you! You can gladly call us at +49 208 44475981 or contact us by filling out our contact form.

If you decide to proceed with the treatment at the LipoClinic, we kindly ask you to consider the following:

  • You need a flat-knitted custom-made compression garment in compression class 2. This can be prescribed by your phlebologist or family doctor.
  • For treatment, a diagnosis for lipedema must be provided in a written form by an external specialist for lipedema (e.g. a phlebologist or lymphologist).
  • For reasons of anaesthesia eligibility, your body weight should be below 130kg. If your weight is higher, we will be happy to advise you on alternative approaches.

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