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Recognising lipoedema in Dortmund

Pain on pressure, heavy legs and proportions that barely change despite weight loss can point to lipoedema. What stages 1, 2 and 3 describe and how we examine you at Westfalenklinik in Dortmund.

Book consultation0231 54 504 900
Who will treat you hereDr. Reifenrath, Dr. Gruner, Dr. Simidjiiska, Dr. med. univ. Zamani, Prof. Witt, Dr. Jenner
Typical
both sides the same, hands and feet slim
Stages
1 to 3, by skin and tissue
German health insurance
Liposuction possible in principle at any stage
At a glance

Lipoedema at a glance

Affected
almost exclusively women
Typical areas
Legs, hips, buttocks and arms
Onset
often in puberty, pregnancy or the menopause
Key symptom
Pain on pressure and touch
Stages
describe skin and tissue, not the pain
Diagnosis
Conversation, examination and palpation
German health insurance
Liposuction possible in principle at any stage since October 2025
Consultation
at Westfalenklinik, Dortmund
  • Symmetrical: lipoedema affects both sides of the body equally, and hands and feet stay slim.
  • Not a measure of pain: severe symptoms are just as possible in stage 1 as mild ones in stage 3.
  • A first orientation: self-test and WHtR calculator; the diagnosis is made by a doctor.

Lipoedema in Dortmund: examination and consultation at Westfalenklinik

Many women with lipoedema have a long road behind them before their symptoms are given a name. The pain is often dismissed as a consequence of being overweight. Yet lipoedema is a condition in its own right of the subcutaneous fat tissue, and anyone who knows the signs finds suitable treatment sooner.

At Westfalenklinik in Dortmund we take our time for the examination: we ask about your medical history and the treatments you have already had, examine your legs and arms and assess the extent and stage. You will find us at Rosemeyerstraße 2–4, right on the B1/A40 near Signal Iduna Park. By train, take the U45 from the main station to Stadtgarten and continue with the U42 to Theodor-Fliedner-Heim; by car, leave the B1 at the Dortmund-Hombruch exit and park on the building’s parking deck directly in front of the entrance.

Typical symptoms: what lipoedema feels like

These symptoms distinguish lipoedema from ordinary overweight:

  • Pain on pressure and touch, often at rest too
  • A feeling of heaviness and tension that increases over the course of the day
  • Legs or arms clearly bulkier than the upper body
  • Diets and exercise make little difference to the legs and arms
  • Symptoms worse in warmth and after standing or sitting for a long time
  • Easy bruising, frequently reported, but not a reliable sign on its own

Do several of these points apply to you? Our lipoedema self-test with ten questions gives a first orientation; the diagnosis is made by a doctor.

How to recognise lipoedema by sight

Both sides the same

Lipoedema always affects both sides of the body equally. Lymphoedema, by contrast, often occurs in only one leg or one arm.

Slim hands and feet

The increased fat distribution often ends at the wrists and ankles as if cut off. Hands and feet stay slim.

Slim upper body

The trunk mostly stays slimmer, while hips, legs or arms noticeably increase in circumference. Top and bottom feel like two clothing sizes apart.

Pads at the knee and upper arm

Typical are fat pads on the inside of the knees and on the back of the upper arms, the same on both sides.

Typical areas

Where lipoedema appears

Lipoedema affects both sides of the body equally. Legs, hips and arms are typical, while hands, feet and trunk mostly stay slim.

Diagram of the legs from the waist to the feet, with the thighs, insides of the knees and lower legs marked

Legsmost often

The increased fat tissue sits on the outer and inner sides of the thighs, on the inside of the knees and on the lower legs. Above the ankles it often ends as if cut off, and the feet stay slim. More under Lipoedema in the legs.

Typical
Thighs, insides of the knees, lower legs
Spared
the feet
Diagram of the legs from the waist to the feet, with the hips marked

Hipsand buttocks

Lipoedema often continues on the hips and buttocks. The upper body looks slim by comparison, and the clothing sizes for trousers and top often do not match.

Often together with
the legs
Trunk
mostly slimmer
Diagram of the upper body with hanging arms, with the upper arms and forearms marked

Armsmainly the upper arms

On the arms, the fat tissue sits mainly on the back of the upper arms; sometimes it extends to the forearms. The hands are spared. More under Lipoedema in the arms.

Typical
Back of the upper arms
Spared
the hands
Five women in white underwear seen from behind, symbolic image on lipoedema of the hips and legs

Stages 1, 2 and 3 of lipoedema

The common classification into three stages describes how skin and fat tissue look and feel. According to the current guideline, it is not a measure of how severe the condition is or how strong the symptoms are.

  1. Lipoedema

    Stage 1

    The skin surface is smooth, and the subcutaneous fat tissue is evenly thickened and soft. Hips and legs look bulkier than the upper body and are often dismissed as an ordinary problem area, even though the symptoms can already be clear.

  2. Lipoedema

    Stage 2

    The skin surface becomes uneven and wavy, and the circumference visibly increases. A step can form above the ankles while the feet stay slim. The insides of the thighs rub against each other more often.

  3. Lipoedema

    Stage 3

    The fat tissue is clearly increased and coarser, and overhanging flaps of tissue form on the insides of the knees and on the thighs. Skin irritation from friction, a misalignment of the knees such as knock knees, and restricted mobility can be added.

Diagram in cross-section:SkinFatty tissueLumpsSmall nodulesMuscle

We explain the classification in detail in the article What stages of lipoedema are there?.

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What the stage says and what it does not

The stage says nothing about the pain

Severe pain is just as possible in stage 1 as mild pain in stage 3. Whether surgery comes into question therefore depends on your symptoms and not on the stage.

Not automatic

Lipoedema does not necessarily progress from stage 1 to stage 3. In some of those affected it remains stable for many years; the course can be linked, among other things, to weight development.

No stage 4

There is no separate fourth stage. What is usually meant is lipoedema to which lymphoedema has been added. This needs its own treatment before diseased fat tissue can be removed.

Lipoedema, lymphoedema or being overweight?

Lymphoedema

In lymphoedema, lymph fluid builds up in the tissue. It often begins on one side and involves the feet or hands, which is not the case in lipoedema.

Overweight

In overweight, fat is distributed over the whole body, including the abdomen. Losing weight changes the proportions; pain on pressure is not part of it.

Cellulite

Cellulite is dimpling of the skin that results from the structure of the connective tissue. It is not painful and is not a disease. More on this under Cellulite treatment.

Your route to diagnosis at Westfalenklinik

  1. Step 1

    Before the appointment

    Note down your symptoms. Where does it hurt, since when, and what have you already tried? The self-test and the WHtR calculator help with a first assessment.

  2. Step 2

    Consultation in Dortmund

    Examination. We talk about your medical history, examine and measure your legs and arms and check whether lymphoedema is also present. You can book your appointment online.

  3. Step 3

    For German health insurance

    Confirmed diagnosis. For a benefit covered by German statutory health insurance, a specialist doctor authorised for this makes the diagnosis. The decision on surgery is made by a different doctor.

  4. Step 4

    At least 6 months

    Conservative therapy. Compression, lymphatic drainage and exercise relieve symptoms. For German statutory health insurance, 6 months of therapy without weight gain are part of it.

  5. Step 5

    Afterwards

    Decision. If the symptoms persist despite therapy, a lipoedema surgery can be an option, through German statutory health insurance or as a self-pay patient.

Woman in white sitting with bent legs on a light background, symbolic image on lipoedema surgery via German statutory health insurance or self-payment

What does lipoedema surgery cost in Dortmund? German health insurance and self-payment

Since October 2025, German statutory health insurance can in principle cover liposuction for lipoedema at any stage. Until then, cost coverage was limited to stage 3. We check your entitlement and support you through the application to your health insurer. The most important requirements:

  • Confirmed diagnosis by a specialist doctor authorised for this
  • At least 6 months of conservative therapy
  • No weight gain during this time
  • BMI below 35; between 32 and 35 only with a WHtR within the age-dependent limit
  • Diagnosis and decision on surgery made by different doctors

Our WHtR calculator calculates your BMI and your waist-to-height ratio. As a self-pay patient, you receive a no-obligation treatment quote after the first consultation at Westfalenklinik; the prices are final prices including statutory VAT, and financing is possible through our financing partner. What German statutory health insurance requires in detail, you can read under Lipoedema surgery as a patient with German statutory health insurance and in the article Lipoedema surgery: when does German statutory health insurance cover the costs?.

Who will treat you here

The whole team

Frequently asked questions

Which lipoedema stage do I have?

The stage is determined by a doctor based on the appearance of the skin, the texture of the tissue and the extent of the fat distribution. It says nothing about the severity of your symptoms. In the consultation at Westfalenklinik in Dortmund we examine you and discuss the findings with you.

Is there a lipoedema stage 4?

Not as a separate stage. “Stage 4” usually means lipoedema to which lymphoedema has been added, a so-called lipolymphoedema. That is a second condition with its own treatment. If your feet or hands swell too, have this checked by a doctor.

Does lipoedema always get worse?

Not necessarily. According to the current guideline, lipoedema does not generally progress; in some of those affected it remains stable for many years. The course can be linked to changes in weight and to hormonal changes such as pregnancy or the menopause. A stable weight, compression and exercise help.

From which stage does lipoedema surgery make sense?

The stage alone does not decide this. Whether liposuction comes into question depends on your symptoms and on how they respond to consistent conservative treatment. Since October 2025, German statutory health insurance can also cover liposuction regardless of the stage, if the other requirements are met.

How do I tell lipoedema from cellulite?

Cellulite is dimpling in the skin that results from the structure of the connective tissue. It does not hurt and is not a disease. Lipoedema is a condition of the subcutaneous fat tissue on the legs or arms that hurts on pressure and touch; the legs or arms are clearly bulkier than the upper body.

Who makes the lipoedema diagnosis for German statutory health insurance?

For a benefit covered by German statutory health insurance, a specialist doctor authorised for this makes the diagnosis, for example from angiology, dermatology, physical and rehabilitation medicine, or with the additional specialist training in phlebology. The decision on surgery is made by a different doctor. In the consultation we tell you how to proceed.

Does German statutory health insurance pay for lipoedema surgery?

Since October 2025, German statutory health insurance can in principle cover liposuction for lipoedema at any stage. The requirements are a confirmed diagnosis, at least 6 months of conservative therapy without weight gain and a BMI below 35, between 32 and 35 only with a waist-to-height ratio within an age-dependent limit. You can calculate your value with our WHtR calculator.

What does lipoedema surgery cost in Dortmund?

The costs depend on the extent of the treatment and the number of affected body regions. After your consultation at Westfalenklinik you will receive, as a self-pay patient, a no-obligation treatment quote with final prices; financing is possible through our financing partner. More on this in the article Lipoedema surgery – when does German health insurance cover the costs?.

Where in Dortmund can I have lipoedema examined?

At Westfalenklinik, Rosemeyerstr. 2–4, 44139 Dortmund. The building is located directly on the B1/A40 near the Signal Iduna Park; take the Dortmund-Hombruch exit and park on the building’s parking deck directly in front of the entrance. From the main station, take the U45 to Stadtgarten and then the U42 to Theodor-Fliedner-Heim.

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