Staging of Lipedema

As lipedema develops in stages, the level of pain, tenderness, swelling and fat accumulation may increase. The images below provide an overview of the four stages of lipedema, showing the location of fat build up and resulting body shape at each stage. Depending on the person, different parts of the body can be affected in different ways at each stage.

These images demonstrate the stages of lipedema as described by Prof. Dr. Wilfried Schmeller and Dr. Karen Herbst (1, 2). This staging criteria, although often used, does not take into consideration pain, size, impact on joints, loss of mobility, or other impacts to quality of life. Other criteria are sometimes used. LF would like to fund research that determines a better way to stage lipedema patients.

These images are protected by copyright laws and the reproduction or distribution of any of these photos is strictly prohibited.

STAGE 1

Smooth skin with an increase of enlarged subcutaneous fat tissue.

Fat buildup around pelvis, buttocks, and hips. For more images go  here .

Fat buildup around pelvis, buttocks, and hips. For more images go here.

Fat buildup from buttocks to knees, with folds of fat around the inner side of the knee. For more images go  here .

Fat buildup from buttocks to knees, with folds of fat around the inner side of the knee. For more images go here.

Fat buildup from buttocks to ankles. For more images go  here .

Fat buildup from buttocks to ankles. For more images go here.

stage 2

Uneven skin with indentations in the fat tissue and larger mounds of fat tissue (lipomas) able to be seen and felt.

Fat buildup around pelvis, buttocks, and hips. For more images go  here .

Fat buildup around pelvis, buttocks, and hips. For more images go here.

Fat buildup from buttocks to knees, with folds of fat around the inner side of the knee. For more images go  here .

Fat buildup from buttocks to knees, with folds of fat around the inner side of the knee. For more images go here.

Fat buildup from buttocks to ankles. For more images go  here .

Fat buildup from buttocks to ankles. For more images go here.

stage 3

Large extrusion of fat tissue causing deformations especially on the thighs and around the knees.

Large extrusions of fat tissue causing buildup from buttocks to knees, with folds of fat around the inner side of the knee. For more images go  here .

Large extrusions of fat tissue causing buildup from buttocks to knees, with folds of fat around the inner side of the knee. For more images go here.

Large extrusions of fat tissue causing buildup from buttocks to ankles. For more images go  here .

Large extrusions of fat tissue causing buildup from buttocks to ankles. For more images go here.

stage 4

Development of lipolymphedema — a condition where both lipedema and lymphedema are present in the body — with large overhangs of tissue on legs and/or arms.

Large extrusion of fat tissue on legs with progression to lipolymphedema. For more images go  here .

Large extrusion of fat tissue on legs with progression to lipolymphedema. For more images go here.

Large extrusion of fat tissue on legs with progression to lipolymphedema. For more images go  here .

Large extrusion of fat tissue on legs with progression to lipolymphedema. For more images go here.


staging of lipedema in arms

Nearly 80 percent of women with lipedema also present with fat on their upper limbs (5). The affected tissue can be located on their upper arms, lower arms, or throughout the entire arm.

stage 1

Fat buildup in upper arms (front view). For more images go  here .

Fat buildup in upper arms (front view). For more images go here.

Fat buildup in lower arms (rear view). For more images go  here .

Fat buildup in lower arms (rear view). For more images go here.

stage 2

Fat buildup in upper arms (front view); For more images go  here .

Fat buildup in upper arms (front view); For more images go here.

Fat buildup in the lower arms (side view); For more images go  here .

Fat buildup in the lower arms (side view); For more images go here.

stage 3

 
Fat buildup in upper arms (side view). For more images go  here .

Fat buildup in upper arms (side view). For more images go here.

Fat buildup in upper arms (rear view). For more images go  here .

Fat buildup in upper arms (rear view). For more images go here.

stage 4

Fat buildup in entire arm (rear view). For more images go  here .

Fat buildup in entire arm (rear view). For more images go here.

Fat buildup in entire arm (front view). For more images go  here .

Fat buildup in entire arm (front view). For more images go here.

Fat buildup in entire arm (side view). For more images go  here .

Fat buildup in entire arm (side view). For more images go here.

References

1. Schmeller, W. & Meier-Vollrath I. Lyphedema. Diagnosis and Therapy. 3 Edition. Chapter 7. (2007).

2. Herbst, K.L. Rare adipose disorders (RADs) masquerading as obesity. Acta Pharmacol. Sin. 33, 155-172 (2012).

3. Herpertz U. Das Lipoedem und seine Kombinationen. Vasomed; 9, 301-307 (1997).

4. Fife, C.E., Maus, E.A. & Carter, M.J. Lipedema: a frequently misdiagnosed and misunderstood fatty deposition syndrome. Adv. Skin Wound Care 23, 81-92 (2010).

5. Herbst, K.L. et al. Lipedema fat and signs and symptoms of illness, increase with advancing stage. Archives of Medicine. 7, 1-8 (2015).