Lipedema Stages and Types – Identifying and Assessing Your Lipedema’s Progression


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There is more to identifying the different types of lipedema than meets the eye.

The severity and progression of the fat deposition disorder known as lipedema is often identified by any one of its four stages – one being the onset and is commonly identified during puberty, while four is the most advanced and physically acute.  However, visual assessment alone isn’t necessarily the most accurate form of identifying which stage a patient’s lipedema lies.  Comprehensive analysis of a patient’s overall symptoms, such as level of inflammation, skin swelling/tenderness, and pain, along with appearance, help to make the best determination of stage and the subsequent, customized therapy needed to mitigate its progression and debilitating effects.  Looks can be deceiving!  A lipedema patient may appear to be in the earlier stages of the adipose tissue disorder, when, in fact, they may be an advanced stage sufferer.  Also, it is estimated that lipedema takes approximately 17 years to progress from stage one to stage four in most patients.  Keep in mind lipedema is an extremely mutable medical disorder and as its stages advance, so too do the accompanying symptoms, including an adverse shift in skin vascularity.

Let’s learn to identify the four stages of lipedema and its characteristic symptoms, including other, lesser-known factors.

Lipedema: Stage One

Stage one of lipedema is usually experienced during the adolescent years with visually smooth skin and a notable increase in enlarged subcutaneous fat tissue lying just beneath the skin’s surface.  This stage introduces an abnormal fat build-up around the pelvic region, bottom, and hips.  Therapies usually include rigorous lifestyle changes, such as diet modification coupled with regimented exercise plans.

Lipedema: Stage Two

A noticeable unevenness to skin takes effect, while deep indentations and larger-than-normal “dimples” begin to take shape in the fat tissue.  Larger mounds of fat can be seen and felt, while skin becomes increasingly tender-to-the-touch and more painful.  Compression therapy is commonly implemented during this accelerating stage.

Lipedema: Stage Three

During this stage, abnormal fat accumulation causes visual deformities and asymmetry of the legs, sparing the ankles and feet.  Knees develop peculiar folds around the inside.

Lipedema: Stage Four

The most advanced and detrimental phase of lipedema, this stage features significant, deformative extrusions of fat tissue with characteristic “overhangs” at the hip area and, in some cases, the upper arms.  During this crucial stage, lymphedema inevitably begins to develop.  Because lymphedema is medically defined as the obstruction of optimal lymph fluid flow, the abnormal accumulation of fat in this latter stage causes lymphedema by default.  Once seemingly simple, everyday tasks are now cumbersome and laborious, while excruciating pain and swelling of the skin continue to worsen.  Surgical intervention is advised to reverse the disorder due to the development of further health challenges and to help the patient regain quality of life and a sense of well-being.


Correctly categorizing your lipedema’s stage isn’t contingent on looks alone and involves a more comprehensive examination of your symptoms and skin’s composition to help slow progression, and ultimately, reverse course.  Lipedema stage identification and therapy is not a one-size-fits-all plan and there are variables to consider.  If you suspect you have lipedema or are unsure about which stage your lipedema lies, the highly skilled specialists at Total Lipedema Care can help.

To learn more, please contact our Beverly Hills, California office to schedule a consultation with any of our highly trained specialists.