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Lipedema literally means fat and fluid accumulation. Lipedema is a chronic, painful fat distribution disorder, in which there is an accumulation of fat and a deterioration of fluid discharge via the lymph. It concerns large amounts of unevenly distributed fat under the skin of the thighs, knees, calves, ankles and arms. In 30% of the cases, lipedema also occurs on the hips, buttocks and lower back. With lipedema, the subcutaneous fat tissue gradually increases, occurring in stages. In addition, there is a tendency for orthostatic edema and bruising after some trauma and a significant sensitivity to touch. In an advanced stage, a lymphostatic edema may develop. This irreversible, advanced stage is a dysfunction of the lymphatic system and should therefore be avoided.

Moreover, in many cases, those affected suffer from obesity; this overweight can in turn aggravate the symptoms. This overweight is in many cases caused by a thyroid gland that works too slowly. Sometimes the base is an eating disorder.

The exact cause of lipedema is unknown. It has been said that lipedema is hormonally triggered expressed in periods of hormonal changes such as during puberty, pregnancy and to a lesser extent during menopause. In addition, hereditary factors may play a role in the development of this disorder. Oftentimes it runs in families; mothers, grandmothers and aunts (on the mother’s side and/or on the father’s side) also have ’thick legs’.

Lipedema is a common disorder. The disease is only known to a limited extent by medical practitioners and those affected. The diagnosis is usually made by phlebologists, dermatologists, skin therapists and/or physiotherapists. The repeated advice to reduce weight and exercise stems from the unfamiliarity with this disease and leads to a lot of frustration and psychological strain in the patients.


Lipedema is classified into different stages:

Stage I

  • In the first phase, the skin surface is smooth, and the subcutaneous tissue thickens.

Stage II

  • During phase II, the skin surface becomes uneven, the skin surface is predominantly characterized by a cellulitis-like skin appearance. The subcutaneous tissue is roughly lumpy.

Stage III          

  • The third phase is characterized by a strong increase in size. There is an excess of skin. Large deformed skin flaps form on legs and/or arms. Especially at the level of the joints. For example the elbows, knees and ankles. There is also a manifest skin laxity.


It is important to stop the course of this disease and treat it as soon as possible. The current standard treatment methods of lipedema are symptomatic: the fitting of elastic stockings and manual lymphatic drainage. Therapeutically, the liposculpture/liposuction has proven to be the only, safe and effective therapy. At the moment there are no other satisfactory therapy.

  • A painful, heavy feeling in the legs, arms, in some cases even back pain
  • Because of tiredness in the legs, walking, stairs and sports become increasingly difficult or even impossible.
  • Weight reduction and sports do not lead to the desired result. With diets, the face and upper body (breasts) etc. are the first to lose weight, while the proportions of the arms and legs have little change.
  • The skin is sensitive to pressure from the outside and bruises easily occur.
  • Large difference in clothing size between upper and lower body (two to three sizes).
  • The skin is sagging and often shows an orange peel skin (cellulite).
  • Hands and feet are not thick.
  • Some patients experience lipedema and associated symptoms as a heavy mental and psychological burden.

Lipedema has serious health consequences if not treated. Therefore, it is very important that lipedema is recognized and treated as early as possible to avoid late and permanent damage. The diagnosis of lipedema can in principle be made on the basis of anamnesis and physical examination.


Treatment path


Before surgery, the doctor will accurately mark out the areas to be treated and photographs will be taken for your medical record. A fine needle and/or cannula will be used to insert the tumescent fluid. As soon as the anaesthetic works, the incisions will be made. We use the “Vibro”-liposculpture using a vibrating cannula. This liquefies the fat cells and the fat can easily be removed (with little suction) without damaging the surrounding tissue or lymphatic

The ’tumescent liposculpture’ has a number of advantages over classical liposuction:

  • Instead of general anesthesia, the procedure can be performed under local anesthesia. This allows the patient to change posture/position during the treatment in order to get the best result. This eliminates the risks and side effects of an anesthesia.
  • With a tumescence liposculpture, a large amount of fluid is injected into the subcutaneous adipose tissue. As a result, the fat is evenly pressurized and emulsified. Due to the vibration of the cannula, the fat is fragmented and reduced to an oily emulsion. An important advantage of this is that the network of the subcutaneous lymphatic membranes is not damaged. The skin contracts nicely after the treatment, which has a lifting effect on the skin.

After the Procedure:

After the treatment you will be cleaned and the small incisions will be closed with a transparent adhesive plaster. As mentioned above, you will be given elastic compression panty, which you will have to wear day and night for six weeks.

To prevent leakage, you will be wrapped in sanitary towels. After 24 hours the leakage stops and the sanitary towels can be removed.  Afterwards you can shower with the tights on. You dry yourself with a towel or put on a bathrobe until you are dry. The use of a hairdryer is not recommended, because of the danger of burning the skin. After a week, the plasters can be removed. From week two you can shower without tights.

After pain and Recovery:

The anesthetic effect of the tumescent fluid continues for a few hours. A light painkiller such as paracetamol or ibuprofen is sufficient for the discomfort, stiffness, and muscle pain sensation after the treatment. The treated area is sensitive during the first week. To give a better and faster recovery, movement is important. Within four weeks, most of the swelling has disappeared and after the four weeks, one gets a kind of result feeling. The patient feels lighter, is more mobile and in the tights the first aesthetic results are visible. Most people go back to work after a day or two, others stay at home for a week.

Thanks to the sophisticated technique we use at Lipocentrum Maastricht, complications rarely occur. Complications that can occur after each operation include bruising, infections, temporary numbness, poor wound healing and an allergic reaction. Another complication, which incidentally can occur after any surgery, is thrombosis. That is why regular exercise or keeping in motion is recommended.

After liposculpture, the unwanted fat deposits were removed and in turn, we reduced the pressure in the fat compartment causing the pain symptoms, and the feeling of pressure in the arms and legs to disappear. In addition, the lymphatic system is able to drain fluid again unhindered. The venous system can also function better again.

The patient can make an important contribution to the success and durability of the treatment:

  • A healthy lifestyle and diet can especially prevent weight fluctuations.
  • Keep moving. Sports exercises support the drainage of lymph and strengthen muscle building.
  • Lipedema overweight is in many cases caused by a thyroid gland that works too slowly. It is recommended to remove a malfunctioning thyroid gland.

Treatment and Price

Lipedema Treatment per area

From € 1.250,- 

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Reach Us:   +31 (0)43 601 495 8

MON – FRI                      09:00 – 18:00

Dr. Kroll has many years of experience in treating lipedema. He developed a sustainably effective method/approach and because of this, thousands of women can finally live again without pain and usually without wearing compression clothing. The patient feels lighter, and relieved of the painful pressure. They can move exceedingly better again (walking stairs, running, etc.). Moreover, there is a clear, aesthetic progress and the patient regains her femininity. She starts a new life with more self-confidence and a better quality of life.

Drs. Roger Kroll

MD, Director and Founder

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