Lipedema (lipoedema) is a chronic fat disorder in which pathologic fat accumulates in legs and arms.  This fat is different than normal fat and can be very painful and debilitating.  Thus lipedema has been called “painful fat syndrome’”.  “Lipedema” is the spelling used in the United States, while “lipoedema” is used in the United Kingdom, Australia and Europe.

This disorder occurs almost exclusively in women.  Lipedema (lipoedema) is estimated to exist in 11% of women, and an estimated 17 million women in the United States and 370 million women worldwide.  Based on these estimates, the National Institutes of Health in the United States does not consider lipedema (lipoedema) to be a “rare disease”.

Even though lipedema (lipoedema) was initially described in 1940, there is a tremendous lack of awareness about lipedema, both in the general public and in the medical community.  There is a poor understanding of the lipedema (lipoedema) disease biology and little research to provide insight on how and why lipedema develops in patients.  Very few physicians in the U.S. and abroad have experience or expertise in diagnosing and treating lipedema (lipoedema).

In the United States, patients with lipedema (lipoedema) are often misdiagnosed or under-diagnosed.  Many lipedema (lipoedema) patients are misdiagnosed with obesity, without the recognition that lipedema (lipoedema) could exist.

There is abundant confusion between lipedema (lipoedema), which is a disorder related to pathologic fat, and lymphedema (lymphoedema), a different disorder of the lymphatic system.  These disorders have different causes and treatments, but can overlap in some lipedema (lipoedema) patients who progress also to develop lymphedema (lymphoedema).

Without proper treatment, lipedema (lipoedema) patients may face various health and quality of life issues which affect both mental health (e.g. anxiety and depression) and physical impairment.


We’re Here To Help

Request a consultation today to get the answers that you need.

The cause of lipedema (lipoedema) is currently unknown.  Exacerbations of lipedema (lipoedema) occur typically during puberty, pregnancy, or menopause.  Some lipedema (lipoedema) patients inherit this disorder from their family, while other patients develop this disorder after surgery or trauma.  Lipedema (lipoedema) patients have a difficult time managing the size of their affected areas even with exercise, weight loss, physical therapy or bariatric surgery.  In short, unlike other fat, the pathologic fat in lipedema patients does not go away with standard weight loss.

In lipedema (lipoedema) patients, fat accumulates differently than other, normal fat.  Lipedema fatty accumulations often resemble tumors and can be quite painful to the touch. The fat mainly deposits on the insides of the legs and knees, causing pain when the legs touch and rub together. This causes the legs to be pushed further and further out during walking, causing eventual damage to the knees and ankles, with significant wear on the insides of the feet and shoes. Lipedema (lipoedema) symptoms can worsen over time.

Besides having accumulation of pathologic fat in the areas of thighs, buttocks, lower legs and sometimes arms, these affected areas may:

  • Feel soft and cold
  • Bruise easily
  • Feel painful
  • Have small broken veins under the skin

In summary, lipedema (lipoedema) patients often show the following signs or symptoms:

  • Excess accumulation of pathologic fat in the legs and arms
  • Fatty accumulations in the legs from the waist down to just above the ankle
  • Fatty accumulations that do not respond to standard weight loss methods
  • Fatty accumulations are often very painful
  • Occurs almost exclusively in women
  • Can occur in women of all sizes, from very slender to very obese
  • Can occur together with or even cause lymphedema
  • Gait/walking problems can occur and worsen
  • Both sides typically are affected equally (in contrast to lymphedema where one side is typically worse than the other)

Lipedema is a clinical diagnosis.  This means that, currently, there are no diagnostic tools or imaging tests to detect lipedema in patients. Dr. Granzow performs a clinical assessment based on the patient’s medical history, family history, and medical examination.

Dr. Granzow is passionate about educating the patient community, therapists and physicians about lipedema (lipoedema).  He publishes highly regarded scientific articles in leading medical journals, and is also a frequently invited speaker at U.S. and international conferences such as the Fat Disorders Research Society (FDRS) Conference, Klose Conference, NLN Conference, World Congress of Lymphology (WCOL) Conference, the Canadian Lymphedema Framework (CLF) Conference, and the American Society for Reconstructive Microsurgery (ASRM) Conference.

Dr. Granzow collaborates closely with lipedema (lipoedema) physicians and specialists in the United States and abroad, as well as organizations such as the Fat Disorders Research Society (FDRS) and the National Lymphedema Network (NLN) to support much needed research in this field.  He also engages with the patient community to generate and raise awareness to further the understanding of these diseases.

Conservative treatment for lipedema patients is similar to the conservative treatment for lymphedema patients.  Treatments include manual lymphatic drainage, bandaging, and custom-fitted compression garments.  Some patients report the reduction of pain with such conservative treatment.  Other conservative treatment includes weight management and appropriate exercise.

Dr. Granzow’s integrated system for lipedema treatment combines effective therapy and his unique lymphatic sparing LipisuctionSM surgery to provide the best results for patients suffering from lipedema. The LipisuctionSM surgery safely removes the excess fat while protecting the important lymphatic channels to prevent the possibility of lymphedema.

Dr. Granzow believes that appropriate physical therapy before and after surgical treatment provides the most effective treatment for patients.

Dr. Granzow’s expertise in treating lymphedema is also crucial in treating lipedema patients who may also suffer from lymphedema.  Some patients with lipedema develop lymphedema as well.  There is little understanding in the medical community and researchers as to why there is a connection between the two diseases.  For patients who have both lipedema and lymphedema, a combination of Dr. Granzow’s FLOSM lymphedema treatment program and LipisuctionSM surgery provides the best treatment. He uses his extensive knowledge of lymphatic anatomy and careful mapping of the lymphatic channels to maximize protection of these vital structures.


All patients have different lipedema presentations and treatment requirements. Dr. Granzow thoroughly evaluates and treats each patient with his team to maximize each patient’s results.

Please contact our office at (310) 882-6261 or contact us for a personalized consultation.

Request Consultation