Which doctor can diagnose lipoedema? How do I recognise whether the doctor I have chosen has the necessary expertise to treat this condition? And how do I find the doctor I trust?
Many women affected by lipoedema ask themselves these and similar questions and start looking for „their“ lipoedema doctor.
Which doctor diagnoses lipoedema?
In Germany, the diagnosis of lipoedema is mainly in the hands of phlebologists (vein specialists) and vascular physicians, as they can clarify the possible differential diagnoses of leg pain with their experience in ultrasound examinations. First and foremost, vascular diseases of the legs should be mentioned here, especially painful varicose veins.
In addition, these specialists have dealt more intensively with the disease „lipoedema“ during their further medical training and specialisation.
However, dermatologists and plastic surgeons also deal with lipoedema. The new and recently published guidelines for the treatment of lipoedema in Germany are a joint effort of phlebologists, vascular physicians (vascular surgeons and angiologists), dermatologists and plastic surgeons under the leadership of the German Society for Phlebology and Lymphology. An experienced lipoedema doctor, be it a phlebologist or vascular specialist, will therefore have the necessary expertise and knowledge to correctly diagnose and treat the condition.
Is there such a thing as „the“ lipoedema doctor?
The answer is a clear no. For the reasons mentioned above, there is no such thing as „the“ lipoedema doctor. Many GPs have now also taken up this topic, as lipoedema has increasingly become the focus of public attention in recent years - due to social media and celebrities affected - and the GP is a person of trust for many people and therefore the first point of contact. If he/she is not familiar with the clinical picture of lipoedema, he/she will refer you to an appropriate specialist.
What characterises a „lipoedema doctor“?
A doctor who deals with lipoedema is familiar with the multifaceted symptoms of this condition and can identify them by asking appropriate questions. Not every disorder of fat distribution or every excess weight that cannot be influenced by exercise or a change in diet is the same as lipoedema. This assumption is a widespread misconception, particularly promoted by forums on the Internet.
The lipoedema specialist will initiate the correct examinations in suspected cases and advise you comprehensively on the various treatment options once the diagnosis has been made.
A good lipoedema doctor will never urge you to choose a course of treatment (conservative or surgical), but will always give you enough time to make a mature decision. What is successful for one patient may not necessarily be the right approach for another. The first priority of treatment is always to reduce the pain. The external appearance is of course also important for most lipoedema patients, but in my experience this is usually secondary to pain treatment.
How do I know if my „lipoedema doctor“ is the right one?
When choosing your „lipoedema doctor“, always trust your gut feeling. This will not usually deceive you. Treatment can only be successful if you can trust that the doctor will take you and your symptoms seriously. The success of a treatment depends on the relationship of trust and mutual respect between both parties. A good doctor will inform you openly and honestly about the possibilities of the individual treatments and their advantages and disadvantages. This is particularly important when planning a course of surgical treatment. Of course, this does not mean that the complications of a treatment mentioned must actually occur, but a well-informed patient is the essential prerequisite for successful treatment - whether conservative or surgical.
Some patients also come to my lipoedema consultation several times to discuss one point or another again after a period of careful consideration. Sometimes a patient's attitude towards a previous conservative approach changes and the patient wants to embark on a new course of treatment together with me as her „lipoedema doctor“. It will then be my task to fully support her in this and, if surgery is desired, to perform an operation appropriate to the stage of the disease in order to improve her symptoms and, ideally, eliminate them completely.
Frequently asked questions about choosing the right lipoedema doctor:
No, there is no such thing as „the“ lipoedema doctor. Many medical specialities in Germany deal with the clinical picture of lipoedema, above all phlebologists (vein specialists), vascular physicians and dermatologists.
The doctor should have already dealt with lipoedema during their specialisation as a specialist and have experience in ultrasound examinations of the leg vessels. They should know and be able to apply the current treatment guidelines for lipoedema.
A reputable „lipoedema doctor“ will give you comprehensive advice on this condition and will not urge you to undergo any particular treatment. However, they will also tell you if you do not have lipoedema, but only have a fat distribution disorder or are overweight.
As a rule, vein specialists, i.e. phlebologists, treat patients with lipoedema. But trust your gut feeling here too. Perhaps ask your friends or look for medical contacts in the relevant self-help groups. If necessary, get a second opinion. Taking these points into account, you will find the right lipoedema doctor for you.
In Germany, phlebologists, surgeons, plastic surgeons, dermatologists and lymphologists have specialised in the diagnosis and treatment of lipoedema. In principle, lipoedema can be diagnosed by any doctor who specialises in the condition. Conservative treatment can also be initiated by a general practitioner, but surgical treatment should be in the hands of a doctor who is familiar with liposuction and has surgical training.
The diagnosis of lipoedema can sometimes be difficult, as the symptoms can be non-specific. However, lipoedema always involves symptoms, usually pain in the subcutaneous fatty tissue or a feeling of heaviness in the extremity. Increased fatty tissue without symptoms is definitely not lipoedema, even if this is often suggested on the internet and in the relevant forums. Increased fatty tissue without symptoms is referred to as lipohypertrophy and from a BMI of 30 as obesity. Dimpling of the skin (cellulite), the inability to lose weight despite exercise and dietary optimisation or the rapid appearance of bruises are not evidence of lipoedema, although they can occur with lipoedema. Unfortunately, social media is often unhelpful and rather frightening in the self-diagnosis of lipoedema. Instead, I recommend serious literature, preferably studying the S2k guideline „Lipoedema“ from the Association of the Scientific Medical Societies in Germany (AWMF) from 2024, which is also easy to understand for a medical layperson. I use these criteria to diagnose lipoedema and we are happy to discuss these criteria together during an initial consultation.
It always makes sense to consult another doctor for a second opinion, especially if the patient feels that the symptoms were not sufficiently clarified during the initial consultation. In addition, sometimes even a colleague with experience in lipoedema can be unsure of the diagnosis. Before undergoing surgery for lipoedema, it is always advisable to seek a second opinion, as the vast majority of patients do not usually have lipoedema.
The doctor's experience with the disease „lipoedema“ is the most important aspect in the diagnosis of lipoedema. Some symptoms may simply be unspecific, but an experienced doctor can make a conclusive diagnosis by asking appropriate questions and carrying out a physical examination. Contrary to many statements on the Internet, ultrasound is not helpful in diagnosing lipoedema. It is only used to rule out other diseases (e.g. varicose veins) as the cause of the symptoms.
I am very happy to offer you a second opinion on lipoedema. I often find that patients are very unsettled by the internet and especially by social media and firmly believe that they have lipoedema, even though this is not the case. Never make a self-diagnosis based on information from social media, but always consult a specialist.
