01 · At a glance
Recognising lipoedema: the features at a glance
Lipoedema is a chronic disorder of the fatty tissue that affects almost exclusively women. What is typical is a painful, symmetrical increase in the subcutaneous fatty tissue on the legs, hips and upper arms — independently of body weight. Diet and exercise have barely any effect on the affected tissue; that is not a failure, it is a feature of the condition.
Lipoedema is recognised clinically: through the medical history, the pressure pain, the distribution pattern and the classification into three stages — not through BMI or a table. Surgical treatment, a gentle liposuction, starts here from €5,000 per area (net); for patients with statutory health insurance there is a separate treatment pathway.
02 · Symptoms
How do I recognise lipoedema? The typical symptoms
The complaints usually develop gradually, and because the weight around the torso often stays normal, lipoedema is for a long time explained away with "too much food, too little exercise". Four features argue against that — and in favour of a medical assessment:
- Painful, pressure-sensitive fat deposits on the legs, hips or upper arms — even light pressure hurts.
- A disproportionate amount of body fat on the legs or arms despite a normal or only slightly raised BMI — symmetrical on both sides.
- Barely any effect of diet and exercise on precisely these regions, while the rest of the body responds.
- A noticeable restriction of quality of life and mobility in everyday life.
03 · Stages
The three stages of lipoedema
The classification into stage I to III follows the clinical findings — what the doctor can see and palpate, not weight or BMI. It describes how the skin and the subcutaneous fatty tissue have changed, and it is the basis of every treatment decision.
- Stage I: smooth skin surface with thickened, homogeneous-looking subcutaneous fatty tissue.
- Stage II: uneven, predominantly wave-like skin surface; nodular structures in the thickened subcutaneous fatty tissue are visible and palpable.
- Stage III: pronounced increase in circumference with overhanging portions of tissue (lobular deformities).
Stage I to III — determined clinically, not by BMI or tables. The classification is the beginning of the therapy, not its verdict.
04 · Distinction
Lipoedema or obesity — or both?
Lipoedema is a chronic, painful fat distribution disorder: symmetrical, almost exclusively in women, independent of body weight — diet and exercise have barely any effect on the affected tissue. Obesity, by contrast, is a generalised increase in fat related to the energy balance, in which diet and exercise do work.
Both can occur at the same time. In the diagnosis we distinguish clinically — via Stemmer's sign, the pressure pain and the distribution pattern — and then treat what is actually there.
05 · Diagnosis
How the diagnosis works: history, examination, stage
We make the diagnosis in the medical initial consultation (€100) in three steps. First the history: a detailed conversation about symptoms, course and previous history — when the complaints began, what makes them worse, what has been tried so far. Second the clinical examination: pressure pain, Stemmer's sign and the distribution of the fatty tissue on the body. Third the staging according to the findings.
At the end there is a treatment concept that fits the stage, the symptoms and your goals — conservative, surgical or both in a coordinated sequence.
06 · Conservative
Conservative therapy: compression, lymphatic drainage, movement
Conservative therapy is the first line and remains part of every concept in the long term: compression garments, manual lymphatic drainage, exercise and nutritional therapy relieve the symptoms and slow the course of the condition. It does not replace the diseased fatty tissue — but it stabilises what has been achieved, and it is at the same time the precondition for a statutory health insurer even reviewing an operation.
07 · Surgical
Lipoedema surgery: liposuction in PAL technique
When conservative measures reach their limit, liposuction is the surgical route: a gentle, tumescence-based fat removal in PAL technique (power-assisted) that permanently reduces the diseased fatty tissue — the fat cells removed do not come back. Depending on the extent, the procedure takes 1.5 to 3 hours and is performed under tumescent local anaesthesia, under twilight sedation or under general anaesthesia, as an outpatient or inpatient procedure, through incisions of only 2 to 5 millimetres.
The areas treated are the inner and outer legs, the hips and the upper arms — typically one to three areas per session. In stage II and III with overhanging portions of tissue, a combination with Renuvion plasma tightening can be useful so that the contour stays firm despite a large reduction in volume. Typical, temporary consequences are swelling, haematomas and tenderness to pressure; the risk of lymphoedema is minimised by the specific surgical technique — we discuss all individual risks in the informed-consent consultation required by § 8 HWG (German Health Advertising Act).
Per operating session we typically treat one to three areas — larger concepts we spread over several sessions.
08 · Recovery
After the operation: compression, everyday life, final result
Recovery follows a clear schedule. The conservative measures — above all compression — continue, because they stabilise the result and slow the progression of the condition.
- Compression garments: at least 4 to 6 weeks
- Return to the office: after a few days
- Light exercise: after 2 to 3 weeks
- Final result visible: after 3 to 6 months
09 · Costs
What does lipoedema treatment in Munich cost?
Surgical lipoedema treatment starts here from €5,000 per area (net). Because one to three areas are typically treated per session and larger concepts are spread over several sessions, the individual calculation follows from the number of areas, the stage, the extent of the operation and any combination with Renuvion plasma tightening — recorded in writing in the initial consultation (€100).
For patients with statutory health insurance there is the option of having the lipoedema treatment carried out under the direction of Dr. Weinschenk at the Maria-Theresia Klinik in Munich; requirements, the application and the individual procedure are discussed directly with the clinic (registration on 089 720 71 31). Approval typically requires documented conservative pre-treatment — compression, lymphatic drainage — and a corresponding stage classification; whether and to what extent the insurer covers the costs is decided by the insurer in each individual case.
Price information
Note on all price information
All starting prices net · plus 19% VAT · excluding clinic fees for anaesthesia and the overnight stay. Specific cost calculation in the personal initial consultation (€100). The consultation fee is set off against a subsequent treatment. As at: September 2026.
Medically reviewed
Dr. Fabian Weinschenk · Facharzt für Plastische und Ästhetische Chirurgie · Last reviewed 14 September 2026
