Treatment area
Hips, buttocks & transitions
When abrupt contours make everyday life harder – harmonious transitions for better function and wellbeing.
Medically reviewed byDr. med. Martin Reifenrath, Specialist in Plastic and Aesthetic SurgeryLast reviewed:
The transition zone
Where lipoedema meets the trunk
Lipoedema primarily affects the limbs – yet the most striking breaks in contour often appear at the hips and buttocks. Where the diseased fatty tissue meets the unaffected trunk, the typical ‘cuffs’ and steps form.
These abrupt transitions are more than a cosmetic problem: they lead to friction, pressure points and pain when sitting or lying down. Many of those affected cannot find clothes that fit – trousers that fit at the waist are too tight on the thighs.
Affected areas
Where we can treat
The transition zone includes several areas, which can be affected individually or in combination.
Outer hips
The classic ‘saddlebags’ – fat deposits on the sides that persist even with a slim upper body and get in the way when walking.
Inner hips
The area between the thigh and the groin – often leads to rubbing and chafing when walking.
Buttocks
Uneven fat distribution on the bottom, leading to an asymmetrical appearance and problems when sitting.
Transitions
‘Cuffing’ – where lipoedema tissue ends abruptly and the slim trunk begins.
Everyday life with affected hips
More than just a question of looks
The effects go far beyond what you see in the mirror – they affect movement, comfort and how you feel about yourself.
Functional problems
Sitting for long periods becomes an ordeal – with pressure points and pain in the buttocks. When walking, the thighs rub together and every step becomes a strain.
Clothes as a challenge
Buying trousers becomes frustrating: the waist fits but the thighs don’t – or the other way round. Many turn to loose skirts or avoid figure-hugging clothes altogether.
Emotional strain
The constant struggle with your own body wears you down. Sport and exercise – actually important – are avoided because every step hurts or feels uncomfortable.
Good to know
Cost coverage – clearly explained
Since October 2025, German statutory health insurance has covered the typical lipoedema areas, the arms and legs, at all stages (for patients insured in Germany). Special rules apply to the hips and buttocks.
With a lipoedema diagnosis
If the hips and buttocks are diagnosed as part of the lipoedema and there are functional problems, treatment can be medically indicated.
- Medical necessity documented
- Functional limitations demonstrable
- Part of the overall treatment
- Exempt from VAT as medical treatment (German rules)
Without a link to lipoedema
If the treatment is purely for body contouring – without functional problems caused by lipoedema – it counts as an aesthetic procedure.
- Self-pay treatment
- Subject to VAT
- Flexible financing possible (in Germany)
- Often combined with the limbs
We clarify this for you
Medical or aesthetic? That is not a decision you have to make alone – together with our specialists, we review your individual case and advise you openly on all options and costs.
Flexible & no obligation
Your consultation – the way you want it
Get to know us – in person, by phone or by video. Every consultation is 100% without obligation.
Our approach
Form and function in harmony
Treating the hips and buttocks is not just about reducing volume. Our aim is harmonious transitions that look and feel natural.
The treatment is usually combined with liposuction of the thighs – creating flowing contours instead of new steps. The result: a balanced overall appearance from the waist to the knee.
The result
What changes
Treating the transition zone improves function and appearance alike.
Sitting without pain
Finally spending hours in the office, the car or the cinema again – without constantly shifting position and without pressure pain
Moving more freely
Walking without rubbing, exercising without chafing – movement becomes a pleasure again instead of a problem
Finding clothes
Buying trousers without compromise – when your waist and thighs finally match
Enjoying your silhouette
Harmonious proportions from the waist to the knee – naturally flowing instead of stepped
After the procedure
Your aftercare
Recovery after treatment of the hips and buttocks is similar to that after leg treatment – with a few particularities.
The first few weeks
Special compression garments for 4–6 weeks. Sitting is possible, but with breaks. Avoid lying on the treated area for long periods. Gentle movement supports healing.
In the long term
The final result becomes visible after about 3–6 months, once all swelling has subsided. The fat cells that have been removed do not come back – a stable weight helps to maintain the result.
Your questions
FAQ on hips, buttocks & transitions
Does health insurance pay for treatment of the hips and buttocks?
The cover provided by German statutory health insurance since October 2025 (for patients insured in Germany, at all stages) primarily includes the arms and legs. However, treatment of the hips and buttocks can be medically indicated if they are diagnosed as part of the lipoedema and cause functional problems. Whether the costs can be covered in your case is something we clarify individually during your consultation. We carry out operations covered by statutory insurance at our NATIONALKLINIK Wertheim – preparation and aftercare remain at the location near you.
Can I have my hips/buttocks treated together with my legs?
Yes – in fact, this often makes sense. If we treat the thighs and stop abruptly, new breaks in the contour appear. A combined treatment creates harmonious transitions. The scope is planned individually so as not to overburden the body.
Is the treatment medical or aesthetic?
That depends on your individual findings. With confirmed lipoedema and functional problems (pain when sitting, chafing, restricted movement), the treatment is medically indicated and, under German rules, exempt from VAT. If the main aim is body contouring without medical necessity, it is an aesthetic procedure. We advise you openly.
How long does recovery take?
Most patients can resume light activities after about 1–2 weeks. Sitting is possible, but with breaks during the first few days. Compression garments should be worn for 4–6 weeks. Sport and intensive exercise are possible again after about 6 weeks.
Will there be visible scars?
The incisions are only a few millimetres long and are placed in discreet spots – usually in natural skin folds or in the bikini area. Once healed, they are practically invisible.
How many sessions are needed?
For a combined treatment of the hips, buttocks and thighs, 2–3 sessions are usually advisable. This way, one defined area is treated at a time and the body has time to recover. We draw up the exact plan after the examination.
Personal & no obligation
Your lipoedema consultation – the way you want it
Talk to our lipoedema specialists – in person, by phone or by video. With no obligation.
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