Treatment area
Legs & knees
The most common lipoedema area – from the hips down to the ankles. For lighter, pain-free legs and better mobility.
Medically reviewed byDr. med. Martin Reifenrath, Specialist in Plastic and Aesthetic SurgeryLast reviewed:
Medically indicated
The most frequently affected area
The legs are affected in almost all lipoedema patients – often first and most severely. The diseased fatty tissue builds up symmetrically on the thighs, knees and lower legs.
Characteristically, the fat deposits end abruptly at the ankles – the feet stay slim. This disproportion leads to functional limitations, pain and considerable emotional strain.
Affected areas
Where lipoedema shows in the legs
Lipoedema can affect different parts of the legs – individually or in combination.
Thighs
Inner and outer thighs, often with pronounced ‘saddlebags’ and painful sensitivity to pressure.
Knees
Fat pads on the inside of the knees restrict movement and cause chafing.
Lower legs
The calves and shins can be affected, often with a feeling of heaviness and swelling.
Ankle area
Characteristic ‘cuffing’ above the ankles – the feet themselves stay slim.
Since October 2025
Covered by German statutory health insurance – at all stages
In July 2025, the Federal Joint Committee (G-BA) decided that since October 2025, German statutory health insurers cover the costs of liposuction for lipoedema – regardless of the stage – for patients insured in Germany. The complicated application process no longer applies.
No more application
The complicated application process no longer applies. The treating doctors check your eligibility directly – we take care of this for you.
All stages
Until October 2025, only at stage III. Since then, patients at stages I and II are included too.
Legs included
Statutory cover includes the legs and arms – the typical lipoedema areas.
In line with G-BA rules
We carry out operations covered by statutory insurance at the NATIONALKLINIK Wertheim, a hospital included in the state hospital plan – using the tumescent technique, as required by the G-BA.
What you need for statutory cover – we take care of it
6 months of conservative therapy, a BMI of no more than 35, the two-doctor principle (diagnosis and the decision to operate made by different doctors) – sounds complicated? It doesn’t have to be. At Lipo Doctors, we coordinate every step: from diagnosis and conservative therapy to surgery and aftercare. You don’t have to worry about a thing.
Typical symptoms
What those affected experience
Lipoedema in the legs causes a wide range of problems in everyday life.
Pain when walking & standing
Even short distances become a strain, and standing for long periods is hard to bear
Heavy legs
The legs feel as heavy as lead, and the feeling gets worse in the evening
Friction & chafing
The thighs rub together, leading to chafed spots and skin irritation
Restricted mobility
Sport, climbing stairs and everyday activities become increasingly difficult
Difficulty finding clothes
Trousers and skirts don’t fit properly; different sizes are needed for top and bottom
Frequent bruising
Even the slightest knocks cause bruises on the legs
The treatment
Liposuction of the legs
Surgical removal of the diseased fatty tissue is the only method that can reduce lipoedema permanently.
01
Gentle technique
We use modern, lymph-sparing liposuction techniques that protect the surrounding tissue and lymphatic vessels as far as possible.
02
Several sessions
Depending on the severity, usually 2–4 sessions are needed to treat the whole leg. A step-by-step approach is gentler on the body.
03
Lasting results
The fat cells that have been removed do not come back. With a stable weight, the results are permanent and the symptoms are significantly reduced.
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.
What you can expect
Aims of the treatment
Successful treatment improves not only appearance but, above all, quality of life.
Less pain
Noticeable relief from pain on pressure and touch in everyday life
More mobility
Walking, climbing stairs and sport become easier again
Better proportions
A more harmonious silhouette and a more natural leg shape
Clothes that fit
Finally being able to wear normal trousers and skirts again
Requirements
The path to treatment
For medically indicated lipoedema treatment of the legs – especially for cover by German statutory health insurance – certain requirements must be met.
- Diagnosis by a specialist (e.g. in angiology or dermatology)
- 6 months of conservative therapy
- BMI of no more than 35
- Two-doctor principle (diagnosis and the decision to operate made by different doctors)
- Individual treatment planning
Aftercare
After the treatment
Structured aftercare is crucial for the long-term success of the treatment.
Compression
Consistently wearing compression garments for 4–8 weeks
Lymphatic drainage
Regular manual lymphatic drainage (MLD) to reduce swelling and support healing
Movement
Gentle, regular exercise supports recovery
Check-ups
Regular follow-up examinations with a specialist
Frequently asked questions
FAQ on treatment of the legs
How many sessions are needed for the legs?
That depends on the severity of the lipoedema and the volume to be treated. As a rule, 2–4 sessions are needed to treat both legs completely. We recommend a step-by-step approach that is gentle on the body and allows precise results.
Are both legs treated at the same time?
In one session we usually treat a specific area – for example both thighs or both lower legs. This gives your body the best chance to recover. We discuss the exact sequence with you individually.
How long does recovery take after treatment?
Most patients can resume light activities after about 1–2 weeks. Compression garments must be worn for 4–8 weeks. Sport and heavy physical strain should be avoided for about 6 weeks.
Does health insurance cover the costs?
For patients insured in Germany: since October 2025, yes – at all stages. The Federal Joint Committee (G-BA) decided that liposuction for lipoedema is now covered by German statutory health insurance. The complicated application process no longer applies. The requirements are: a BMI of no more than 35, 6 months of conservative therapy and the two-doctor principle (diagnosis and the decision to operate made by different doctors). With a BMI between 32 and 35, the waist-to-height ratio (WHtR) must also be appropriate for your age. We carry out operations covered by statutory insurance at our NATIONALKLINIK Wertheim – preparation and aftercare remain at the location near you. At Lipo Doctors, we coordinate every step for you – you don’t have to worry about a thing.
Can the fat deposits come back after treatment?
The fat cells that have been removed do not come back. With a stable weight, the results are permanent. However, lipoedema is a chronic condition – the remaining fat cells can enlarge again with significant weight gain or hormonal changes. That is why long-term aftercare is important.
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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