Pain on pressure, heavy legs and proportions that barely change despite weight loss can point to lipoedema. What stages 1, 2 and 3 describe and how we examine you at Klinik am Seestern in Düsseldorf.
Liposuction possible in all stages since October 2025
Consultation
at the Klinik am Seestern, Düsseldorf-Lörick
Symmetrical: lipoedema affects both sides of the body equally, and hands and feet stay slim.
Not a measure of pain: severe symptoms are just as possible in stage 1 as mild ones in stage 3.
A first orientation: self-test and WHtR calculator; the diagnosis is made by a doctor.
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Lipoedema in Düsseldorf: examination and consultation at Klinik am Seestern
Consultation room
Many women with lipoedema have a long road behind them before their symptoms are given a name. The pain is often dismissed as a consequence of being overweight. Yet lipoedema is a condition in its own right of the subcutaneous fat tissue, and anyone who knows the signs finds suitable treatment sooner.
At Klinik am Seestern in Düsseldorf we take our time over the examination: we ask about your medical history and the treatments you have already had, examine your legs and arms and assess the extent and the stage. You will find us on the left bank of the Rhine in Düsseldorf-Lörick, in the Am Seestern office district not far from the B7. By public transport, you take the U77 at the main station and ride without changing to the Am Seestern stop; if you come by car, you can park free of charge on the clinic grounds. This is how you reach us from all districts of the city as well as from Meerbusch and Neuss.
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Typical symptoms: what lipoedema feels like
These symptoms distinguish lipoedema from ordinary overweight:
Pain on pressure and touch, often at rest too
A feeling of heaviness and tension that increases over the course of the day
Legs or arms clearly bulkier than the upper body
Diets and exercise make little difference to the legs and arms
Symptoms worse in warmth and after standing or sitting for a long time
Easy bruising, frequently reported, but not a reliable sign on its own
Do several of these points apply to you? Our lipoedema self-test with ten questions gives a first orientation; the diagnosis is made by a doctor.
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How to recognise lipoedema by sight
Both sides the same
Lipoedema always affects both sides of the body equally. Lymphoedema, by contrast, often occurs in only one leg or one arm.
Slim hands and feet
The increased fat distribution often ends at the wrists and ankles as if cut off. Hands and feet stay slim.
Slim upper body
The trunk mostly stays slimmer, while hips, legs or arms noticeably increase in circumference. Top and bottom feel like two clothing sizes apart.
Pads at the knee and upper arm
Typical are fat pads on the inside of the knees and on the back of the upper arms, the same on both sides.
Typical areas
Where lipoedema appears
Lipoedema affects both sides of the body equally. Legs, hips and arms are typical, while hands, feet and trunk mostly stay slim.
01Legsmost often
The increased fat tissue sits on the outer and inner sides of the thighs, on the inside of the knees and on the lower legs. Above the ankles it often ends as if cut off, and the feet stay slim. More under Lipoedema in the legs.
Typical
Thighs, insides of the knees, lower legs
Spared
the feet
02Hipsand buttocks
Lipoedema often continues on the hips and buttocks. The upper body looks slim by comparison, and the clothing sizes for trousers and top often do not match.
Often together with
the legs
Trunk
mostly slimmer
03Armsmainly the upper arms
On the arms, the fat tissue sits mainly on the back of the upper arms; sometimes it extends to the forearms. The hands are spared. More under Lipoedema in the arms.
Typical
Back of the upper arms
Spared
the hands
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Stages 1, 2 and 3 of lipoedema
The common classification into three stages describes how skin and fat tissue look and feel. According to the current guideline, it is not a measure of how severe the condition is or how strong the symptoms are.
Lipoedema
Stage 1
The skin surface is smooth, and the subcutaneous fat tissue is evenly thickened and soft. Hips and legs look bulkier than the upper body and are often dismissed as an ordinary problem area, even though the symptoms can already be clear.
Lipoedema
Stage 2
The skin surface becomes uneven and wavy, and the circumference visibly increases. A step can form above the ankles while the feet stay slim. The insides of the thighs rub against each other more often.
Lipoedema
Stage 3
The fat tissue is clearly increased and coarser, and overhanging flaps of tissue form on the insides of the knees and on the thighs. Skin irritation from friction, a misalignment of the knees such as knock knees, and restricted mobility can be added.
Diagram in cross-section:SkinFatty tissueLumpsSmall nodulesMuscle
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What the stage says and what it does not
The stage says nothing about the pain
Severe pain is just as possible in stage 1 as mild pain in stage 3. Whether surgery comes into question therefore depends on your symptoms and not on the stage.
Not automatic
Lipoedema does not necessarily move from stage 1 to stage 3. With a stable weight it stays the same for many women for years; weight gain can make it worse.
No stage 4
There is no separate fourth stage. What is usually meant is lipoedema to which lymphoedema has been added. This needs its own treatment before diseased fat tissue can be removed.
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Lipoedema, lymphoedema or being overweight?
Lymphoedema
In lymphoedema, lymph fluid builds up in the tissue. It often begins on one side and involves the feet or hands, which is not the case in lipoedema.
Overweight
In overweight, fat is distributed over the whole body, including the abdomen. Losing weight changes the proportions; pain on pressure is not part of it.
Cellulite
Cellulite is dimpling of the skin that results from the structure of the connective tissue. It is not painful and is not a disease. More on this under Cellulite treatment.
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Your route to diagnosis at Klinik am Seestern
Step 1
Before the appointment
Note down your symptoms. Where does it hurt, since when, and what have you already tried? The self-test and the WHtR calculator help with a first assessment.
Step 2
Consultation in Düsseldorf
Examination. We talk about your medical history, examine and measure your legs and arms and check whether lymphoedema is also present. You book your appointment online.
Step 3
For German health insurance
Confirmed diagnosis. For a benefit covered by German statutory health insurance, a specialist doctor authorised for this makes the diagnosis. The decision on surgery is made by a different doctor.
Step 4
At least 6 months
Conservative therapy. Compression, lymphatic drainage and exercise relieve symptoms. For German statutory health insurance, 6 months of therapy without weight gain are part of it.
Step 5
Afterwards
Decision. If the symptoms persist despite therapy, a lipoedema surgery can be an option, through German statutory health insurance or as a self-pay patient.
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German statutory health insurance and the costs of lipoedema surgery in Düsseldorf
Since October 2025, German statutory health insurance can cover liposuction for lipoedema in all stages. Until then, cost coverage was limited to stage 3. Surgery is then usually carried out at the Nationalklinik of the Weight Doctors in Wertheim, while consultation and aftercare remain in Düsseldorf. An individual application to the health insurer is no longer needed; the treating doctors check the requirements:
Confirmed diagnosis by a specialist doctor authorised for this
At least 6 months of conservative therapy
No weight gain during this time
BMI no higher than 35, between 32 and 35 with a suitable WHtR
Diagnosis and decision on surgery made by different doctors
Our WHtR calculator works out your BMI and your waist-to-height ratio. At Klinik am Seestern in Düsseldorf you can book the consultation on lipoedema surgery as a patient with German statutory health insurance, as a self-pay patient or still undecided. You can read what a treatment costs and how you can finance it under Costs, health insurance and financing.
A doctor determines the stage from the appearance of the skin, the nature of the tissue and the extent of the fat distribution. It says nothing about how strong your symptoms are. In the consultation at Klinik am Seestern in Düsseldorf we examine you and discuss the findings with you.
Is there a lipoedema stage 4?
Not as a separate stage. “Stage 4” usually means lipoedema to which lymphoedema has been added, a so-called lipolymphoedema. That is a second condition with its own treatment. If your feet or hands swell too, have this checked by a doctor.
Does lipoedema always get worse?
Not necessarily. According to the current guideline, lipoedema does not generally progress; with a stable weight it stays the same for many women for years. Weight gain and hormonal changes such as pregnancy or the menopause can make the symptoms worse. A stable weight, compression and exercise help.
From which stage does lipoedema surgery make sense?
The stage alone does not decide this. Whether liposuction comes into question depends on your symptoms and on how they respond to consistent conservative treatment. Since October 2025, German statutory health insurance can also cover liposuction regardless of the stage, if the other requirements are met.
How do I tell lipoedema from cellulite?
Cellulite is dimpling in the skin that results from the structure of the connective tissue. It does not hurt and is not a disease. Lipoedema is a condition of the subcutaneous fat tissue on the legs or arms that hurts on pressure and touch; the legs or arms are clearly bulkier than the upper body.
Who makes the lipoedema diagnosis for German statutory health insurance?
For a benefit covered by German statutory health insurance, a specialist doctor authorised for this makes the diagnosis, for example from angiology, dermatology, physical and rehabilitation medicine, or with the additional specialist training in phlebology. The decision on surgery is made by a different doctor. In the consultation we tell you how to proceed.
Does German statutory health insurance pay for lipoedema surgery?
Since October 2025, German statutory health insurance can cover liposuction for lipoedema in all stages; surgery is then usually carried out at the Nationalklinik of the Weight Doctors in Wertheim, while consultation and aftercare remain in Düsseldorf. The requirements are a confirmed diagnosis, at least 6 months of conservative therapy without weight gain and a BMI of no more than 35, between 32 and 35 with a suitable waist-to-height ratio. You can calculate your value with our WHtR calculator.
What does lipoedema surgery cost in Düsseldorf?
The costs depend on the extent of the treatment and the number of affected body regions. After your consultation at Klinik am Seestern you will receive a personal treatment quote; financing is possible through our financing partner. More on this under Costs, health insurance and financing.
Where in Düsseldorf can I have lipoedema examined?
At Klinik am Seestern, Am Seestern 4, 40547 Düsseldorf. The building stands on the left bank of the Rhine in Lörick, the U77 stops directly at the Am Seestern stop, and parking spaces on the grounds are free of charge.
I am a lipoedema and lymphoedema patient and have been trying to find help for about 10 years. Here it was no problem at all! I was called in quickly, was well looked after, my questions were answered very professionally, and I was able to leave the practice in tears of joy! Many thanks for the support so far.
Alina · October 2026
The friendliness of everyone I dealt with.
Anonymous · July 2026
I had my appointment at the practice for a consultation about my lipoedema, and I really want to leave a review even though I haven't had any surgery there yet. The reason is that this was the first time I felt truly taken seriously during an examination of my lipoedema. Dr. Witt was very friendly and professional from the start, and at the same time incredibly pleasant and humane. He took an exceptional amount of time, examined me very thoroughly and answered all my questions in detail. He is incredibly respectful and explains realistically what could be done and how the whole process would work. I found it particularly positive that at no point did a hectic or unpleasant mood arise. You never had the feeling of being “brushed off” or being under time pressure. Instead, the whole atmosphere was calm, relaxed and trusting. Dr. Witt was very committed, photos were taken of the affected areas and every possible treatment was explained in an understandable way. Dr. Witt explained everything in detail, yet never came across as complicated or distant. Although he is an absolute specialist in his field, I felt at all times that I could speak openly and ask any question. It felt more as if I had been a patient there for a long time. It was also particularly important to me that I never felt pushed towards an operation. It is still not at all clear whether I will have my operation at all, and yet I was taken incredibly seriously and treated with respect. That is exactly what built so much trust in me. I would also very much like to mention the lady at reception, Marris, in a positive way. She was super polite, had a very pleasant and calm manner and immediately gave me a good feeling. Although it was almost 5 p.m. and the end of the working day was approaching, she was incredibly friendly to me and did not seem at all annoyed or stressed. It is precisely such little things that make a huge difference to me personally and reinforced my positive overall impression of the practice. The practice itself is also absolutely impressive. It is extremely modern, high-quality and stylishly furnished. You feel more as if you are entering a luxury hotel than a traditional doctor's practice. Everything seems very well thought out, calm and professional. The organisation around the appointment was also excellent. Even before the appointment, communication was always very friendly, quick and professional. Questions were answered immediately and the whole process seemed perfectly organised. I was also allowed to park in the clinic's car park, which was an enormous relief since everything in the area was completely full. Although it was already later in the afternoon, Dr. Witt even personally saw to it that enquiries were made internally about my question regarding costs. Shortly after I had left the practice, I already received all the information by email. That too simply shows how professionally and attentively they work there. Overall, an exceptionally positive experience, of a kind you unfortunately only rarely have in the medical field. Absolutely fabulous.
Kerasoula P. · June 2026
Very beautiful clinic, wonderful reception and great service. The consultation with the doctor was very comprehensive and she addressed all my questions, which is all you could wish for as a patient / customer. I will definitely have my treatment done here.
Sandra W. · April 2026
Dr. Bromba took the time and advised me very well.
Anonymous · April 2026
A very kind doctor. I felt very comfortable from the first moment!
Elisabeth-katrin · March 2026
Everything was great, just one small remark..... I didn't get any dinner/bread in the evening. The most important thing for me was the operation, or rather everything around it.
Mix · February 2026
I was welcomed and advised incredibly kindly. The consultation takes place on an equal footing and without medical jargon, and what I like best is that they paid attention to what the best treatment is for my concern, and not to what would earn the practice the most money. I took a week to think it over, but actually the decision to choose the clinic was made much sooner.
Anonymous · January 2026
Everyone was very friendly, especially the nurses.
Anonymous · October 2025
I had a consultation and felt taken seriously and understood. They took a lot of time for me, and the examination and the conversation were very thorough. In the end, the treatment is too expensive for me, so I won't be able to have it done.
Anonymous · October 2025
Very competent and friendly consultation.
Anonymous · October 2025
Very competent consultation, super friendly staff!
Anonymous · September 2025
Medical assistant with partly insufficient professional competence.
Andreas M. · August 2025
Very competent consultation and medical examinations. I feel very well looked after.
BrigitteM · August 2025
I really liked the super friendly manner of the ladies at reception, and also that the doctor took the time to see and advise me, as well as the nice lady who went through the cost plan with me. I felt wonderfully looked after and will definitely have my treatment there. Thank you once again for everything so far.
Astrid R. · August 2025
A conversation in peace and without time pressure. I felt very well looked after.
Anonymous · August 2025
I was welcomed very nicely. The doctor was also very nice and answered all my questions. She also showed understanding that one does not decide straight away.
Anonymous · July 2025
Dr. Bromba's calm, matter-of-fact manner and his competence really convinced me during the consultation.
