Lipedema, lymphedema, and fat accumulation—what is the difference?

Swelling, pain, and uneven fat distribution on the legs and arms are often misinterpreted as "normal overweight." However, many women actually suffer from lipedema or lymphedema —medical conditions that require completely different treatment.
At TBL Medical in Bergen, we often meet patients who have gone for many years without a correct diagnosis—and therefore without receiving the right help.

Lipedema – hormonally induced and painful fat accumulation

Lipedema is a chronic disease of the fatty tissue, in which fat cells grow abnormally and fluid accumulates in the subcutaneous tissue. The condition is hormone-related and affects almost exclusively women. It tends to worsen during puberty, pregnancy, or menopause.

Typical characteristics

• Fat accumulation is symmetrical on the legs, hips, and arms.
• Pain and tenderness when pressed
• Prone to bruising
• Hands and feet are not affected
• Weight reduction helps little

Lipedema cannot be "exercised away" or treated with diet alone. Many people experience psychological and physical stress and therefore seek lasting relief.

Lymphedema – fluid accumulation due to impaired lymph drainage

Lymphedema occurs when lymph fluid cannot be drained normally, causing fluid to accumulate in the tissue.
This can be congenital (primary) or occur after surgery, infection, or cancer treatment (secondary).

Characteristics

• Often asymmetrical swelling (one arm or one leg)
• The skin feels tight and hard
• Pressure leaves marks
• Hands or feet are affected
• Improved with compression and massage

Lymphedema can in some cases be combined with lipedema – known as lipolymphedema.

Normal fat accumulation – cosmetic and weight-dependent

Normal fat accumulation is not a disease, but the result of excess energy over time. The fat is distributed evenly and is neither painful nor hormonally induced.
Reduced calorie intake and exercise have a clear effect – unlike lipedema.

How to tell the difference

Characteristics	Lipedema	Lymphedema	Normal fat accumulation
Symmetry	Yes	No	Yes
Pain/tenderness	Yes	Light	No
Hands/feet affected	No	Yes	No
Bruises	Regular	Rare	Rare
Reacting to weight loss	No	Partially	Yes
Hormone-influenced	Yes	No	Partially

Surgical treatment of lipedema at TBL Medical

The procedure is performed by our plastic surgery specialist at TBL Medical, who has experience with the WAL technique and lipedema surgery.

What is WAL surgery?

The WAL method uses a precise, controlled water jet to loosen the fatty tissue before it is removed.
This technique preserves lymph vessels, reduces bleeding, and provides a shorter recovery time than traditional liposuction—while effectively and permanently removing diseased fat.

Advantages of WAL at TBL Medical Bergen

• Performed by a plastic surgery specialist with WAL experience
• Gentle on the lymphatic system
• Less bruising and pain
• Shorter downtime
• Lasting results and symptom relief