{"id":3799,"date":"2025-08-30T16:44:29","date_gmt":"2025-08-30T16:44:29","guid":{"rendered":"https:\/\/lipedemaac.com\/grados-del-lipedema\/"},"modified":"2026-08-26T11:08:58","modified_gmt":"2026-08-26T11:08:58","slug":"stages-of-lipedema","status":"publish","type":"page","link":"https:\/\/lipedemaac.com\/en\/stages-of-lipedema\/","title":{"rendered":"Classification of Lipedema"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"3799\" class=\"elementor elementor-3799\" data-elementor-settings=\"{&quot;ha_cmc_init_switcher&quot;:&quot;no&quot;}\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-52ad71c elementor-section-full_width elementor-section-stretched elementor-section-height-default elementor-section-height-default\" data-id=\"52ad71c\" data-element_type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;,&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-1299e4d\" data-id=\"1299e4d\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4a10a48 elementor-widget elementor-widget-html\" data-id=\"4a10a48\" data-element_type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<!--\r\n=====================================================================\r\n\/en\/stages-of-lipedema\/  -  FULL PAGE (ALL IN ONE)  -  EN\r\nInformational landing used transactionally: premium hero + blog-style body.\r\nPaste into a block that PROCESSES shortcodes (Gutenberg \"Custom HTML\" or Elementor).\r\nIncludes the rich snippet (JSON-LD) at the end and the WPForms shortcode (form 3655).\r\nIMAGES: uses the 6 in-house illustrations ALREADY in the media library (stages 1-4,\r\ncombined stages and combined types). 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p{margin:0;color:#555;font-size:16px;line-height:1.8;}\r\n.grdlac-faq-item p a{color:#9b7b3d;font-weight:700;text-decoration:none;}\r\n\r\n\/* AUTOR \/ FUENTES *\/\r\n.grdlac-section .grdlac-authorbox{max-width:1180px;margin-left:auto !important;margin-right:auto !important;background:#fff;border:1px solid rgba(180,151,95,.28);border-left:4px solid #b4975f;padding:30px 34px;}\r\n.grdlac-authorbox p{margin:0 0 10px;color:#3b3b3b;font-size:14.5px;line-height:1.7;}\r\n.grdlac-authorbox p:last-child{margin:0;}\r\n.grdlac-authorbox strong{color:#111;}\r\n.grdlac-authorbox a{color:#9b7b3d;font-weight:700;text-decoration:none;}\r\n.grdlac-section .grdlac-refs{max-width:920px;margin-left:auto !important;margin-right:auto !important;}\r\n.grdlac-refs h3{color:#111;font-size:15px;text-transform:uppercase;letter-spacing:.1em;}\r\n.grdlac-refs ol{color:#666;font-size:13.5px;line-height:1.7;padding-left:18px;}\r\n.grdlac-refs a{color:#9b7b3d;text-decoration:none;}\r\n\r\n.grdlac-section figure{margin-left:auto !important;margin-right:auto !important;float:none !important;}\r\n@media(max-width:820px){\r\n  .grdlac-grade{grid-template-columns:1fr;gap:20px;}\r\n  .grdlac-grade-img{max-width:240px;}\r\n  .grdlac-section{padding:56px 20px;}\r\n}\r\n@media(max-width:767px){\r\n  .grdlac-hero{min-height:560px;background-position:72% center;}\r\n  .grdlac-hero::before{background:linear-gradient(180deg, rgba(5,8,9,.96) 0%, rgba(5,8,9,.84) 45%, rgba(5,8,9,.96) 100%);}\r\n  .grdlac-hero-inner{padding:92px 22px 56px;}\r\n  .grdlac-actions{flex-direction:column;}\r\n  .grdlac-btn-primary,.grdlac-btn-secondary{width:100%;}\r\n}\r\n<\/style>\r\n\r\n<!-- ============================= HERO ============================= -->\r\n<section class=\"grdlac-hero\">\r\n  <div class=\"grdlac-hero-inner\">\r\n    <div class=\"grdlac-hero-content\">\r\n      <div class=\"grdlac-kicker\">Lipedema classification<\/div>\r\n      <h1>Stages of lipedema:<span>the 4 stages, explained<\/span><\/h1>\r\n      <p class=\"grdlac-hero-text\">\r\n        Lipedema is classified in two different ways that are often confused: by <strong>stages<\/strong> (1 to 4, according to how the skin and tissue evolve) and by <strong>types<\/strong> (I to V, according to where the fat accumulates). Here we explain both with our own illustrations, so you can place your case and understand what each stage involves.\r\n      <\/p>\r\n      <div class=\"grdlac-hero-links\">\r\n        <a href=\"\/en\/what-is-lipedema\/\">What is lipedema<\/a>\r\n        <a href=\"\/en\/lipedema-symptoms\/\">Symptoms<\/a>\r\n        <a href=\"\/en\/lipedema-diagnosis\/\">Diagnosis<\/a>\r\n        <a href=\"\/en\/lipedema-test\/\">Lipedema test<\/a>\r\n        <a href=\"\/en\/lipedema-treatment\/\">Treatment<\/a>\r\n      <\/div>\r\n      <div class=\"grdlac-actions\">\r\n        <a href=\"#contacto_footer\" class=\"grdlac-btn-primary\">Request a concierge assessment<\/a>\r\n        <a href=\"\/en\/lipedema-diagnosis\/\" class=\"grdlac-btn-secondary\">See the diagnosis<\/a>\r\n      <\/div>\r\n    <\/div>\r\n  <\/div>\r\n<\/section>\r\n\r\n<!-- ============================= INTRO + COMBINED STAGES ILLUSTRATION ============================= -->\r\n<section class=\"grdlac-section white\">\r\n  <div class=\"grdlac-container\">\r\n    <div class=\"grdlac-prose\">\r\n      <div class=\"grdlac-eyebrow\">Where to start<\/div>\r\n      <h2>Stages and types: two classifications, <span>two different questions<\/span><\/h2>\r\n      <p>\r\n        When a patient searches for \"stages of lipedema\" she is usually trying to answer one very specific question: <em>where am I?<\/em>. And that is where the first confusion appears, because lipedema has two classifications that do not mean the same thing and are often mixed up.\r\n      <\/p>\r\n      <p>\r\n        The <strong>stages<\/strong> from 1 to 4, which you will also see as <strong>grades<\/strong> or <strong>phases<\/strong>, describe <strong>the state of the tissue and the skin<\/strong>: whether the surface is smooth, whether there are nodules, whether there are lobules of fat that hang. The <strong>types<\/strong> (I to V) describe <strong>where the fat accumulates<\/strong>: hips, thighs, down to the ankle, arms or only the calves.\r\n      <\/p>\r\n      <p>\r\n        In other words: the stage tells you <strong>how far it has advanced<\/strong>, the type tells you <strong>which areas it affects<\/strong>. Every patient always has both: for example, a <strong>type III lipedema at stage 2<\/strong>.\r\n      <\/p>\r\n    <\/div>\r\n\r\n    <figure class=\"grdlac-figure\">\r\n      <img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/lipedemaac.com\/wp-content\/uploads\/2025\/08\/Ilustraciones-Lipedema_Conjunta-Grados.png\" alt=\"Image of the 4 stages of lipedema: comparison from stage 1 to stage 4 in the legs\" loading=\"lazy\" width=\"1024\" height=\"725\" title=\"\">\r\n      <figcaption>The four stages of lipedema, from 1 to 4: the skin and tissue change as the condition progresses. In-house illustration by Lipedema Advanced Care.<\/figcaption>\r\n    <\/figure>\r\n  <\/div>\r\n<\/section>\r\n\r\n<!-- ============================= STAGES VS TYPES TABLE ============================= -->\r\n<section class=\"grdlac-section\">\r\n  <div class=\"grdlac-container\">\r\n    <div class=\"grdlac-prose\">\r\n      <div class=\"grdlac-eyebrow\">The key difference<\/div>\r\n      <h2>Stage or type: how not to confuse them<\/h2>\r\n      <p>This is the table that settles the most repeated question in consultation. Both classifications are complementary and are used together.<\/p>\r\n    <\/div>\r\n    <div class=\"grdlac-tablewrap\">\r\n      <table class=\"grdlac-table\">\r\n        <thead><tr><th><\/th><th>Stages (1 to 4)<\/th><th>Types (I to V)<\/th><\/tr><\/thead>\r\n        <tbody>\r\n          <tr><td>What it describes<\/td><td>The state of the skin and the fat tissue<\/td><td>The anatomical distribution of the fat<\/td><\/tr>\r\n          <tr><td>Question it answers<\/td><td>How far has it advanced?<\/td><td>Which areas does it affect?<\/td><\/tr>\r\n          <tr><td>Can change over time<\/td><td>Yes, it can progress<\/td><td>Usually stays the same, although it can extend<\/td><\/tr>\r\n          <tr><td>Example<\/td><td>Stage 2: skin with waviness and nodules<\/td><td>Type III: from hips to ankles<\/td><\/tr>\r\n        <\/tbody>\r\n      <\/table>\r\n    <\/div>\r\n    <p class=\"grdlac-tnote\">Indicative classification for educational use. Your stage and type are determined by an experienced professional through clinical examination.<\/p>\r\n  <\/div>\r\n<\/section>\r\n\r\n<!-- ============================= THE 4 STAGES ============================= -->\r\n<section class=\"grdlac-section white\">\r\n  <div class=\"grdlac-container\">\r\n    <div class=\"grdlac-lead\">\r\n      <div class=\"grdlac-eyebrow\">One by one<\/div>\r\n      <h2>The 4 stages of lipedema<\/h2>\r\n      <p style=\"max-width:780px;margin:0 auto 22px;\">Each stage describes a state of the tissue, not a sentence: lipedema does not evolve the same way in every patient, and the stage alone does not decide the treatment.<\/p>\r\n      <p style=\"max-width:820px;margin:0 auto 44px;font-size:16px;color:#5a727d;\">It is worth knowing that there is no single official classification. The classic morphological description (Meier-Vollrath and Schmeller, 2004) sets out three stages, and many centres add a fourth when lymphoedema is added to the lipedema (lipo-lymphoedema). We use the four-stage nomenclature because it is the most widespread and the one patients search for, but with an important caveat: the German S2k guideline on lipedema (AWMF 037-012, 2024) recommends understanding these stages as a description of the appearance of the tissue and not as a measure of the severity of the condition, because volume and skin appearance do not correspond to the intensity of the pain or the impact on daily life. The lymphatic component, moreover, can be present at any stage and not only at the fourth.<\/p>\r\n    <\/div>\r\n\r\n    <div class=\"grdlac-grade\">\r\n      <div class=\"grdlac-grade-img\">\r\n        <img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/lipedemaac.com\/wp-content\/uploads\/2023\/02\/Ilustraciones-Lipedema_Grado-1.png\" alt=\"Image of stage 1 lipedema in the legs: smooth skin with palpable nodules\" loading=\"lazy\" width=\"300\" height=\"300\" title=\"\">\r\n      <\/div>\r\n      <div>\r\n        <span class=\"grdlac-num\">Stage 1<\/span>\r\n        <h3>Stage 1 lipedema: smooth skin, but the tissue has already changed<\/h3>\r\n        <p><strong>Stage 1 lipedema<\/strong> is the earliest phase: to the eye the skin looks <strong>smooth and even<\/strong>. The change is underneath. On palpation you can feel small nodules, like grains of rice or peas, and the tissue is denser than normal. It is what many patients know as \"mild lipedema\".<\/p>\r\n        <p>It is the stage that takes longest to diagnose, precisely because \"there is nothing to see\". Many women spend years here being told it is a matter of diet, or that it is cellulite. The difference lies in three details that cellulite does not have: <strong>it hurts on pressure<\/strong>, <strong>bruises appear easily<\/strong> and <strong>the disproportion is symmetrical<\/strong> in both legs or both arms. We compare them in <a class=\"grdlac-link\" href=\"\/en\/difference-lipedema-cellulite\/\">lipedema or cellulite<\/a>.<\/p>\r\n        <p><strong>Is it worth seeking advice at stage 1?<\/strong> Yes. It is the point at which conservative management (compression, drainage, habits) has the most room to control symptoms, and at which a correct diagnosis saves years of the wrong approach. It does not mean you need surgery: it means knowing what you have.<\/p>\r\n        <ul class=\"grdlac-keys\">\r\n          <li>Smooth skin surface<\/li>\r\n          <li>Small nodules palpable under the skin<\/li>\r\n          <li>Pain on pressure and easy bruising may already be present<\/li>\r\n          <li>Symmetrical disproportion, although still subtle<\/li>\r\n        <\/ul>\r\n      <\/div>\r\n    <\/div>\r\n\r\n    <div class=\"grdlac-grade\">\r\n      <div class=\"grdlac-grade-img\">\r\n        <img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/lipedemaac.com\/wp-content\/uploads\/2023\/02\/Ilustraciones-Lipedema_Grado-2.png\" alt=\"Image of stage 2 lipedema in the legs: skin with waviness and nodules\" loading=\"lazy\" width=\"300\" height=\"300\" title=\"\">\r\n      <\/div>\r\n      <div>\r\n        <span class=\"grdlac-num\">Stage 2<\/span>\r\n        <h3>Stage 2 lipedema: waviness appears on the surface<\/h3>\r\n        <p>The skin is no longer smooth: visible <strong>waviness and irregularities<\/strong> appear, and the nodules are larger and easier to locate by touch. The feeling of heaviness usually increases.<\/p>\r\n        <p>Here the disproportion between legs or arms and the trunk is normally obvious, and it is often mistaken for cellulite. We look at it in detail in <a class=\"grdlac-link\" href=\"\/en\/difference-lipedema-cellulite\/\">lipedema or cellulite<\/a>.<\/p>\r\n        <ul class=\"grdlac-keys\">\r\n          <li>Visible waviness on the skin<\/li>\r\n          <li>Larger and more numerous nodules<\/li>\r\n          <li>Clear disproportion with the trunk<\/li>\r\n        <\/ul>\r\n      <\/div>\r\n    <\/div>\r\n\r\n    <div class=\"grdlac-grade\">\r\n      <div class=\"grdlac-grade-img\">\r\n        <img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/lipedemaac.com\/wp-content\/uploads\/2023\/02\/Ilustraciones-Lipedema_Grado-3.png\" alt=\"Image of stage 3 lipedema in the legs: lobules of fat and deformed contour\" loading=\"lazy\" width=\"300\" height=\"300\" title=\"\">\r\n      <\/div>\r\n      <div>\r\n        <span class=\"grdlac-num\">Stage 3<\/span>\r\n        <h3>Stage 3 lipedema: lobules of tissue and functional limitation<\/h3>\r\n        <p>The tissue forms <strong>lobules of fat that deform the contour<\/strong>, especially on the inner thighs and knees. The skin is harder and the volume can make walking difficult or cause rubbing between the legs.<\/p>\r\n        <p>At this point the impact is no longer only aesthetic or only painful: it is <strong>functional<\/strong>, and it is usually when <a class=\"grdlac-link\" href=\"\/en\/lipedema-reduction-surgery\/\">lipedema surgery<\/a> is most clearly considered.<\/p>\r\n        <ul class=\"grdlac-keys\">\r\n          <li>Visible lobules of fat and deformed contour<\/li>\r\n          <li>More fibrous, hardened tissue<\/li>\r\n          <li>Limited mobility and impact on daily life<\/li>\r\n        <\/ul>\r\n      <\/div>\r\n    <\/div>\r\n\r\n    <div class=\"grdlac-grade\">\r\n      <div class=\"grdlac-grade-img\">\r\n        <img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/lipedemaac.com\/wp-content\/uploads\/2023\/02\/Ilustraciones-Lipedema_Grado-4.png\" alt=\"Image of stage 4 lipedema or lipo-lymphoedema: swelling with an associated lymphatic component\" loading=\"lazy\" width=\"300\" height=\"300\" title=\"\">\r\n      <\/div>\r\n      <div>\r\n        <span class=\"grdlac-num\">Stage 4<\/span>\r\n        <h3>Stage 4 lipedema or lipo-lymphoedema: when the lymphatic component is added<\/h3>\r\n        <p>A <strong>lymphoedema<\/strong> is added to the lipedema: the lymphatic system stops draining properly and persistent swelling appears which, unlike pure lipedema, <strong>can affect the feet<\/strong>.<\/p>\r\n        <p>This is the scenario that benefits most from an approach that protects the lymphatic system, both in conservative management with <a class=\"grdlac-link\" href=\"\/en\/manual-lymphatic-drainage-lipedema\/\">manual lymphatic drainage<\/a> and in surgery.<\/p>\r\n        <ul class=\"grdlac-keys\">\r\n          <li>Persistent swelling that does not settle with rest<\/li>\r\n          <li>Can also affect the feet and ankles<\/li>\r\n          <li>More fibrous skin and greater functional deterioration<\/li>\r\n        <\/ul>\r\n      <\/div>\r\n    <\/div>\r\n  <\/div>\r\n<\/section>\r\n\r\n<!-- ============================= STAGES SUMMARY TABLE ============================= -->\r\n<section class=\"grdlac-section\">\r\n  <div class=\"grdlac-container\">\r\n    <div class=\"grdlac-prose\">\r\n      <div class=\"grdlac-eyebrow\">Summary<\/div>\r\n      <h2>The 4 stages, at a glance<\/h2>\r\n    <\/div>\r\n    <div class=\"grdlac-tablewrap\">\r\n      <table class=\"grdlac-table\">\r\n        <thead><tr><th>Stage<\/th><th>Appearance of the skin<\/th><th>Tissue<\/th><th>Usual impact<\/th><\/tr><\/thead>\r\n        <tbody>\r\n          <tr><td>Stage 1<\/td><td>Smooth<\/td><td>Small palpable nodules<\/td><td>Pain on pressure, easy bruising<\/td><\/tr>\r\n          <tr><td>Stage 2<\/td><td>Wavy and uneven<\/td><td>Larger nodules<\/td><td>Heaviness and clear disproportion<\/td><\/tr>\r\n          <tr><td>Stage 3<\/td><td>Deformed, with lobules<\/td><td>Fibrous and hardened<\/td><td>Limited mobility<\/td><\/tr>\r\n          <tr><td>Stage 4<\/td><td>Added swelling, fibrosis<\/td><td>Lipedema + lymphoedema<\/td><td>Functional deterioration; can affect the feet<\/td><\/tr>\r\n        <\/tbody>\r\n      <\/table>\r\n    <\/div>\r\n    <p class=\"grdlac-tnote\">The stage guides the approach, but does not decide it on its own: how much lipedema affects your quality of life weighs just as much.<\/p>\r\n  <\/div>\r\n<\/section>\r\n\r\n<!-- ============================= THE 5 TYPES ============================= -->\r\n<section class=\"grdlac-section white\">\r\n  <div class=\"grdlac-container\">\r\n    <div class=\"grdlac-prose\">\r\n      <div class=\"grdlac-eyebrow\">The other classification<\/div>\r\n      <h2>The 5 types of lipedema <span>by affected area<\/span><\/h2>\r\n      <p>\r\n        While the stage looks at the tissue, the type looks at the map of the body. It is a descriptive classification: it helps plan which areas need treating, not measure severity. In the legs, types I to III describe how far up the fat reaches; type IV is the arm type and type V the one confined to the lower leg.\r\n      <\/p>\r\n    <\/div>\r\n\r\n    <figure class=\"grdlac-figure\">\r\n      <img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/lipedemaac.com\/wp-content\/uploads\/2023\/02\/Ilustraciones-Lipedema_Conjunta-Tipos-1.png\" alt=\"Image of the 5 types of lipedema: distribution of fat by body area\" loading=\"lazy\" width=\"1024\" height=\"725\" title=\"\">\r\n      <figcaption>The five types of lipedema by anatomical distribution. In-house illustration by Lipedema Advanced Care.<\/figcaption>\r\n    <\/figure>\r\n\r\n    <div class=\"grdlac-tablewrap\">\r\n      <table class=\"grdlac-table\">\r\n        <thead><tr><th>Type<\/th><th>Affected area<\/th><th>Characteristic feature<\/th><\/tr><\/thead>\r\n        <tbody>\r\n          <tr><td>Type I<\/td><td>Hips, buttocks and pelvis<\/td><td>Volume concentrated in the pelvic area<\/td><\/tr>\r\n          <tr><td>Type II<\/td><td>From hips to knees<\/td><td>Build-up in the thighs, with knees affected<\/td><\/tr>\r\n          <tr><td>Type III<\/td><td>From hips to ankles<\/td><td>The most frequent in our series (41.7%); spares the feet<\/td><\/tr>\r\n          <tr><td>Type IV<\/td><td>Arms<\/td><td>Can appear alone or alongside other types<\/td><\/tr>\r\n          <tr><td>Type V<\/td><td>Calves<\/td><td>Isolated involvement of the lower leg<\/td><\/tr>\r\n        <\/tbody>\r\n      <\/table>\r\n    <\/div>\r\n    <p class=\"grdlac-tnote\">Types can combine: it is common, for example, to see a type III with arm involvement (type IV). The frequency data comes from <em>The Advanced Care Study<\/em> (IJERPH, 2023), carried out by our team on patients with lipedema in Spain: type III was the most common (41.7%), followed by type IV (36.8%). Proportions vary across other series.<\/p>\r\n\r\n    <div class=\"grdlac-callout\">\r\n      <p><strong>One feature repeats across every type:<\/strong> lipedema <strong>spares the hands and the feet<\/strong>, which is why a clear step is often visible at the ankle or the wrist. When the foot is affected, a lymphatic component or lipo-lymphoedema should be considered, which can appear at any stage.<\/p>\r\n    <\/div>\r\n  <\/div>\r\n<\/section>\r\n\r\n<!-- ============================= PROGRESSION ============================= -->\r\n<section class=\"grdlac-section dark\">\r\n  <div class=\"grdlac-container\">\r\n    <div class=\"grdlac-prose\">\r\n      <div class=\"grdlac-eyebrow\">What usually worries patients<\/div>\r\n      <h2>Does lipedema always move <span>from one stage to the next<\/span>?<\/h2>\r\n      <p>\r\n        Not necessarily. Lipedema is a chronic condition and it <strong>can<\/strong> progress, but not every patient goes through all four stages or does so at the same pace. Some women stay at the same stage for years.\r\n      <\/p>\r\n      <p>\r\n        A prospective Spanish study of 100 patients with a mean follow-up of 4.6 years (Forner-Cordero and Mu\u00f1oz-Langa, <em>Vascular Medicine<\/em>, 2025) found that lipedema remained <strong>stable in 62%<\/strong> of the women, <strong>progressed in 28%<\/strong> and <strong>improved in 10%<\/strong>. Progression was not linked to age, but to an increase in abdominal fat. This is why the German S2k guideline (2024) recommends not regarding lipedema as a necessarily progressive condition.\r\n      <\/p>\r\n      <p>\r\n        What we do know is that certain hormonal moments (puberty, pregnancy, menopause) tend to coincide with changes, and that conservative management and follow-up help control the symptoms. No classification replaces a <a class=\"grdlac-link\" href=\"\/en\/lipedema-diagnosis\/\">medical assessment<\/a>: two people at the same stage may need different plans.\r\n      <\/p>\r\n      <div class=\"grdlac-actions\" style=\"justify-content:flex-start;margin-top:28px;\">\r\n        <a href=\"#contacto_footer\" class=\"grdlac-btn-primary\">Request a concierge assessment<\/a>\r\n        <a href=\"\/en\/lipedema-test\/\" class=\"grdlac-btn-secondary\">Take the lipedema test<\/a>\r\n      <\/div>\r\n    <\/div>\r\n  <\/div>\r\n<\/section>\r\n\r\n<!-- ============================= APPROACH BY STAGE ============================= -->\r\n<section class=\"grdlac-section white\">\r\n  <div class=\"grdlac-container\">\r\n    <div class=\"grdlac-prose\">\r\n      <div class=\"grdlac-eyebrow\">What each stage involves<\/div>\r\n      <h2>What approach fits each stage<\/h2>\r\n      <p>\r\n        Knowing your stage is useful above all to guide the plan. This is the general logic we follow in the <a class=\"grdlac-link\" href=\"\/en\/advanced-care-method\/\">Advanced Care Method<\/a>, always adjusted to each case.\r\n      <\/p>\r\n    <\/div>\r\n    <div class=\"grdlac-tablewrap\">\r\n      <table class=\"grdlac-table\">\r\n        <thead><tr><th>Stage<\/th><th>Usual approach<\/th><th>Goal<\/th><\/tr><\/thead>\r\n        <tbody>\r\n          <tr><td>Stage 1<\/td><td>Conservative: compression, drainage, habits<\/td><td>Control symptoms and limit the impact<\/td><\/tr>\r\n          <tr><td>Stage 2<\/td><td>Conservative + surgical assessment<\/td><td>Assess whether surgery brings functional improvement<\/td><\/tr>\r\n          <tr><td>Stage 3<\/td><td><a href=\"\/en\/lipedema-reduction-surgery\/\">Surgery<\/a> + conservative management<\/td><td>Reduce diseased tissue and restore mobility<\/td><\/tr>\r\n          <tr><td>Stage 4<\/td><td>Lymph-preserving approach and lymphoedema control<\/td><td>Protect the lymphatic system and ease the swelling<\/td><\/tr>\r\n        <\/tbody>\r\n      <\/table>\r\n    <\/div>\r\n    <p class=\"grdlac-tnote\">Indicative. The indication for surgery is not decided by the stage: current guidelines (S2k, 2024) recommend basing it on symptoms, functional impact and vascular status, because the appearance of the tissue does not correspond to the intensity of the pain. The stage helps to plan, not to decide.<\/p>\r\n\r\n    <div class=\"grdlac-prose\" style=\"margin-top:34px;\">\r\n      <p>\r\n        When surgery is indicated, the technique is also chosen according to the tissue: <a class=\"grdlac-link\" href=\"\/en\/wal-lipedema-liposuction\/\">WAL liposuction<\/a> as the lymph-preserving base, <a class=\"grdlac-link\" href=\"\/en\/pal-lipedema-liposuction\/\">PAL liposuction<\/a> for the more fibrous tissue of advanced stages and, if laxity remains after removing volume, <a class=\"grdlac-link\" href=\"\/en\/renuvion-lipedema\/\">Renuvion&reg;<\/a>.\r\n      <\/p>\r\n    <\/div>\r\n  <\/div>\r\n<\/section>\r\n\r\n<!-- ============================= HOW TO KNOW YOUR STAGE ============================= -->\r\n<section class=\"grdlac-section\">\r\n  <div class=\"grdlac-container\">\r\n    <div class=\"grdlac-prose\">\r\n      <div class=\"grdlac-eyebrow\">The next step<\/div>\r\n      <h2>How to know which stage you are in<\/h2>\r\n      <p>\r\n        The stage and the type are determined <strong>clinically<\/strong>: through the patient's history and a physical examination by an experienced professional, assessing the texture of the tissue, the distribution of volume and pain on palpation. There is no single test that gives it, although the vascular study and the 3D scan help document it and measure progress.\r\n      <\/p>\r\n      <ul>\r\n        <li><strong>If you do not have a diagnosis yet:<\/strong> start with the <a class=\"grdlac-link\" href=\"\/en\/lipedema-test\/\">lipedema test<\/a> and the <a class=\"grdlac-link\" href=\"\/en\/lipedema-symptoms\/\">symptoms<\/a>.<\/li>\r\n        <li><strong>If you already suspect you have it:<\/strong> see how the <a class=\"grdlac-link\" href=\"\/en\/lipedema-diagnosis\/\">lipedema diagnosis<\/a> works.<\/li>\r\n        <li><strong>If you are looking at options:<\/strong> see the <a class=\"grdlac-link\" href=\"\/en\/lipedema-treatment\/\">integrated treatment<\/a>.<\/li>\r\n      <\/ul>\r\n    <\/div>\r\n  <\/div>\r\n<\/section>\r\n\r\n<!-- ============================= FAQ ============================= -->\r\n<section class=\"grdlac-section white\">\r\n  <div class=\"grdlac-container\">\r\n    <div class=\"grdlac-lead\"><div class=\"grdlac-eyebrow\">Frequently asked questions<\/div><h2>Questions about the stages of lipedema<\/h2><\/div>\r\n    <div class=\"grdlac-faq\"><div class=\"grdlac-faq-item\"><h3>How many stages of lipedema are there?<\/h3><p>Four. From stage 1 (smooth skin with palpable nodules) to stage 4 (lipo-lymphoedema, with an associated lymphatic component). They describe the state of the tissue and the skin.<\/p><\/div><div class=\"grdlac-faq-item\"><h3>What is stage 1 lipedema?<\/h3><p>It is the earliest phase of lipedema: the skin looks smooth, but on palpation you can feel small nodules and the tissue is denser. Pain on pressure and easy bruising may already be present. It is the stage that takes longest to diagnose because there is nothing to see, and it is often mistaken for cellulite.<\/p><\/div><div class=\"grdlac-faq-item\"><h3>What is the difference between stages and types of lipedema?<\/h3><p>Stages (1 to 4) indicate how far the condition has advanced in the tissue; types (I to V) indicate which areas of the body it affects. Every patient has a stage and a type at the same time.<\/p><\/div><div class=\"grdlac-faq-item\"><h3>How do I know which stage of lipedema I am in?<\/h3><p>It is determined by an experienced professional through clinical examination, assessing the texture of the tissue and the distribution of volume. You can get an initial idea with the <a href=\"\/en\/lipedema-test\/\">lipedema test<\/a>.<\/p><\/div><div class=\"grdlac-faq-item\"><h3>Does lipedema always get worse over time?<\/h3><p>Not necessarily. A prospective Spanish study of 100 patients (Forner-Cordero and Mu\u00f1oz-Langa, 2025) found that lipedema remained stable in 62% of the women, progressed in 28% and improved in 10%. Hormonal changes tend to be sensitive moments.<\/p><\/div><div class=\"grdlac-faq-item\"><h3>What is stage 4 lipedema or lipo-lymphoedema?<\/h3><p>It is lipedema with an added lymphoedema: there is persistent swelling and, unlike pure lipedema, it can also affect the feet.<\/p><\/div><div class=\"grdlac-faq-item\"><h3>Can you go back down a stage?<\/h3><p>Lipedema is chronic and has no cure, so you do not move back down a stage as such. Symptoms can be improved and the diseased fat tissue reduced when <a href=\"\/en\/lipedema-reduction-surgery\/\">surgery<\/a> is indicated.<\/p><\/div><div class=\"grdlac-faq-item\"><h3>Which type of lipedema is most common?<\/h3><p>Type III, which affects from the hips down to the ankles while sparing the feet. In <em>The Advanced Care Study<\/em> (IJERPH, 2023), carried out by our team, it was the most common (41.7%), followed by type IV (36.8%). The two often combine.<\/p><\/div><div class=\"grdlac-faq-item\"><h3>Does the stage decide whether I need surgery?<\/h3><p>It is one criterion, but not the only one. Functional impact, pain and vascular status weigh just as much. The decision is medical and individualised.<\/p><\/div><div class=\"grdlac-faq-item\"><h3>What is mild lipedema?<\/h3><p>It is the everyday name for <strong>stage 1<\/strong>: the skin looks smooth and the change is in the tissue, which on palpation has small nodules and feels denser. Be careful with the word mild, because it describes the appearance and not what it feels like: at stage 1 there can already be tenderness on pressure, heaviness and easy bruising. It is not a separate medical category, so if you have been told you have mild lipedema, that means stage 1.<\/p><\/div><div class=\"grdlac-faq-item\"><h3>What symptoms does stage 1 lipedema cause?<\/h3><p>The three that come up most: <strong>discomfort or pain when the area is pressed<\/strong>, <strong>heaviness<\/strong> at the end of the day and <strong>bruises<\/strong> that appear from a knock. Alongside those, a still discreet disproportion between trunk and legs, and the cut-off at the ankle that spares the foot. The skin can look normal while the lipedema is already there, which is why stage 1 is the one that takes longest to diagnose.<\/p><\/div><\/div>\r\n  <\/div>\r\n<\/section>\r\n\r\n<!-- ============================= SOURCES ============================= -->\r\n<section class=\"grdlac-section white\" style=\"padding-top:0;\">\r\n  <div class=\"grdlac-refs\">\r\n    <h3>Sources and references<\/h3>\r\n    <ol>\r\n      <li>Carballeira Bra\u00f1a A, Poveda Castillo J. <em>The Advanced Care Study: Current Status of Lipedema in Spain<\/em>. Int J Environ Res Public Health, 2023. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37681787\/\" target=\"_blank\" rel=\"noopener\">View on PubMed<\/a> (study by our team)<\/li>\r\n      <li>S2k guideline Lip\u00f6dem, AWMF 037-012, v5.0 (2024). <a href=\"https:\/\/register.awmf.org\/assets\/guidelines\/037-012l_S2k_Lipoedem_2024-01_01.pdf\" target=\"_blank\" rel=\"noopener\">View guideline<\/a><\/li>\r\n      <li>Forner-Cordero I, Mu\u00f1oz-Langa J. <em>Is lipedema a progressive disease?<\/em> Vascular Medicine, 2025;30(2):205-212. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/39831319\/\" target=\"_blank\" rel=\"noopener\">View on PubMed<\/a><\/li>\r\n      <li><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK573066\/\" target=\"_blank\" rel=\"noopener\">Lipedema - StatPearls (NCBI)<\/a><\/li>\r\n      <li><a href=\"https:\/\/www.lipedema.org\/staging\" target=\"_blank\" rel=\"noopener\">Lipedema Foundation - Staging<\/a> (organisation that has retired the \"stage 4\" designation)<\/li>\r\n    <\/ol>\r\n  <\/div>\r\n<\/section>\r\n\r\n<!-- ============================= DISCLAIMER \/ AUTHORSHIP ============================= -->\r\n<section class=\"grdlac-section white\" style=\"padding-top:0;\">\r\n  <div class=\"grdlac-authorbox\">\r\n    <p><strong>Medically reviewed content.<\/strong> Content produced by the medical team at Lipedema Advanced Care and reviewed by <strong>Dr. Alexo Carballeira Bra&ntilde;a<\/strong>, plastic surgeon (SECPRE-recertified) specialised in the treatment of lipedema, registered with the ICOMV. Meet <a href=\"\/en\/doctor-alexo-carballeira-brana\/\">Dr. Alexo Carballeira<\/a> and the rest of our <a href=\"\/en\/medical-team\/\">medical team<\/a>.<\/p>\r\n    <p>This information is for educational purposes and does not replace a medical consultation or diagnosis. Lipedema is a chronic condition; it has no cure, but its symptoms can be treated. The classification by stages and types is indicative and must be confirmed by a professional. Last updated: August 2026.<\/p>\r\n  <\/div>\r\n<\/section>\r\n\r\n<section id=\"lac-prefooter-contacto-unico\" class=\"lpf-main-section\">\r\n    <div class=\"lpf-container\">\r\n        <div class=\"lpf-flex-wrapper\">\r\n\r\n            <div class=\"lpf-doctor-side\">\r\n                <div class=\"lpf-doctor-sticky-box\">\r\n                    <img decoding=\"async\" src=\"https:\/\/lipedemaac.com\/wp-content\/uploads\/2026\/03\/dr-alexo-carballeira-consulta-lipedema-marques-del-turia.jpg\" alt=\"Dr. Alexo Carballeira\" class=\"lpf-doctor-img\" title=\"\">\r\n\r\n                    <div class=\"lpf-text-overlay\">\r\n                        <p class=\"lpf-tagline\">PERSONALISED CARE<\/p>\r\n                        <h2 class=\"lpf-hero-title\">\r\n                            Begin your journey to <br>\r\n                            <span class=\"lpf-gold-text\">freedom from lipedema<\/span>\r\n                        <\/h2>\r\n\r\n                        <div class=\"lpf-quote-container\">\r\n                            <p>\"My commitment is to offer you a precise diagnosis and complete support throughout the process.\"<\/p>\r\n                            <span class=\"lpf-signature\">Dr. Alexo Carballeira<\/span>\r\n                        <\/div>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n\r\n            <div class=\"lpf-form-side\" id=\"contacto_footer\">\r\n                <div class=\"lpf-form-box\">\r\n                    <div class=\"lpf-form-header\">\r\n                        <h3 class=\"lpf-form-main-title\">Request an Assessment<\/h3>\r\n                        <p class=\"lpf-form-subtitle\">SPECIALISED PRELIMINARY ANALYSIS<\/p>\r\n                    <\/div>\r\n\r\n                    <div class=\"lpf-form-engine\">\r\n                        <div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-3655\"><form id=\"wpforms-form-3655\" class=\"wpforms-validate wpforms-form\" 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From stage 1 (smooth skin with palpable nodules) to stage 4 (lipo-lymphoedema, with an associated lymphatic component). They describe the state of the tissue and the skin.\" } },{ \"@type\": \"Question\", \"name\": \"What is stage 1 lipedema?\", \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"It is the earliest phase of lipedema: the skin looks smooth, but on palpation you can feel small nodules and the tissue is denser. Pain on pressure and easy bruising may already be present. It is the stage that takes longest to diagnose because there is nothing to see, and it is often mistaken for cellulite.\" } },{ \"@type\": \"Question\", \"name\": \"What is the difference between stages and types of lipedema?\", \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Stages (1 to 4) indicate how far the condition has advanced in the tissue; types (I to V) indicate which areas of the body it affects. Every patient has a stage and a type at the same time.\" } },{ \"@type\": \"Question\", \"name\": \"How do I know which stage of lipedema I am in?\", \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"It is determined by an experienced professional through clinical examination, assessing the texture of the tissue and the distribution of volume. You can get an initial idea with the lipedema test.\" } },{ \"@type\": \"Question\", \"name\": \"Does lipedema always get worse over time?\", \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Not necessarily. A prospective Spanish study of 100 patients (Forner-Cordero and Munoz-Langa, 2025) found that lipedema remained stable in 62% of the women, progressed in 28% and improved in 10%. Hormonal changes tend to be sensitive moments.\" } },{ \"@type\": \"Question\", \"name\": \"What is stage 4 lipedema or lipo-lymphoedema?\", \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"It is lipedema with an added lymphoedema: there is persistent swelling and, unlike pure lipedema, it can also affect the feet.\" } },{ \"@type\": \"Question\", \"name\": \"Can you go back down a stage?\", \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Lipedema is chronic and has no cure, so you do not move back down a stage as such. Symptoms can be improved and the diseased fat tissue reduced when surgery is indicated.\" } },{ \"@type\": \"Question\", \"name\": \"Which type of lipedema is most common?\", \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Type III, which affects from the hips down to the ankles while sparing the feet. In The Advanced Care Study (IJERPH, 2023), carried out by our team, it was the most common (41.7%), followed by type IV (36.8%).\" } },{ \"@type\": \"Question\", \"name\": \"Does the stage decide whether I need surgery?\", \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"It is one criterion, but not the only one. Functional impact, pain and vascular status weigh just as much. The decision is medical and individualised.\" } }, { \"@type\": \"Question\", \"name\": \"What is mild lipedema?\", \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"It is the everyday name for stage 1: the skin looks smooth and the change is in the tissue, which on palpation has small nodules and feels denser. Mild describes the appearance, not what it feels like: at stage 1 there can already be tenderness on pressure, heaviness and easy bruising. It is not a separate medical category: mild lipedema means stage 1.\" } }, { \"@type\": \"Question\", \"name\": \"What symptoms does stage 1 lipedema cause?\", \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Discomfort or pain when the area is pressed, heaviness at the end of the day and bruises that appear from a knock, alongside a still discreet disproportion between trunk and legs and the cut-off at the ankle that spares the foot. The skin can look normal while the lipedema is already there.\" } }]\r\n    }\r\n  ]\r\n}\r\n<\/script>\r\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Lipedema classification Stages of lipedema:the 4 stages, explained Lipedema is classified in two different ways that are often confused: by stages (1 to 4, according to how the skin and tissue evolve) and by types (I to V, according to where the fat accumulates). Here we explain both with our own illustrations, so you can [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-3799","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/lipedemaac.com\/en\/wp-json\/wp\/v2\/pages\/3799","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lipedemaac.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/lipedemaac.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/lipedemaac.com\/en\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/lipedemaac.com\/en\/wp-json\/wp\/v2\/comments?post=3799"}],"version-history":[{"count":15,"href":"https:\/\/lipedemaac.com\/en\/wp-json\/wp\/v2\/pages\/3799\/revisions"}],"predecessor-version":[{"id":7099,"href":"https:\/\/lipedemaac.com\/en\/wp-json\/wp\/v2\/pages\/3799\/revisions\/7099"}],"wp:attachment":[{"href":"https:\/\/lipedemaac.com\/en\/wp-json\/wp\/v2\/media?parent=3799"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}