Lipedema of the Knee: 3 Effective Solutions – Take Action Now!

Legs of a woman with soft fat pads on the inner side of the knees, in olive green lace lingerie, symbolic image on the subject of lipedema of the knee at BONITAS in Nuremberg

At a glance

Lipedema on the knee is a chronic fat distribution disorder with disproportionate fat deposits around the joint. The central identifying feature is the symmetrical swelling of the inner sides of the knees, which does not change noticeably with exercise or dieting.

Typical signs
pressure pain and sensitivity to touch, feelings of tightness after standing for a longer time, hematomas without any recognizable cause, cold patches of skin around the knee
Telling it apart
lipedema persists despite a calorie deficit, and lymphedema can be distinguished by the Stemmer sign
Conservative treatment
compression stockings, manual lymphatic drainage, exercise therapy and an anti-inflammatory diet ease symptoms, but they do not make the lipedema recede
Liposuction
where the findings are advanced, the diseased tissue is removed in a targeted way, especially on the inner side of the knee; afterwards a recovery phase with compression is essential
When you should act
if you regularly feel pressure, tightness or pain around the knee, an early medical assessment makes sense

1. What is lipedema in the knee region?

Lipedema is a chronic disorder of fat distribution that typically affects women. It is characterized by the disproportionate deposition of fatty tissue on the legs, arms – and frequently around the knees as well. In the case of the knees, lipedema leads not only to aesthetic changes but often also to painful limitations when walking or standing.

2. Typical causes of fat accumulation at the knee

Many of those affected initially suspect weight gain or a lack of exercise to be the cause of the “fat at the knee”. With lipedema, however, this is a misconception. It is not normal fat, but rather pathologically altered tissue. Hormonal changes (puberty, pregnancy, menopause) are considered common triggers. Genetic factors also play a role.

3. How can lipedema on the inner side of the knee be recognized?

A key identifying feature is the symmetrical swelling of the inner sides of the knees, which does not change noticeably with exercise or dieting. Further signs include:

  • Pressure pain or tenderness to touch

  • A feeling of tightness in the knees after prolonged standing

  • Bruising without an identifiable cause

  • Cool patches of skin around the knee

The affected tissue often feels soft and nodular, and in some cases a palpable transition to normal skin develops.

4. Distinguishing it from other fat distributions

Lipedema at the knee should be clearly distinguished from being overweight, from lymphedema, and from lipohypertrophy. Unlike pure fatty tissue, lipedema persists despite a caloric deficit. Fluid retention, such as occurs with lymphedema, can also be differentiated by tests such as the Stemmer sign.

An experienced specialist can quickly arrive at an initial diagnosis based on palpation findings and the patient history.

5. Knee pain caused by lipedema – why?

The pain arises from the inflammatory irritation of the altered fatty tissue as well as from pressure on the surrounding structures. Symptoms appear in particular during movement or under load:

  • Climbing stairs becomes difficult

  • The knees feel “stiff” or blocked

  • Pressure on the inner side of the knee is uncomfortable

This pain is not imaginary but a clear indication of the progressive strain caused by the pathological tissue.

6. Options for conservative treatment

In early stages, progression can be slowed by conservative methods:

  • Compression stockings or bandages

  • Manual lymphatic drainage

  • Movement therapy with a focus on joint-friendly activity

  • An anti-inflammatory diet

While these measures do not lead to regression of the lipedema, they relieve symptoms and improve quality of life.

7. Liposuction as a lasting solution

In advanced lipedema in the knee region, liposuction (fat removal) is currently the only treatment known to provide a lasting effect. In this procedure, the pathological tissue is removed in a targeted manner – particularly on the inner side of the knee, where many of those affected are especially restricted.

One advantage: thanks to modern techniques such as PAL (Power Assisted Liposuction) and WAL (water-jet-assisted liposuction), the procedure is particularly gentle. It reduces not only the volume but also the intensity of pain considerably. A subsequent recovery phase with compression is essential for the outcome.

8. When should you take action?

The earlier lipedema is recognized, the better it can be treated. If you regularly experience a feeling of pressure, tightness, or pain around the knee, it is worth arranging an appointment at a specialized practice. Particularly in the region of the inner side of the knee, the risk of movement restrictions is high – acting early helps protect against later complications.

At BONITAS, we combine medical precision with a clear understanding of the everyday realities of our patients’ lives. Our expertise in the area of lipedema of the leg allows for a well-founded assessment and a targeted therapy – from conservative approaches to professional liposuction for lipedema.

9. FAQ: Lipedema of the Knee

References & Scientific Sources

6 sources
  1. Kruppa P et al. „Lipedema – Pathogenesis, Diagnosis, and Treatment Options.” Deutsches Ärzteblatt International. 2020. PubMed PMID 32762835
  2. van la Parra RFD, Deconinck C. „Lipedema: What we don’t know.” Journal of Plastic, Reconstructive & Aesthetic Surgery. 2023. PubMed PMID 37390539
  3. Lundanes J et al. „Effect of a low-carbohydrate diet on pain and quality of life in female patients with lipedema: a randomized controlled trial.” Obesity. 2024. PubMed PMID 38627016
  4. Mortada H, Alhithlool AW. „Lipedema: Clinical Features, Diagnosis, and Management.” Archives of Plastic Surgery. 2025. PubMed PMID 40386000
  5. Buso G et al. „Lipedema: A Call to Action!.” Obesity (Silver Spring). 2019. PubMed PMID 31544340
  6. Forner-Cordero I et al. „Update in the management of lipedema.” International Angiology. 2021. PubMed PMID 33870676