How to distinguish cellulite from lipedema

Cellulite behandeln München

Many women are dissatisfied with their bodies, their proportions or the texture of their skin. Due to their specially designed connective tissue, many patients experience dimples, ripples or small holes on their buttocks and thighs. Around 90 percent of women develop cellulite in the course of their lives. Lipedema, which affects an estimated 3 million women in Germany, should be distinguished from cellulite. In this blog post, we explain how the two phenomena differ and how they can be treated.

Cellulite: dimples, waves and indentations lead to orange peel skin

Cellulite is a skin condition that can occur in women. It usually affects the buttocks and thighs, which can have dimples, ripples and indentations that resemble small holes. Thus, a pattern reminiscent of the surface of a golf ball or an orange appears on the affected areas of the skin.

Cellulite has its origins in the anatomy of women: while the male connective tissue runs net-like under the skin and can bind fat into a kind of smooth package, the female connective tissue is fundamentally different. It is significantly thinner and also has a horizontal structure. Visually, it resembles lattice bars. In addition, there are larger fat cells in the subcutaneous tissue of women, which can increase tenfold during pregnancy, for example. The skin is also thinner in women. The skin and connective tissue yield slightly to the pressure exerted by the fat cells from below. This is what causes the dimples and ripples.

Cellulite has no effect on health, only on appearance. Many women feel disturbed by their orange peel skin and make many attempts to reduce or remove it.

Lipedema: chronic fat distribution disorder and proliferation of subcutaneous fatty tissue

Lipedema is a chronic disease. It is associated with a severe increase in subcutaneous fatty tissue, which can occur on the legs, but also on the arms.

As a result, lipedema patients suffer from pain, unpleasant feelings of tension and pressure, and a pronounced sensitivity to touch in the affected areas of the skin. Bruises can also form quickly and frequently. In advanced stages, lipedema can impair the gait pattern and cause deformities of the joints. These often wear out prematurely.

Dr. Tatjana Pavicic

Dr. Tatjana Pavicic is a specialist in dermatology and venereology with her own practice in Munich. She is an internationally recognized expert in aesthetic dermatology with a special focus on dermocosmetics, botulinum toxin, fillers and lasers.

Cellulite or lipedema: this is how the symptoms differ in their 3 stages
Stage 1

Here, the cellulite is in its initial state: when standing, no dimples etc. are visible. Only when the skin is compressed do deformations appear.

In comparison, patients with incipient lipedema already have to contend with more severe manifestations: legs or arms already appear thicker than the rest of the body in this first stage, and the proportions are affected. If the skin is palpated, small fat nodules and thickenings can be felt underneath.

Stage 2

The orange peel skin now becomes visually more obvious: dimples are no longer only visible when the skin is squeezed, but are also noticeable when standing. The tissue of some patients reacts more sensitively to pressure.

If the patient suffers from lipedema, then in the second stage of the disease, bumps become more and more prominent. As the fat deposits in the subcutaneous tissue increase in size, they are increasingly palpable as rough lumps under the skin. Those affected now frequently complain of tension and pressure pains.

Stage 3

In the third stage of cellulite, strong visual changes appear: Distinct dents, waves and holes are visible – and always. In addition, the skin slackens and can appear sallow.

Patients with lipedema now show considerable thickening in the affected areas of the body. Large-shaped and deforming fat flaps appear. The subcutis is significantly thickened and the tissue is very hard.

Treating cellulite and lipedema

Women who experience mild cellulite can often improve the condition with exercise, alternating showers, massages and special cosmetics.

If this does not help, we can treat the orange peel skin with various therapies, which can also be combined depending on the findings. In our repertoire are innovative and effective treatments that convince with their smoothing effect and activating the formation of new collagen.

These include:

  • Cellfina
    With this minimally invasive treatment, we can loosen individual thickened strands of connective tissue, causing the tension on the skin’s surface to subside. As a result, dimples and holes are permanently attenuated.
  • BTL Exilis Elite™
    Non-invasive treatment using radio/ultrasound technology can kill fat cells and tighten skin and connective tissue by rebuilding collagen. Cellulite waves respond well to the therapy.
  • Attiva
    With this endodermal radiofrequency therapy, we can use heat to encourage the skin to form new collagen. Connective tissue and skin become firmer and achieve new strength.

Lipedema, on the other hand, can be improved with compression stockings, lymphatic drainage or complex physical decongestive therapies. If the condition causes too much restriction, liposuction by a specialist can help.

Treat cellulite munich

Conclusion: it is “better” to suffer from orange peel skin than from lipedema. Cellulite is a purely aesthetic problem, lipedema is a disease.

Nevertheless, cellulite can also be very disturbing, as it affects the appearance of legs and buttocks. If you want to actively do something about it, our practice for dermatology and aesthetics in Munich is the right address. Simply contact us and arrange your personal consultation appointment, during which we will develop a treatment concept against your cellulite.

Foto: © fxquadro /

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