NHS Patient Information
Lipoedema.
National Health Service
Lipoedema Clinic
Lipoedema (also spelled lipedema) is a chronic, often misdiagnosed condition that causes a disproportionate, painful build-up of fat in the legs, hips, buttocks and sometimes the arms. It is not obesity, and it does not respond to weight loss or exercise alone.
KONCEPT® runs a dedicated lipoedema clinic led by Mr Abdullah Jibawi, Consultant Vascular and Endovascular Surgeon and Lipoedema Lead, supported by a multidisciplinary team including a Lymphoedema-trained Physiotherapist and a compression fitter. Most patients with lipoedema have waited years for a diagnosis. Our service is built around shortening that wait, getting the diagnosis right, and giving you a clear, tailored management plan.
At a glance
Lead clinician
Mr Jibawi
First visit
30 to 45-min consult
Diagnostic adjuncts
Duplex on same visit
Initial consult
£295
Verified statistics
Drawn from NHS, NICE guidance, the European Society for Vascular Surgery (ESVS), Lipoedema UK’s Standards of Care and peer-reviewed reviews. Every figure links to its citation in the References section at the bottom of this page.
How common lipoedema is
When lipoedema typically begins
3 life stages
when lipoedema most often starts or worsens: puberty, pregnancy, menopause
Lipoedema is a chronic condition in which fat cells in particular regions of the body, most often the legs, hips, buttocks and sometimes the arms, build up in a way that is disproportionate to the rest of the body, tender to touch, and does not respond to weight loss or exercise alone.
It is not obesity. Patients with lipoedema often have a relatively normal upper body and waist with a markedly larger lower body. The feet are typically spared, the affected area stops abruptly at the ankle (sometimes called a “cuff” or “bracelet” sign).
It is not lymphoedema either, although lipoedema can develop a secondary lymphoedema component later (lipo-lymphoedema).
Lipoedema is recognised by the NHS[1], BUPA[2], the European Society for Vascular Surgery[4] and NICE, which published Interventional Procedures Guidance IPG744 on liposuction for chronic lipoedema in 2023[3].
Differential diagnosis
| Lipoedema | Lymphoedema | |
|---|---|---|
| What it is | Disproportionate build-up of fat tissue | Build-up of lymph fluid in the tissues |
| Who is affected | Almost exclusively women, both legs symmetrically | Either sex, often one limb (post-cancer, post-surgery) or both (primary lymphoedema) |
| Feet involved? | Feet are typically spared (cuff at the ankle) | Feet are often involved, Stemmer’s sign positive |
| Tender to touch? | Yes, often very tender, bruises easily | Usually not tender unless cellulitis is present |
| Responds to weight loss? | Disproportionately affected areas resist weight loss | Compression and decongestive therapy reduce swelling |
| Tests | Clinical diagnosis, duplex to rule out venous cause | Lymphoscintigraphy, ICG lymphography in selected cases |
Many patients carry both conditions over time (lipo-lymphoedema). Our clinic distinguishes between them and treats accordingly. KONCEPT® also runs a dedicated Lymphoedema service led by a Lymphoedema-trained Physiotherapist.
Clinical staging
International clinical staging recognises four stages[3][4][5]:
Soft, increased subcutaneous fat tissue in the affected area. Often misattributed to weight gain.
Indentations (orange-peel appearance), small fat nodules palpable beneath the skin.
Distorting the shape of the leg or arm. Significant impact on mobility.
A secondary lymphoedema component has developed alongside the lipoedema. Skin changes and recurrent cellulitis can develop at this stage.
Mr Jibawi will stage your lipoedema at your first appointment and build the plan around your stage and your goals.
If several of these apply to you, lipoedema is worth assessing. Many patients tell us they had been told the problem was “just weight” for years before getting a correct diagnosis.
Diagnosis
Diagnosis is clinical. There is no single blood test or scan that confirms lipoedema. Our clinic combines:
Initial lymphoedema / lipoedema consultation with clinical assessment is £295. Where a duplex scan is added, please see the pricing page for the full schedule.
Management
There is no cure for lipoedema[1][3]. Management aims to reduce symptoms, slow progression, protect joints and improve quality of life. Our approach is staged, conservative-first, with surgical options considered only after a full assessment.
For patients with mixed lipo-lymphoedema or a venous component, we coordinate input from:
Tumescent liposuction is the most commonly described surgical treatment for chronic lipoedema in the international literature. NICE Interventional Procedures Guidance IPG744 (2023)[3] reviewed the evidence and concluded that the evidence base is limited but the procedure shows promise, and recommended that it should only be performed with special arrangements for clinical governance, consent, audit and research.
KONCEPT® does not perform tumescent liposuction for lipoedema at the Kingston clinic. Where surgery is indicated, Mr Jibawi will discuss the published evidence with you and, if appropriate, support a referral to a suitable specialist centre that performs the procedure under the NICE governance framework. This referral pathway, the second opinion, and the post-procedure follow-up sit within our scope.
First visit
For full pre-care and post-care instructions, see our Patient instructions page. Lipoedema sits alongside the Lymphoedema and Compression pathways in that guide.
You receive a written quote before any treatment is booked.
Insurance
Lipoedema is recognised by most major UK private medical insurers when there is a clinical indication. Cover for compression garments, physiotherapy and any onward referral varies by policy.
Recognition at KONCEPT® is at both clinic and consultant level, and cover is expanding. Call 020 8129 1011 with your insurer and policy details and we will come back to you within one working day with confirmation, before any appointment is booked.
Read more on the Insurance & access page →
Your consultant
Mr Abdullah Jibawi, Consultant Vascular & Endovascular Surgeon, GMC 6036704. Mr Jibawi has been on the GMC Specialist Register for Vascular Surgery since 2015, holds a substantive NHS consultant post at St George’s University Hospitals NHS Foundation Trust, and is the Lipoedema Lead at KONCEPT®. He sees private patients here on a practice-privileges basis, alternate Mondays.
He is supported by a multidisciplinary team including a Lymphoedema-trained Physiotherapist and a compression fitter.
FAQs
Lipoedema is a chronic condition in which fat builds up disproportionately in the legs, hips, buttocks and sometimes the arms. It is tender to touch, does not respond to weight loss or exercise alone, and almost exclusively affects women. It is recognised by the NHS and NICE. KONCEPT®’s lipoedema clinic is led by Mr Abdullah Jibawi, Consultant Vascular Surgeon and Lipoedema Lead.
Diagnosis is clinical. At KONCEPT® we use a 30 to 45-minute consultation, detailed history, examination, limb measurement, photography with consent, and duplex ultrasound where clinically indicated, to confirm or exclude lipoedema and identify any venous component.
Lipoedema is a build-up of fat, lymphoedema is a build-up of lymph fluid. Lipoedema usually affects both legs symmetrically and spares the feet. Lymphoedema usually involves the feet and can affect one limb (often after cancer surgery or radiotherapy). Some patients develop both (lipo-lymphoedema) over time. See the comparison table above for a full breakdown.
International consensus reviews estimate around 11% of adult women worldwide have lipoedema, although the figure varies by study because the condition is so often misdiagnosed. Lipoedema UK reports that patients typically wait 15 to 30 years from symptom onset to diagnosis.
Lipoedema in men is very rare. It is almost exclusively a female condition, with hormonal life stages (puberty, pregnancy, menopause) being the most common triggers.
BUPA recognises lipoedema as a condition. Cover for individual elements (consultation, compression, physiotherapy, surgery) varies by policy. Call 020 8129 1011 with your BUPA membership number for a recognition check at clinic and consultant level. Both KONCEPT® consultants are Platinum BUPA Consultants.
There is no cure. Management aims to reduce symptoms, slow progression, protect joints and improve quality of life through compression, lymphoedema-trained physiotherapy, MLD where appropriate, exercise, skin care and, in selected cases, surgical referral.
Tumescent liposuction is the most commonly described surgical treatment in the international literature. NICE Interventional Procedures Guidance IPG744 (2023) concluded the evidence base is limited but the procedure shows promise, and that it should only be performed with special arrangements for clinical governance, consent, audit and research. KONCEPT® does not perform liposuction for lipoedema at the Kingston clinic, but supports referrals to suitable specialist centres where indicated.
The exact cause is not known. Strong evidence points to a hormonal component (the condition usually starts or worsens at puberty, after pregnancy or around menopause) and a genetic component (most patients have an affected female relative).
If you have disproportionate fat distribution in the legs, hips, buttocks or arms, with tenderness, easy bruising, and the affected area has not responded to weight loss or exercise, lipoedema is worth assessing. Book a consultation with Mr Jibawi for a clinical diagnosis. There is no single test, the diagnosis is made by an experienced clinician based on history and examination.
For self-pay, no, you can book directly. Most insurers also allow direct booking. A small number still require a GP referral letter, we will confirm what your insurer needs when you enquire.
The first appointment is 30 to 45 minutes with Mr Jibawi. Allow 60 to 75 minutes for your visit including arrival and reception time.
Medical-grade compression is the cornerstone of conservative management for lipoedema. Correctly fitted garments reduce tenderness, support the affected limbs and slow progression, particularly when used alongside lymphoedema-trained physiotherapy where indicated. Our compression fitter measures, fits and replaces garments as needed.
Surrey catchment also includes Esher, Cobham, Weybridge, Walton-on-Thames, Oxshott and Hampton.
Related vascular services
To book a lipoedema consultation with Mr Abdullah Jibawi, our Lipoedema Lead, or to discuss your case, get in touch.
Email info@konceptmedicalclinic.com · Visit 46-48 Wood Street, Kingston upon Thames, KT1 1UW · See full self-pay pricing →
Regulation and standards
KONCEPT® Medical Clinic is registered with the Care Quality Commission (CQC) for the regulated activities provided at our Kingston upon Thames premises. Mr Abdullah Jibawi is on the General Medical Council (GMC) Specialist Register for Vascular Surgery and remains personally accountable to the GMC under Good Medical Practice. Allied-health clinicians supporting the lipoedema service are registered with their relevant professional bodies (HCPC for physiotherapists). Information on this page is written to be factual and verifiable in line with the Committee of Advertising Practice (CAP) Code and Advertising Standards Authority (ASA) rules for medical advertising.
Claims about prevalence, staging, diagnosis and management on this page are drawn from NHS, NICE, peer-reviewed publications and national specialist body guidance. Each source is linked for verification.
Lipoedema.
National Health Service
Lipoedema, symptoms and treatment.
BUPA
Liposuction for chronic lipoedema. Interventional Procedures Guidance IPG744.
NICE, March 2023
Management of Chronic Venous Disease, Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS).
European Journal of Vascular and Endovascular Surgery 2015, 49(6),678-737
Lipedema fat and signs and symptoms of illness, increase with advancing stage.
Archives of Medicine 2015, 7(4),10
Best Practice Guidelines, the Management of Lipoedema. Lipoedema UK Standards of Care.
Lipoedema UK, 2017
Consent, Supported Decision-Making, A Guide to Good Practice.
RCS England, 2018
First Dutch guidelines on lipedema using the international classification of functioning, disability and health.
Phlebology 2017, 32(3),152-159
Lipedema, an overview of its clinical manifestations, diagnosis and treatment of the disproportional fatty deposition syndrome, systematic review.
Clinical Obesity 2012, 2(3-4),86-95
Lymphoedema and lipoedema.
Patient.info, EMIS Group
Last clinical review: Dr Maryam Attarzadeh, Medical Director (GMC 7193218), 2026-05-27. Next review due: 2026-11-27. Statistical claims are re-verified every 6 months, or sooner if peer-reviewed evidence changes.