Lymphatic Massage for Lipedema - 101

Lipedema is a condition that’s real, common- and too often dismissed.

What is lipedema?

Lipedema is a chronic connective-tissue disorder where there’s a symmetrical buildup of painful, fibrotic fat, that doesn’t respond to diet and exercise like typical fat. It commonly forms in the legs, hips or arms. It almost always affects women and often shows up or worsens around hormonal shifts (puberty, pregnancy, menopause). Common symptoms include easy bruising, tenderness to pressure, and swelling that spares the feet (so shoes fit while legs feel heavy).

How is it diagnosed?

Lipedema is a clinical diagnosis (a specialist evaluates history and does an exam). Key checkboxes are:

• Bilateral, symmetric enlargement of legs/arms with hands/feet typically spared (meaning both legs have similar swelling patterns - rather than one side being swollen which is more classic lymphedema)

• Pain or tenderness, easy bruising, and/or non-pitting swelling

• Texture that can feel nodular/“pebbly” (rice, cottage cheese, or peas) under the skin

• Stability of limb size despite weight loss elsewhere.

• Imaging (ultrasound/MRI) may be used to rule out other conditions; some people also have combined lipo-lymphedema (lipedema + lymphedema).

  
  

Common misdiagnoses & why it gets missed

Lipedema is frequently mistaken for obesity, lymphedema, or venous disease. Many people are told to “just lose weight,” which can help overall health but doesn’t reduce lipedema tissue. Lack of clinician awareness and inconsistent coverage policies add to delays in treatment and frustration for clients.

Issues & barriers people face

• Delayed diagnosis and years of invalidating advice

• Insurance hurdles - especially around surgery, even when symptoms limit mobility and quality of life

• Confusion between lipedema and look-alike issues; like cellulite, obesity, lymphedema, CVI, edema, and so forth.

• Our role: help you feel heard, help clarify what bodywork can/can’t do, and be a supportive part of your care team.

  
  

What Manual Lymphatic Drainage (MLD) can help with

MLD is gentle, skin-level work that supports lymph flow and calms sensitive tissues. For many clients with lipedema, MLD can:

• Reduce a sense of heaviness and aching

• Ease tenderness

• Help manage day-to-day swelling

• Support comfort with compression, movement, and sleep.

• Important honesty: MLD doesn’t remove lipedema fat. It’s conservative care that helps you feel and function better, often alongside compression, movement, and inflammation-aware habits. Results vary; some clients feel best with a consistent rhythm (e.g., weekly, bi-weekly, or monthly), others come in as needed. Insurance doesn't cover MLD performed by a massage therapist but we can accept HSA and FSA cards.

  
  

What MLD can’t do

• It won’t “melt” or permanently reduce lipedema tissue

• It doesn't usually reduce the appearance of lipedema

• It’s not a cure and isn’t a substitute for medical care, surgical consults, or compression when indicated.

• We’ll always be up-front about what’s realistic - and we happily collaborate with your medical team.

  
  

What a care plan might look like (examples)

• Painful Lipedema in advanced stage: Weekly MLD for 4–6 weeks to settle symptoms; test-and-learn your ideal frequency

• Mid-level discomfort: Weekly or Biweekly MLD for a month and adjusting as the body needs to maintain comfort.

• Low-level discomfort: Biweekly or Monthly sessions to prevent advanced symptoms

Self-care that tends to help

• Movement you enjoy (walks, cycling, pool/aquafit); water provides natural hydrostatic pressure that often helps the most for Lipedema clients.

• Compression that’s tolerable and practical for your life.

• Inflammation-aware daily habits (sleep, stress support, balanced nutrition). Your lived experience matters - your plan should be doable, not perfect.

  
  

When to consider a specialist referral

• Rapid progression or functional limits (stairs, walking, work).

• Skin changes or signs of lymphedema (pitting, foot swelling).

• Questions about diagnosis or surgical options. We can point you toward vascular/lymphatic clinicians familiar with lipedema and coordinate care.

Cavitation and Fascia Blasting

Using cavitation machines, which reduce fat with soundwaves, or hand held bumpy massage sticks, are some common at-home treatment techniques clients discovery when searching social media and the internet for answers and support. We have not had any first-hand positive experiences with these techniques for lipedema fat. In fact, they often cause inflammation and bruising for our clients. Not enough research has be done to prove benefit for us to risk bruising and pain for our clients.

Post-op care after lipedema reduction by liposuction

Some clients pursue liposuction to remove lipedema fat and improve mobility, pain, and limb contour. Many client experience relief after liposuction and it's the only way to actually reduce the appearance of the fat. Insurance coverage for liposuction for lipedema can be a battle; often women opt to pay out of pocket. There are several Facebook groups; like Lipedema Sisters Texas who post about successes in insurance coverage. When searching for a surgeon; please ensure they are board-certified if in the USA.

Our post-op approach (what to expect with us)

• Surgeon-aligned timing: We follow your surgeon’s protocol for when to start bodywork.

• Gentle, precise MLD: Vodder-certified techniques to move fluid buildup, calm tissues, and support comfort in the early weeks.

• Positioning & pacing: We have a highly adjustable table for treatments to ensure you are comfortable; we avoid pressure that could stress healing tissues.

• Scar-care & fibrosis support: As cleared by your surgeon, we layer in deeper massage work around scars, cupping/taping as appropriate, and home-care tips.

• Compression & self-care coaching: We reinforce donning tips, basic exercises, and skin care that fit your energy level.

• Team communication: With your consent, we keep your surgeon in the loop if anything concerns us.

  
  

Our philosophy at Evolved Massage & Lymphatics

You deserve care that’s validating, gentle, and grounded in evidence - with space to talk through what’s actually workable in your week. Sessions are quiet and calming; pressure is always adjusted for tender lipedema tissue. We’re science-based and also deeply human; we're here to help you on this journey.

Ready to start?

If you’re in the Austin area and think you may have lipedema - or you’re navigating post-op recovery - we’d love to help. Book online or reach out with questions. We’ll meet you where you are and build a plan that respects your body and your goals.