The Deep Oscillation Personal Recommended for Lipoedema Symptom Management and Keloid Scar Reduction

PhysioPod loaned Jacqueline a Deep Oscillation Personal after learning of her medical situation on Instagram, which was then featured on their website. After working with her to discover in detail the background to such a heartbreaking story, Mary and Julie felt that "Jax", as they had come to know her, actually really deserved a break and some practical help to get her back on her feet.

>> The Background Story


Jax's summary of how she got on with the Deep Oscillation Personal follows.  She has since invested in her own unit, to maintain a better quality of life and hopefully retain her mobility in the absence of NHS funded liposuction.

Thank you Jax, for keeping this very thorough diary, it may help others to realise that there is a non-invasive therapy than can help in both conservative management of Lipoedema and in pre and post liposuction aftercare and scar management, whatever the reason for that scar.



"In March 2021, I had knelt on my knees for just a second, supported by a cushion. When I stood up, I immediately sensed pain in my knee and in the evening my knee began to swell. I had previously experienced this happening in 2019, when my knee was forced into a seat in front of me on a bus, then X-rays showed nothing, only slight wear and tear on the patella and lumps/lipomas.

As before, I knew to use ice on the knee and that I would need Naproxen to manage the pain, perhaps a visit to the GP and a Physiotherapist. I knew I'd be heading for problems if I didn't get on top of it quickly.   I requested an X-ray but was told at this time it was not possible due to the COVID19 pandemic.. I had a telephone conversation, and directions to ice the area and to carry out exercises that were prescribed in an email from a Physiotherapist. But no x-ray. Not even now, 10 months on. Everything has been pretty much a failure to get me back onto my feet. 

As each month passed my leg got weaker. I was in and out of A&E for suspected clots due to the severity of pain and swelling in my right leg. My leg, each time I went into A&E felt strangely better. Until I realised it was the blood clotting injection they gave me that was helping the pain to ease and reduce the size of my calf. It was one of the Doctors on the ward that finally said, after he'd seen me the night before, that he noticed the reduced size of my knee and calf and that I most probably needed to see a Vascular Doctor. He told me to raise my legs above heart, that it would help. And we discussed Lipoedema, he was knowing of the disease. I thought 'thank goodness' a Doctor who knows about Lipoedema. 




At the time, I was awaiting an appointment for diagnosis of Lipoedema, booked for the October which thankfully took place sooner. I was diagnosed with Lipoedema in my knees, upper and inner thighs, hips, buttocks and arms.




In between this time, Mary and Julie from PhysioPod were running my story around my misdiagnosis of Cancer & Lipoedema on their website and they asked me if I would like to try Deep Oscillation Therapy (DOT), as a self-management tool via the Personal unit. A chance to try this treatment for my knee was such a privilege. I was overwhelmed. Unbeknownst to Mary, I cried when I got off the phone from that call. Relieved someone was helping me. 

Previously to using DOT, I was getting quite desperate. Thinking if this doesn't improve, I'll end up in a wheelchair and then how will I be able to care for my disabled daughter? She is severely Autistic, she relies on me, I am her sole Carer. 

I was unable to climb more than 3 steps. I'd climb stairs on one leg. My left leg. Going up one at a time. My right poorly leg was beginning to give way. It was weakened by lack of use. When the pain is so bad you limp. And after months of limping, unable to bend my knee, because of its poor condition, swelling, and tightness. It basically became unusable. It got so bad I couldn't bare for the quilt to touch my knee. It was keeping me awake at night. Just getting up from the sofa was proving to be difficult. Getting out was getting undoable. I just felt hopeless. And having just lost my mum in January, I was just about living on pilot mode! Giving up. The Doctors were not listening. They don't believe in you, your voice . They don't believe your knee is having trouble because of the lumps in it, around it. I got told.. "Let's not talk about the lumps, it’s your weight that's causing the problem" at a physical examination. A very stressful time. Again, having the finger pointed at you like it's your fault. 


So, when Mary said "We are loaning you the personal unit for a few months. I was thinking "Wonderful, that's truly amazing". I was so grateful, overwhelmed and yet apprehensive all at the same time. Because I didn't know what was going to happen and if it would help me. 

Well, as soon as I received the device. I tried it. Having had a particularly bad day with both my legs. Because my left leg was starting to feel the pressure of being over used. Quite honestly, it was exhausted and as far has heroes go, my left leg is my hero!  And for all those physiotherapist and doctors I've seen, I have one thing to say... And did say... "If my weight was causing my problems then surely both knees would be affected? I have two legs and my left leg has had to do the work of two!  And it's had to maintain my mobility. So, if my weight mattered so much, then both my knees would be in the same trouble!  My little sidekick left leg has kept me upright and it deserved some love. So yes, I used the Deep Oscillation Personal (DOP) immediately. I couldn't wait. 



I couldn't believe it, I was absolutely truthfully shocked! It was an "OMG moment" because it felt like my skin was being brushed, massaged, tickled, and it felt So GOOD. I felt my entire body relax. It wasn't painful, the vibration was so light and after being in so much pain, for so long, for seven months it was such a relief. I could have cried. I found the handles easy to hold. And there is something quite meditative about using it in the circular motions. I found it deeply relaxing, for myself and my body. My first thoughts were 'THANK GOD', thank God something is going to work. That night, I went to bed for first time in months without pain, just a dull ache. I could live with a dull ache, I thought. 

I'd had a shower before I used it and it was easy to use. Being a Mum of an adult with special needs, it was some 'ME time' for once, something I rarely allow myself.  I felt lovely and relaxed after using it, out of pain and sleepy, my first full nights sleep for months. And in the morning, it seemed like I was passing more urine than ever. Austin Powers moment ha-ha 

I thought "WOW"... and my poorly knee felt less tight, I could bend it. I knew I was on to something that was going to help me. Finally! 

So, I continued each day. Using the DOP with my personal Oscillation card that Julie prescribed, based on years of her knowledge of working with ladies with Lipoedema and Practitioner feedback. Working on my Tummy first, then inguinal nodes, to help my lymphatics work better, as Julie had instructed me to. This was great, as I'd had a huge operation in my stomach area, with a long scar from breast to pelvis, that had never had any manual lymphatic drainage. That scar was still visible after 11 years. I'd got a lot of internal scars too, so my tummy always felt tight. The skin was always tight. I was shocked to feel the skin start to loosen. I didn't expect that. I knew it'd possibly help the old scar become less visible, but never did I realise just how tight that skin was. So, it was another 'WOW' moment for me. 

I battled on with getting mobile over the next coming weeks. Trying to work with the DOP each day for an hour and doing strengthening using a rubber band, step climbing, and gradually to walking. 

After just a few days from using the DOP, I was in less pain when walking. I was not in pain when sat. So, the constant pain had subsided. The weakness was still present in my leg and I knew that had to be worked on. But what was possible, was that I could work on that, without being in excruciating pain and that was what made the massive difference to being mobile or not. And the reduced inflammation (which is a proven effect of Deep Oscillation) helped transform me from being unable to walk to being able to walk. 

The physio exercises I'd been instructed to do and 'to work through the pain' did not get me mobile. How ridiculous to imagine it would.? Lipoedema isn't just about the nerve pain. It's about the joints and our joints are compromised by compression of the nodules which not only cause pain but inflammation too. Until that inflammation isn't influencing movements, then NO amount of physical activity will help you recover. None!  

Without the DOP, I'd have been stuck in a Catch-22 scenario and just putting more pressure on an already inflamed joint. The pain was SO bad, crying at night, I couldn't get to sleep because of it. Quite honestly, it would been better to just chop my leg off from the knee I'd think. There is nothing worse than nerve damage pain. 



I thought I was going to lose my way of living. Strangely, I also had hairs on my legs for  the first time in like forever. Who'd ever think you'd be happy about leg hairs ha-ha. I'd normally shave but you honestly don't realise how little things like this can reassure you that your health is moving in the right direction, with blood circulating as it should.  Passing more urine is a known after effect of using the device and that's all great news too, because it means your lymphatics are pumping more affectively.

It is such a relief to watch the swelling limb reduce in size and see the gradual reduction in the size of your legs. The constant pressure on the knees and pain reducing and all this in a such little device. This little device has your condition under control. I'd say that's something pretty miraculous and some good news for anyone who is experiencing difficulties with a reduction in mobility, pain or injury and scarring. 

Lipoma Removal Recovery Aided by Deep Oscillation


In addition to recovering from my knee problem, I'd gone on to have two operations to remove two lipomas in my forearms carried out on the NHS by a Dermatologist.

The first operation on 20th August 2021 was on my left forearm.

It took 20 mins to remove. Then further time to stitch, as it would not stop bleeding. Sticky clear tape had been put on my skin before the procedure and when he removed it, it actually lifted the skin, which was like tissue paper and I bruised immediately. (This is common with Lipoedema skin). The Dermatologist kept rubbing the bruises saying "my, my, such delicate skin!"


The scar became keloid, rasied, itchy, sore and bright red.  I was able to use the DOP to reduce the itching, redness and the raised keloid which is now pink and flatter. (Mary said that itching reduction had been reported in burns too).




The second Lipoma was removed from my right arm on 8th November, 2021. 

A smaller lipoma, but like the others pressed on nerves and causes tingling in the fingers, a numbness if holding anything for long or too tightly.

It was the same Dermatologist that did the left arm and because the first operation was traumatic with such scarring, he decided to remove this one via a different approach.  He rested a paper sheet over the site before operating and stitched inside of the wound, so this was removed in minutes! .. It was a smaller lipoma than the first, but still it was raised under skin. Visible. He rolled the skin somehow to do a different stitch so it wouldn't become keloid. That was the idea. Only now I have a crease in the skin and still three raised lumps where stitching was done under skin. The second was sorer than the first and hurt for longer. But it didn't itch. After using Deep Oscillation, it reduced the redness and soreness. And the deep crease. So, I still continue to try reduce the three pin lumps. DOT work is still ongoing but they are vastly improved.

The Dermatologist has said he will only remove one more lipoma, even though I have lots in my lower arms that are troublesome. He said.. "It needs a plastic surgeon to remove them". This is because the lumps around my wrists and the lumps near my main veins are far too delicate an area for him to do. There are many in one area at a time. and it needs a Plastic Surgeon to go in and make one incision and remove as many as possible. I have large Lipomas in my back, knees, legs, and I think shoulders and collarbone but without scans, I can't confirm; my shoulders lock and my arm just suddenly go dead. My elbow locks depending on how I rotate it. I need my arms seeing to the most!  

I'm presently using the DOP on my arms, lower and upper. Both full of lumps, and ache, heavy, due to the Lipoedema. The DOP on its lower vibration mode really works the knots out; like a deep massage BUT WITHOUT any pain. My arms and shoulders often ache due to the heaviness of my breasts and bra pressure, so to use DOP in these areas is like pure pleasure to reduce that heavy feeling.

If I can sum up what I believe: 

The trauma of not having a Doctor available to understand Lipoedema is horrific enough, but what you can’t understand is why these Deep Oscillations personal devices are not available on the NHS to ladies suffering with Lipoedema, for the many reasons that it can bring relief. And when nothing else helps and you know 100% that this type of lymphatic drainage challenges all other therapies and the results are so positive, amazing in fact, I'd go as far to say, then why isn't it prescribed?

Because trust me, without this device, the only direction that I was going was into a wheelchair.  So, I ask, why are we not seeing these devices available on the NHS? After all, Deep Oscillation is being used in NHS Lymphoedema clinics in the UK and Ireland already for Lymphoedema and has been since around 2008.

Thank goodness for ladies like Mary and Julie, who are passionate about protecting our health and getting our many messages out there with our real-life Lipoedema experiences, so others can become aware of the condition of Lipoedema and seek out this treatment. They work hard, based on the principles of knowledge and care and they know what works through experience. I've nothing to lose nor gain from telling you my experience. I only want you to know that there is something that works. Especially if you are suffering as I was. 

I have now invested in my own unit, I say it is a small cost to retain my quality of life and mobility. 

Jacqueline Smith 





4th October 2021


60 min on high frequency, 30 mins on lower frequency


"First day of using the DOP. It felt lovely on the skin. Having just had a shower. It was very relaxing. The feather like vibration immediately relaxed my legs. It felt like a massage but not one of pressure. I felt no discomfort. In fact, it began to take away the pain. The more I worked over a certain area of pain. My knee mainly, it released the pain. Like it had just massaged something away. The skin felt softer, more supple and more so, my leg felt relaxed and less tight. I was taken aback myself, just how much it eased the terrible pain I'd been in due to the Lipoedema. And me kneeling on that knee back in March that had caused the sudden onset of pain and inflammation. I'd been in constant pain since. So, for eight months I'd been in agonising pain. And inflammation in the leg and knee. And it giving way more recently. I was on strong painkillers and Naproxen prescribed by my GP. O was unable to climb stairs or bare weight on it. In a constant rotation of icing, resting, and physio instructions. And nothing had worked. 

So, for me to say, after using this Device just the once for the first time, that it gave me some relief and hope after using, it speaks for itself and volumes! Especially when nothing else was working. 

After three days of using the unit 60 mins high frequency every day then 30 mins on lower frequency. I was able to sleep at night, out of pain. And able to walk, out of sharp pain, and able to climb a few steps, and weight bear. Albeit, my leg muscles were weakened by lack of use. The point was, I could see an improvement and a light at the end of the tunnel because I could weight bare without being in excruciating pain. And for me that was a massive relief.

I had a flare up on right leg (above) because I'd pushed myself too much, giddy because I could walk. Ha-ha. 

I noticed whilst using the DOP initially that after 2 days, I'd gotten a boil in my inner groin area. I don't and have never had boils. It was quite large and sore. I'd like to think it was my lymphatics trying to release blockages. I did get one or two more further down the line of treatment. As I say, I've never suffered with boils in the groin. 

On the 4th day of using the DOP, I was able to walk my first mile without my knee buckling. I was in less pain. Hardly noticeable. The dull ache was terrible. Was on my feet 5hrs. Before the aching became more than an ache and I needed to rest my legs. I was able to use the DOP though later that day to ease any aches away. And it did. And my thoughts were WOW. Why wow? Because I knew by then. that if I were to push myself a bit more, then I'd have this little device to help me. It'd have my back, so to say. And that means So much to someone like myself who can't afford to pay for liposuction for my Lipoedema. And when Doctors at the GP Surgeries don't have answers for you, only pills, painkillers. And physiotherapists think the only way out of pain is to lose weight and put you through physio, to put even more pressure on joints that are already compromised by these lumps, these lipomas, adipose fibrosis tissue, that in fact, that action is just worsening the issues. So yes, to know something has your back to get you out of pain, so you can be mobile I'd say it’s a WOW moment!

The bad leg, that is my right leg, by the 4th day is beginning to reduce in size. This means its less tight. Less restricted. Again, I work on it for same amount of time. And am finding the slower frequency helps with teasing out the knots in muscles. Like anyone who likes that deep massage feeling. The lower frequency gives a really good sense of deep massage. So, on high or low you can feel the effort the device is putting your skin through. And without pain. 

I found the handles easy to hold. And there is something quite meditative about using it. In the circular motions. I found it deeply relaxing. For myself and my body. 



You can really see here the difference in the size of my legs from the 4th October. Six days of using the Hivamat. And the inflammation in my legs has reduced quite a lot. Enough that my legs are starting to take on a shape. There is more range of movement in the right leg. I'm able to wake in the mornings and not limp to the bathroom in pain. Agony usually. There is just a dull ache on inner knee. But no longer on outer knee. The pain I use to be constantly trying to rub away on outer knee is gone!  Fab! 

I am still pain-free throughout the night. So, I woke feeling really refreshed. Which is important to me, as I'm sole carer for my Autistic Daughter and it's important to my mental health as well as physical health, that I get a good night's sleep. It's also important to slow down the progression of the Lipoedema. 

On the 10th day, I was able to climb 16 steps. As opposed to not being able to climb any. And from day 4 climbing just 3 steps. On day 10 I can climb 16 steps in the home. I'm pretty pleased about that. Quite Amazed. Again, the leg strengthening needs physio but I'm confident now it'll all be possible.  

I'm now almost a month into using the DOP daily. 
I've added into my routine a 15min high frequency on tummy area. It did initially begin with just 5 mins working on tummy area to help open up the larger lymphatics in that area as instructed to. But I found, having had previous operations in my tummy area and large scaring some 10 years ago that it helped release tightness in the skin in the upper ribcage area. I wasn't really aware it was tight. Until I used the unit in this area and began to notice the skin becoming supple. And moveable. As opposed to it being taught, tight. Plus it felt like it was releasing fluid in there. Or at least that my tummy was feeling flatter. So I'm guessing it was releasing fluid perhaps? .. So I've added into my routine. 
I find I don't now need 60 mins on my legs now. And that 30 mins helps reduce any inflammation and aching from the day. I've added around 15mins on scar tissue on my arm where I'd had a lipoma removed in early October this year. The scar had bled out and is extremely itchy. The DOP relieves that itchiness and is reducing the redness. It is also reducing the scar on my tummy that I've had for 10 years. 
I'm now able to walk around 6,000 steps on the beach. So my legs are getting stronger to maintain that support without giving way. And without pain. I'm able to climb 25 steps!  Before my right leg begins to wobble with any weakness. Only 4 weeks ago, I couldn't walk out my home to the bus stop without needing a walking stick for support. And if it gave way I'd be petrified I'd not make it home. Or that I was in constant pain. Swollen, restricted movement. Unable to climb stairs. In four weeks, just solely from using the DOP I'm able to do all the above. Pain free! 
Whilst in between working on my arms to reduce the pain from fibrosis tissue in arms and lipomas in my arms, I am also working on shoulder aches due to constricted bra straps and heaviness in large breasts. 
I am Amazed at how this device has got me this far. And I tell anyone and everyone just what it's achieved for me. because ladies who are suffering, as I was, need to know about it. And that there is something that will help them. And hopefully, if you are in the process of finding cures, answers, and you can find a better solution to your problems then you need to know about Deep Oscillation. I'm not in any way in the middle of any promotion financially for this. I just want Ladies like me suffering, not helped, to get relief and get their life back! 

Photograph shows my tummy area is flatter and legs from first pics on 4th October. And one Hairy leg! I'd forgotten what it was to have hairs on my legs. Having not seen or needed to shave them for a few years now since the Lipoedema progressed. It what was strangely nice to see my leg hairs growing. I think what was good about that was because I knew Deep Oscillation was doing my legs good by improving circulation and breaking up the fibrous tissue and so hairs were a welcome sight. For once! Who would ever think a woman would be so happy to leave the hairs on her legs, just so she can prove something to herself and others. To see something doing miracles. Not me, but I am happy. Finally!
Jacqueline Smith 


By Sue Hansard, Lymphoedema Nurse Specialist of First Lymph Care 


Thank you to Jax and PhysioPod for this interesting case study and powerful patient story.  Like many women who have Lipoedema Jax sought help many times for the distressing and debilitating symptoms she was experiencing, but did not always feel she was actually ‘being heard’. And, until someone with the relevant expertise and knowledge examines and assesses her,  she is left trying to self-manage her pain and reduced mobility with ‘bit-part’ care rather than holistic management.

The article raises many salient points not uncommon in people living with Adipose-Connective Tissue disorder (known, unhelpfully as Lipoedema).

I am pleased that Mary and Julie at PhysioPod UK could help. Having used Deep Oscillation for many years for my clients and myself, I am not surprised that Jax found the device helpful in relieving some of her symptoms and reducing her swelling. And it has helped her to regain some strength and joint stability and improved her quality of life.

Below are just a few of my thoughts as I read Jax’s story to better health.

  1. Never under estimate the power of elevating legs that swell. She says how the swelling eased. It is easy to forget in our busy lives that when we are standing or sitting for any period of time the leg veins are trying to work against gravity. We all need to keep moving and elevate now and then.
  2. The treatment for ovarian cancer (misdiagnosed) and major abdominal surgery may have impacted on lymphatic drainage from the pelvis and legs, especially if lymph nodes were removed. This could cause a slow cumulative back logging in the lower abdomen, hips and thighs.
  3. Adipose-Connective Tissue Disorder . A.C.TeD. (Lipoedema) affects not only the proliferation of adipocytes (fat cells), which increases further with high BMI, it is also characterised by connective tissue elasticity. This can cause the knee joint to have reduced stability. It may affect hips and ankle joints also. And adipose tissue tends to increase to the medial (inside) aspect of the knee. In turn, this can lead to altered gait, which affects the way the foot touches the ground when walking, and creates alterations in posture over time, leading to lower back pain. This is why I believe gait analyisis, podiatry and physiotherapy should all be part of the care pathway for people living with this condition.
  4. Jax describes the improvements to scarring , even long healed scars. Deep Oscillation is a very useful tool for scar treatments and her pre and post D.O.P photos show this well.
  5. Jax mentions LIPOMAS . A Lipoma is a slow growing fatty lump. Often they are painless. This is a separate condition to LIPOEDEMA, and not everyone with Lipoedema experiences lipoma. However, the abnormal deposition of enlarged fat cells in Lipoedema can result in tenderness and a tendency to bruise easily. Because Deep Oscillation influences deeper tissues and lymphatics with the lightest of pressures it is a perfect aid to Manual Lymph Drainage in patients with Lipoedema, post-surgery swelling and scar tissue.

 I would advise Jax to ask her GP  for the following further referrals:

  • Podiatry for gait analysis.
  • Physiotherapy for postural assessment and exercises.


Like Jax, I would not be without my D.O.P device and nor would the hundreds of patients I have treated with it!


Well done! 

Sue Hansard



DEEP OSCILLATION® is a unique, non-invasive and non-traumatic therapy method with strong pain-reducing potential.

DEEP OSCILLATION® is an internationally patented, proven technology based on the effects of creating an electrostatic field in the tissue of the patient. Easy application is from therapist to client via hygienic, vinyl gloved hands; utilizing all normal massage movements or via circular movements over the tissue with a handheld applicator. The handheld applicator also enables self-treatment.

The special structure of DEEP OSCILLATION® allows the creation of biologically effective oscillations in the treated tissue using electrostatic attraction and friction. In contrast to other therapies, these pleasant oscillations have a gentle and deep-acting effect on all tissue components to an 8 cm depth (through skin, connective tissue, subcutaneous fat, muscles, blood and lymph vessels.

Because of the non-invasive, non-traumatic, gentle nature of this therapy, very early possibilities of application are possible following injury and from Day One post operatively. Chronic conditions can also be worked upon with effective results.

The following physiological effects of DEEP OSCILLATION® are clinically proven: 

  • Highly effective in reducing pain
  • Anti-inflammatory
  • Effective in reabsorbing oedema (swelling)
  • Encouraging wounds to heal
  • Fibrosis Reduction
  • Improving trophicity
  • Rubor reduction (haematoma/bruising)
  • Detoxification
  • Improving quality of tissue

Learn more about DEEP OSCILLATION® biological and clinical effects


About Lipoedema - extracted from "Liposuction treatment improves disease-specific quality of life in lipoedema patients"

Torsten Schlosshauer,Christian Heiss,Ann-Kathrin von Hollen,Stefano Spennato,Ulrich M. Rieger First published: 05 May 2021


"The term lipoedema describes a chronic condition featuring bilaterally distributed, abnormally large deposits of subcutaneous fat in the upper or lower extremities.1 The disease is progressive and almost exclusively affects women.2 The prevalence of lipoedema is still not known for certain, although the estimated incidence of one in nine adult women found by an older unpublished epidemiological study3 is routinely cited in the literature on lipoedema.

The condition is well described, and a definition of lipoedema as code EF02.2 has been proposed for the 11th Revision of the International Classification of Diseases (ICD-11),4 which is set to take effect in 2022. The German version of the ICD-10 includes separate codes for lipoedema stage I, II, II, and other, or unspecified lipoedema.5 However, misdiagnoses still seem to be the rule rather than the exception, mostly due to lack of information and awareness about this disease.26-8

In the lower extremities, the condition is associated with considerable pain, pressure, easy bruising, and tenderness, which does not respond to weight loss.9 Patients often report steadily reduced daily activity levels and a high psychosocial burden, in conjunction with low levels of self-esteem due to high degree of aesthetic deformity.710 Left untreated patients with lipoedema may develop secondary lymphoedema, depression,11 anxiety,9 and eventually become immobilised.12.


  1. Reich-Schupke S, Schmeller W, Brauer WJ, et al. S1 guidelines: lipedema. J Dtsch Dermatol Ges. 2017;15(7):758-767.
  2. Fife CE, Maus EA, Carter MJ. Lipedema: a frequently misdiagnosed and misunderstood fatty deposition syndrome. Adv Skin Wound Care. 2010;23(2):81-92. 
  3. Földi E, Földi M. Lipedema. In: Földi M, Földi E, Strössenreuther RHK, Kubik S, eds. Földi's Textbook of Lymphology for Physicians and Lymphedema Therapists. 2nd ed. Munich: Elsevier Urban & Fischer; 2006:417-427. 
  4. Paolacci S, Precone V, Acquaviva F, et al. Genetics of lipedema: new perspectives on genetic research and molecular diagnoses. Eur Rev Med Pharmacol Sci. 2019;23(13):5581-5594. 
  5. DIMDI. ICD-10-GM Version 2020: Kapitel IV Endokrine, Ernährungs- und Stoffwechselkrankheiten (E00-E90). https://wwwdimdide/static/de/klassifikationen/icd/icd-10-gm/kode-suche/htmlgm2020/block-e70-e90htm. Accessed April 14, 2020.
  6. Warren Peled A, Kappos EA. Lipedema: diagnostic and management challenges. Int J Womens Health. 2016;8:389-395. 
  7. Wiedner M, Aghajanzadeh D, Richter DF. Differential diagnoses and treatment of lipedema. Plastic Aesthet Res. 2020;7:10. 
  8. Buck DW, Herbst KL. Lipedema: a relatively common disease with extremely common misconceptions. Plast Reconstr Surg Glob Open. 2016;4(9):e1043. 
  9. Herbst KL. Rare adipose disorders (RADs) masquerading as obesity. Acta Pharmacol Sin. 2012;33(2):155-172. 
  10. Alwardat N, Di Renzo L, Alwardat M, et al. The effect of lipedema on health-related quality of life and psychological status: a narrative review of the literature. Eat Weight Disord. 2020;25(4):851-856. 
  11. Dudek JE, Bia?aszek W, Ostaszewski P, Smidt T. Depression and appearance-related distress in functioning with lipedema. Psychol Health Med. 2018;23(7):846-853. 
  12. Stutz JJ, Krahl D. Water jet-assisted liposuction for patients with lipoedema: histologic and immunohistologic analysis of the aspirates of 30 lipoedema patients. Aesthetic Plast Surg. 2009;33(2):153-162.