Lipoedema compression garments: a practical guide to leggings

Lipoedema (spelt lipedema in the US) is a chronic condition in which fat builds up symmetrically in the legs, hips and sometimes the arms, usually sparing the feet and hands. It almost always affects women, often starts or worsens around puberty, pregnancy or menopause, and the affected tissue is commonly tender, bruises easily and feels heavy.

Compression garments are one of the mainstays of lipoedema care. This guide explains what compression can and can't do, the difference between flat-knit and circular-knit garments, how to choose a compression level and size, and how to make wearing compression every day more comfortable. It is general information, so please work with your GP, lymphoedema therapist or specialist on your own plan.

What are the stages of lipoedema?

Lipoedema is often described in stages, based on how the skin and tissue look and feel:

• Stage 1: the skin surface is smooth, but the tissue underneath feels thickened or has small nodules.
• Stage 2: the skin surface becomes uneven or dimpled, with larger nodules underneath.
• Stage 3: larger lobes of tissue form, particularly around the thighs and knees.
• Stage 4: lipoedema with lymphoedema (lipo-lymphoedema), where fluid swelling develops as well.

Some clinicians also describe types by the areas affected, for example hips and buttocks, hips to knees, or hips to ankles. Your stage and type shape the kind of compression your therapist recommends.

Is it lipoedema or lymphoedema?

The two are often confused. Lipoedema is a build-up of painful fat that is usually symmetrical and spares the feet, often leaving a "cuff" at the ankles. Lymphoedema is swelling caused by fluid that the lymphatic system can't clear. It often involves the feet and may affect one side more than the other. They can occur together, especially in later stages. A diagnosis from a doctor experienced in lipoedema helps you get the right compression and care.

What can compression do for lipoedema?

Let's be clear first: compression does not remove lipoedema fat. What it can do, and what many women tell us it does, is:

• reduce the feeling of heaviness, aching and fatigue in the legs;
• give firm, even support to tender tissue, so movement is more comfortable;
• support venous and lymphatic return, which can help with swelling later in the day;
• reduce chafing between the thighs;
• make exercise, which is important in lipoedema, easier to keep up.

Compression is also commonly prescribed after lipoedema liposuction, under the direction of your surgeon.

Flat-knit or circular-knit: which is right for me?

Medical compression is made in two main ways.

Flat-knit compression

Flat-knit garments are knitted flat and sewn together with a seam. The fabric is thicker and stiffer, so it doesn't cut into skin folds and holds its shape over uneven limbs. Flat-knit is often prescribed for more advanced lipoedema, for lipo-lymphoedema (when lymphoedema develops as well) and for marked shape changes. It is usually custom measured.

Circular-knit compression

Circular-knit garments are knitted in a tube, so they are seamless, thinner and smoother. They are often suited to earlier stages of lipoedema, everyday wear under clothes, warm weather and exercise. Supacore lipoedema compression leggings are seamless and circular-knit.

Many women use both: flat-knit as prescribed by their therapist, and circular-knit leggings for exercise, hot days or times when a softer garment is easier to wear. Ask your lymphoedema therapist what suits your stage and shape.

Why should lipoedema compression go up to the waist?

Lipoedema often affects the hips, buttocks and thighs as much as the lower legs. Compression that stops at the knee, or a garment that rolls down at the waist, leaves those areas unsupported and can create a tight band where fluid collects. Look for leggings with compression zones through the abdomen, hips and thighs and a waistband that stays put.

Supacore's lipoedema leggings deliver 25+ mmHg graduated compression with integrated abdominal, pelvic, thigh and lower-leg zones, plus the patented CORETECH® waistband with a sacroiliac (SI) belt knitted in for pelvic and lower back support.

What compression level should I choose?

There is no single right number. The level depends on your stage, your symptoms, your skin and what you can comfortably put on and wear. Many women with lipoedema wear firm compression, but some start lower and build up. If a garment is so firm you can't get it on, or you take it off by lunchtime, it isn't helping. Your therapist can advise; our team can help you compare styles.

How do I get the right size?

Supacore compression is sized by height and weight, not by your usual clothing size. Use the women's size guide, and if you are between sizes, choose the smaller size. Leggings should feel firm and even, without digging in at the waist or behind the knee.

Tips for putting compression on:

• Put leggings on in the morning, before swelling builds.
• Sit down, gather each leg and roll it up from the foot, smoothing as you go, rather than pulling on the waistband.
• Rubber gloves give you grip and protect the fabric from rings and nails.
• Smooth out any wrinkles, which can create pressure lines on tender skin.

How can I make daily compression more comfortable?

• Look after your skin. Moisturise at night rather than right before dressing, so the fabric goes on easily.
• Keep moving. Walking, swimming, aqua aerobics, cycling and gentle strength work are commonly recommended in lipoedema. Compression can make them more comfortable.
• Choose breathable garments in summer. Seamless circular-knit leggings or a 7/8 length are easier in Australian heat.
• Rotate pairs. Two pairs means one can be washed while you wear the other, and both last longer.

How do I look after lipoedema leggings?

Machine wash cold on a gentle cycle, inside out, and line dry in the shade. Don't bleach, tumble dry, iron or use fabric softener, so the compression keeps working for longer.

Can I get a rebate on lipoedema compression?

Supacore lipoedema leggings are registered with the TGA (ARTG 372670). Many Australian private health funds offer a rebate under Extras cover for medical compression garments when your treating practitioner completes our Health Fund Rebate Form. Check your level of cover with your fund.

Shop lipoedema compression

Browse the lipoedema (lipedema) compression leggings collection. Shipping is free within Australia and internationally on orders of A$199 and over, with free size exchanges and 30-day returns on unworn items (see shipping and returns). Questions? Call us on +61 468 072 885.

Frequently asked questions

Do compression leggings help lipoedema?

Compression does not remove lipoedema fat, but many women find firm, graduated compression makes their legs feel lighter and less painful, supports tender tissue and makes it easier to stay active. It is usually one part of a wider plan that can include movement, skin care and therapy.

Should I wear flat-knit or circular-knit compression for lipoedema?

Flat-knit garments are firmer and are often prescribed for more advanced lipoedema or when there is lymphoedema. Circular-knit garments, like Supacore leggings, are seamless and smoother and are often suited to earlier stages, everyday wear and exercise. Your lymphoedema therapist can advise which suits you.

What compression level is used for lipoedema?

Levels vary with your stage, symptoms and what you can tolerate. Supacore lipoedema leggings deliver 25+ mmHg graduated compression with abdominal, hip, thigh and leg zones.

Is lipoedema the same as lipedema?

Yes. Lipoedema is the Australian and British spelling and lipedema is the American spelling of the same condition.

Can I claim lipoedema leggings on private health insurance?

Supacore lipoedema leggings are registered with the TGA. Many Australian private health funds offer a rebate under Extras cover when your treating practitioner completes our Health Fund Rebate Form. Check your level of cover with your fund.