Lipoedema Assessment, Diagnosis and Management

Manual Lymphatic Drainage and Specialist Support

Lipoedema is a chronic and often misunderstood condition that can cause painful swelling, tenderness, and disproportionate fat distribution, most commonly affecting the legs and sometimes the arms. It is frequently misdiagnosed or dismissed, leaving many people feeling frustrated, unheard, and unsure where to turn.

I provide specialist clinical assessment, diagnosis, and ongoing management for lipoedema. Treatment may include Manual Lymphatic Drainage (MLD), compression support, hands-on therapy, and tailored movement strategies. My approach is evidence-based, supportive, and focused on helping you manage symptoms, improve comfort, and better understand your condition

Logo with the text 'FG-MLD' in blue letters and a stylized human figure in blue, with arms raised and a curved line.

What is Lipoedema?

Lipoedema is a chronic, progressive condition characterised by abnormal fat accumulation, most commonly affecting the hips, thighs, legs, and sometimes the arms. It primarily affects women and is not caused by lifestyle, diet, or lack of exercise.

  • Disproportionate fat distribution

  • Pain, tenderness, or sensitivity to touch

  • Easy bruising

  • A feeling of heaviness or aching in the limbs

  • Swelling that often worsens through the day

Lipoedema is distinct from lymphoedema. While lymphoedema involves fluid-based swelling due to lymphatic system impairment, lipoedema is a disorder of fat tissue. In some cases, secondary lymphatic compromise may develop, particularly where lipoedema is combined with obesity or longstanding tissue overload.

International and UK-based organisations, including the Lipedema Foundation and Lipedema UK, continue to raise awareness, advance research, and improve understanding and diagnostic clarity around lipoedema.

Clinical Assessment and Diagnosis

Lipoedema remains widely underdiagnosed. I carry out a detailed clinical assessment using recognised diagnostic criteria and can clinically diagnose lipoedema.

Assessment considers:

  • Symptom history and progression

  • Pain, tenderness, and bruising patterns

  • Fat distribution and tissue characteristics

  • Swelling behaviour and response to elevation or compression

With your consent, I can write to your GP or consultant outlining this diagnosis, along with relevant clinical findings, to support onward medical care and management planning.

Who is it for?

  • Suspected Lipoedema

    Clinical assessment and diagnosis to help clarify symptoms and support next steps.

  • Confirmed Lipoedema

    Ongoing management to reduce discomfort, manage swelling, and support daily function.

  • Painful or Heavy Legs

    Support when symptoms persist despite weight loss or lifestyle changes.

  • Daily Discomfort and Fatigue

    Management strategies to ease heaviness, tenderness, and end-of-day worsening symptoms.

  • Before and After Surgery

    MLD primes tissue pre-surgery and supports swelling reduction and recovery post-procedure.

  • Dismissed or Misunderstood Symptoms

    Clear, evidence-based assessment when you feel unheard or unsure where to turn.

  • Prior to having vaser liposuction on my stomach area...I was advised by the surgeon the most important part of the recovery is the aftercare treatment. So I booked a number of MLD (Manual Lymphatic Drainage) & myofascial release sessions with Esmé and I'm so glad I did. I can highly recommend Esmé, she is very personable and professional. In each session she assessed what was needed and focused on that....My body responded very well to Esmé's techniques, and I was so impressed when the planned sessions ended I arranged more and was actually sad when I no longer needed them as Esmé helped me so much with my recovery and achieving great results. I'm a very happy client and would definitely recommend Esmé.​

    D. Smith, November 2016

  • I have been seeing Esmé for MLD monthly for about 1.5 yrs. The knowledge and experience Esmé has is very reassuring when discussing lymphoedema and all that comes with it and that coupled with her enthusiasm and general positive approach to health and wellbeing makes her MLD sessions not only excellent for my leg but for my mindset as well. I recently undertook a 5 day intensive bandaging course with Esmé, the ultimate aim being to reduce swelling and in doing so reshaping my leg. What I had imagined was going to be an arduous and uncomfortable 5 days turned out to be very productive both in the overall reduction achieved in my leg volume and in the knowledge I gained in lymphoedema care and general health and wellbeing through daily chats with Esmé. I am now in the 4 week maintenance period following the intensive bandaging and Esmé has been actively checking in with me and incredibly accessible for any advice or questions I have had. It goes without saying that I would have absolutely no hesitation in recommending Esmé to anyone seeking help with Lymphoedema – you’ll be in very safe hands.

    B.Garrett, 2024

  • I can't express how lucky I feel to have found Esmé. I have now had 2 surgeries for Lipoedema. For each surgery Esmé came over the day after I returned home to treat me with MLD ( Sunday! ) and then every day for a week. Getting compression to fit correctly is never easy especially after surgery and Esmé was continually thinking up new ideas, to make sure I could go back to work wearing something that was comfortable and efficient. She is a gem full of compassion and caring for her clients.

    E.Hearle, 2020

  • I’m so happy I found Esmé! I came to her after I had surgery on my legs for Lipoedema and I was struggling pretty badly with the recovery, despite the MLDs I was having somewhere else. The relief I felt after our first session together was unbelievable, I was in less pain and visibly less swollen. From our first exchange via email and WhatsApp, then in person, she made me feel safe (she clearly knew what she was doing) and at ease. With each session I feel more confident in my recovery, and also less alone in this process! I would definitely recommend 🤩 Additionally: great communication, fast replies, very knowledgeable, really nice studio, and easy parking!

    C.Mestiri, 2025

  • Following a total knee replacement and follow up surgery, my recovery was being hindered by swelling of the knee that would just not go away. A series of MLD sessions with Esmé was the 'magic' key to unlocking my recovery. I found MLD to be gentle, calming and relaxing but at the same time this technique has simply eliminated the chronic and long term swelling. In addition Esmé has released the muscular tension that was surrounding my knee and that was causing me pain. I am now much more fully realising the benefits of my new joint. I think about my knee much less.

    A.Munro, 2015

Techniques used

Manual Lymphatic Drainage (MLD)

In lipoedema care, MLD is used to help manage swelling, improve comfort, and support tissue health. While it does not treat the underlying fat disorder, many people find it beneficial for symptom management and recovery support.

Myofascial Release

Supports tissue mobility, reduce restriction, and improve tolerance to compression or movement where appropriate.

Pre & Post-Surgical Support

For clients who have undergone lipoedema-related surgery, treatment may include MLD, tissue and scar support, and strategies to assist recovery and swelling management.

Compression garments

Compression is a key component of lipoedema management. I provide guidance on appropriate compression use, garment types, and strategies to improve comfort, fit, and consistency. I can also provide a GP prescription if you’ve been diagnosed with lymphoedema.

Movement and Functional Strategies

Gentle, purposeful movement supports joint health, tissue tolerance, circulation, and day-to-day function. Guidance may include support for people who have never exercised before, with movement adapted to be safe, achievable, and appropriate for lipoedema symptoms.

Pricing

FAQs

  • Yes. I carry out a detailed clinical assessment using recognised diagnostic criteria and can clinically diagnose lipoedema. With your consent, I can write to your GP or consultant outlining this diagnosis and relevant clinical findings to support further care.

  • Yes. With your consent, I can write to your GP or consultant to share clinical findings, diagnosis, and management recommendations. This can be helpful both for confirmed diagnoses and for supporting further medical input.

  • While MLD does not treat the underlying fat disorder, it can help manage swelling, reduce discomfort, and support tissue health for many people with lipoedema.

  • This depends on your symptoms, goals, and stage of management. Some people benefit from more regular sessions initially, followed by maintenance support.

  • Please contact me directly. As I’m self-employed, I have flexibility with my schedule and can provide alternative times that aren’t shown online.

  • Yes. Lipoedema and lymphoedema can coexist, and treatment is adapted accordingly.

Get in touch

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