Yes, and it’s more common than you think! It’s called accessory breast or axillary breast that appear under your armpit, and with or without a nipple.
February 25, 2026
Table of Contents
Lipedema and cellulite are distinct medical and skin conditions, although they can appear quite similar, often presenting as skin dimpling and uneven, bumpy skin texture.
Recognising the symptoms of lipedema and cellulite is the first step toward obtaining an accurate diagnosis to receive the appropriate treatment.
What lipedema and cellulite look like, including their stages, types and grades
Lipedema stages and types
According to Herbst KL et. al,
- Lipedema Stage 1: The skin looks smooth but feels pebbly underneath due to loose connective tissue.
- Lipedema Stage 2: There is more lipedema tissue, causing skin dimpling and larger nodules. The arms may show sagging tissue and a noticeable cuff around the wrists.
- Lipedema Stage 3: The lipedema tissue is thicker with many large nodules and hanging lobes of tissue. Patients (e) and (f) have lipedema, obesity and lipo-lymphedema.
Note: A tissue cuff around the ankles or wrists can appear in all stages.
Types I to V describe the locations of lipedema tissue.
- Type I Lipedema: Lipedema tissue around the hips and buttocks
- Type II Lipedema: From just under the belly to the knees
- Type III Lipedema: From just under the belly to the ankles
- Type IV Lipedema: In the arms
- Type V Lipedema: In the lower legs (not shown)
Cellulite grades
The classification of cellulite, as proposed by Nürnberger and Müller, is based on four distinct grades according to clinical presentation:
- Cellulite Grade 0: No skin dimpling under any circumstances
- Cellulite Grade 1: Dimpling when pinched
- Cellulite Grade 2: Visible skin dimpling while standing
- Cellulite Grade 3: Visible skin dimpling both when standing and lying
Differences & Similarities in Lipedema & Cellulite
| Lipedema | Cellulite | |
|---|---|---|
| Definition | Painful fat disease with high output lymphatic failure | Skin dimpling and indentation of the subcutaneous fat |
| Occurrence | In females only | More common in females than males |
| Causes | • Genetic • Hormones • Inflammation • Fibrosis • Fluid build-up in tissues |
• Hormonal fluctuations • Significant weight gain • Poor diet • Unhealthy lifestyle • Dehydration • Medical conditions • Ageing |
| Limbs affected | Both limbs affected by cuffs, including the arms and shoulders | In the outer and inner thighs, buttocks, abdomen |
| Symptoms | • Pain and tenderness • Symmetrical swelling • Easy bruising • Heaviness in the affected area • Unusual or sudden fatigue • Reduced range of movement • Irregular fat distribution • Skin Changes |
• No pain, no tenderness • Skin Changes |
| Skin | Tender to the touch | Dimpled skin texture |
| Would a compression garment improve the appearance? | ✓ | X |
| Medical condition | ✓ | X |
| Danger to health | • Immobility • Disability due to impaired daily activities • Orthopaedic changes |
• Limited clothing choices |
| Diagnosis | • Physical examination • Medical history • Ultrasound |
• Visual examination • Pinch test • Lifestyle history |
| Treatment | • Manual lymphatic drainage • Exercise • Compression garment • Lipedema Surgery with Liposuction |
• Manual lymphatic drainage • Exercise • Weight loss programme • Cellulite Reduction with Liposuction with Fat Grafting |
Self-assessment on Lipedema & Cellulite
How to self-assess lipedema: Pinch test
How to do: Gently pinch the affected area and pay attention to any feeling of pain or if there's a difference in texture compared to other places. Pain or unusual texture could suggest lipedema.
Limitation: Not fully reliable, as non-essential and overlapping conditions can affect results.
Red flag: Pain, tenderness, swelling, or feelings of heaviness impacting mobility
How to self-assess cellulite: Pinch test
How to do: Pinch areas with dimpled skin, usually on the thighs and buttocks. If dimples show more when pinched, it's likely cellulite.
Limitation: This test measures temporary changes and may not accurately reflect the overall condition due to factors such as skin slackness or body type.
Red flag: Pain or swelling in the dimpled areas
If you've been wondering whether those painful legs and arms are more than just stubborn fat or cellulite, let Dr Ivan Puah take a closer look and guide you with the right solution — book your appointment today!
