Figure 3.

Nodules and thickened extracellular matrix fibers in lipedema calf loose connective tissue. (a) Example of thick fibrotic fibers (white arrowhead) connecting skin to superficial fascia (*). The abnormal fibers when palpated through the wound are firm and thick and less mobile due to fibrosis in comparison to adjacent fibers. (b) Three nodules under the skin (black arrows) that can be palpated through the skin as firm and that when removed feel firm. Notice extensive scar under the skin (white arrowheads). (c) Lipedema nodules (black arrows) intermingled amongst yellow fat obtained during modified suction lipectomy.

Source: Photos courtesy of Jaime Schwartz.