For most people with lipedema, flat-knit compression is the better choice, especially as the condition progresses. The way a garment is knitted changes how it fits, how it feels and how well it holds up on legs and arms with uneven shape.
Lipedema causes painful, uneven fat buildup, often with soft tissue, folds and a "cuff" of tissue above the ankles. A garment that fits a straight, even limb may roll, dig in or leave gaps on a lipedema limb. Understanding the two main types of knit helps you and your fitter choose the right one.
Circular-knit vs. flat-knit at a glance
How it's made — Circular-knit: Knitted in a tube on a round machine, no seam; Flat-knit: Knitted flat, row by row, then sewn with a seam
Feel — Circular-knit: Thinner, smoother, stretchier; Flat-knit: Thicker, firmer, less stretch
Fit — Circular-knit: Ready-to-wear sizes or made-to-measure; Flat-knit: Usually custom-made from your measurements
On uneven limbs — Circular-knit: Can dig into folds, roll or bunch; Flat-knit: Bridges folds and holds its shape without cutting in
Look — Circular-knit: More like regular hosiery; Flat-knit: Heavier, but available in many colors and patterns
Best for — Circular-knit: Early-stage lipedema with an even limb shape; Flat-knit: Moderate to advanced lipedema, lipo-lymphedema, tissue folds or an ankle cuff
Why flat-knit often works better
Flat-knit fabric is stiffer, so it rests on the skin instead of sinking into soft tissue. That spreads pressure more evenly, reduces pinching and helps the garment stay in place. Because it's knitted to your exact measurements, it can follow sudden changes in limb size, such as a wider thigh or a fat pad at the knee.
When circular-knit makes sense
Circular-knit garments can be a good fit in early lipedema, when the limb shape is fairly even. They're lighter, easier to put on and cooler in warm weather. Some people also use them for exercise or as a lighter option on some days.
Choosing the right garment
The best garment is one you can wear comfortably every day. When you're deciding, think about:
Your limb shape. Folds, lobules or an ankle cuff usually point to flat-knit.
Pain and tenderness. Lipedema tissue is often sore and bruises easily. Your fitter may start with a lower compression level and adjust over time.
Lymphedema. If you also have swelling from lymphedema (lipo-lymphedema), flat-knit is usually recommended.
Style. Leggings, capris, thigh-highs and arm sleeves are all available. Many brands offer flat-knit in fashion colors and prints.
Getting fitted
A professional measurement is the most important step. Flat-knit garments are made from detailed measurements taken at many points along the limb, ideally early in the day when swelling is lowest. Popular flat-knit options include Juzo Expert, mediven 550 and Jobst Elvarex, along with custom lines from Sigvaris and L&R.
Will insurance cover it?
Coverage depends on your plan and diagnosis. Medicare covers compression garments only for a lymphedema diagnosis, so lipedema alone isn't covered. Some commercial plans and Medicaid programs may cover garments for lipedema. Contact us and we'll help you check your benefits. Email us at customersupport@midwestcompression.com or call 800-883-1549.
This article is for general information only and is not medical advice. Talk with your doctor or lymphedema therapist about the right garment for you.
