Carla Keech was only 10 years old when she first noticed that her legs were larger than those of other girls her age.
PE lessons were the worst. Not only did she dread changing in front of other girls, but the unflattering gym skirts left her painfully self-conscious.
’I would look at other girls in my class who had toned legs with slim thighs and wonder why mine didn’t look like that,’ says Carla, now 39.
’I didn’t understand why I was gaining weight or why my legs were growing so large – especially when I had a slim waist and collarbones that stuck out.’
It would be more than two decades before Carla would find out that her swollen legs were not due to being overweight, but were triggered by a medical condition called lipoedema, a condition characterised by an abnormal build-up of fat beneath the skin.
It occurs most commonly in the legs, hips and bottom, and sometimes the arms – often creating a striking imbalance between the upper and lower body.
Lipoedema can cause pain, tenderness, easy bruising and a disproportionate body shape that does not respond to a conventional diet or exercise.
And it was not until she was given this diagnosis that Carla was eventually able to access a life-changing surgery that shrunk the size of her legs and allowed her to, for the first time, wear shorts.
’I thought it was my fault at the time,’ says Carla. ’My legs felt heavy and bruised easily, which only made me want to hide them even more.
’It didn’t help that I was tall for my age. At five foot six, I already stood out among the more petite girls – I didn’t want another reason to feel different.
’I dreaded photos, school discos and mufti days. While everyone else wore short skirts and dresses, I hid behind baggy jeans and trousers.’
As an adult, Carla found herself trapped in a cycle of yo-yo dieting. Even when she lost weight, the fat on her legs refused to budge – leaving her frustrated and demoralised.
Carla Keech, now 39, pictured in 2009, has struggled with her leg size since puberty
Despite losing weight, Carla struggled with stubborn fat on her legs, pictured here in April 2024
Pictured in Egypt in November 2025, Carla now feels confident wearing shorts again
’I’ve lost count of how many times I’ve started running or eating healthily, watched the scale go down, and still seen no change in my legs.
’The weight would come off my stomach, but never where I wanted it to. I had to wear size 16 trousers just to get them over my thighs – but there was always a huge gap at the back because of my small waist.
’Eventually, I’d just think, “What’s the point?” – and the weight would pile back on.’
Two pregnancies only worsened her symptoms, though she assumed it was simply baby weight.
On summer holidays, she would sit by the pool, watching other women pass by in shorts and bikinis.
’I would always look to see if anyone had legs like mine – but they never did. I remember seeing women much bigger than me and thinking how unfair it was that even they had slimmer legs.’
The turning point came while working as a receptionist at a hospital when a colleague suggested a thigh lift.
Hopeful that surgery might finally shift the stubborn fat, Carla booked a consultation with a plastic surgeon.
But instead of recommending surgery, the doctor gave her an unexpected response, explaining that she most likely had lipoedema.
’It was the first time I’d ever heard the word,’ Carla recalls. ’But as soon as he explained it, everything clicked – I fit the description exactly.’
Thought to affect around one in ten women, the condition is often triggered by hormonal changes such as puberty, pregnancy and the menopause.
’I walked out of the appointment and burst into tears. I felt ashamed, upset and relieved all at once,’ says Carla.
’When I got home and told my husband, and he just hugged me, I realised it wasn’t my fault. That diagnosis changed everything.’
A growing number of celebrities, including Shaughna Phillips, Josie Gibson, Kerry Katona and Gemma Atkinson – and most recently Doja Cat – have helped thrust lipoedema into the spotlight.
Though research is ongoing, experts believe female hormones – particularly oestrogen – may play a key role in the development and progression of lipoedema.
Treatment options on the NHS are limited, with specialist services scarce and surgical interventions, which many patients find necessary, rarely funded.
Many women go for years or their entire lives without receiving an accurate diagnosis due to a lack of awareness within the medical profession.
’If I’d gone ahead with the thigh lift, I think the lipoedema would have just kept growing – it might even have made it worse,’ says Carla.
’Because it’s a progressive disease and a lot of surgeons don’t really understand it, I honestly think I’d be a lot worse off now.’
In April 2025, Carla visited London-based lipoedema specialist Dr Dennis Wolf, who recommended a procedure known as VASER liposuction.
Often described as the ’gold standard’ treatment for lipoedema, VASER liposuction uses ultrasound energy waves to break down stubborn fat deposits. This is then removed from the skin through a surgical tube under anaesthetic.
However, the treatment comes at a high cost. Carla paid around £13,000 for two rounds of the procedures.
According to Dr Dennis Wolf, it is not available on the NHS because there is no official NHS definition of lipoedema.
This, he argues, means that it is unclear exactly how many patients would qualify for – or benefit from – the treatment.
Health officials at the National Institute for Health and Care Excellence (NICE), who decide what the NHS will spend money on, also argue that the long-term benefits of the treatment are still unclear.
However, for Carla, it was worth the money.
’We couldn’t really afford it,’ she says. ’But I just thought, “I’ve got to have it – it’s the only option.”’
In April 2025, Carla is pictured pre-surgery with her legs as they were before treatment
Carla’s calves are pictured eight days after her second surgery in August 2025
’Four or five weeks later, I had the surgery. I went back on a diet to prepare myself as much as possible and, on the day, my husband took me to London.
’The operation took around three hours, and I woke up to a cup of tea and a biscuit before heading home.
’I took a week off work – the recovery was pretty brutal at first. It’s not nice to look at while your legs are healing and the bandages need constant changing.’
Carla underwent her second surgery in July last year. ’I found it easier the second time because I knew what to expect,’ she says.
’The pain was more manageable and the healing time was shorter but it was a very quiet summer – I was bandaged up and covered most of the time.’
Carla is pictured one day post-op in August 2025, in full compression following her second surgery
Carla’s legs were badly bruised after the surgery, which is a normal part of the healing process
’The hardest part is wearing the compression garments for six to eight weeks after surgery when you’re out or at work, as you have to wear your clothes over the top.’
But for Carla, the results have been life-changing.
As well as her legs looking slimmer and more toned, her weight has dropped from around 12st 12lbs to around 10st 3lbs – which she attributes to a combination of the surgeries and following the WeightWatchers programme.
For the first time since childhood, she feels comfortable showing her legs – swapping baggy jeans for shorts.
’I can now pick up a size eight or 10 in trousers and know they’ll fit over my calves and thighs,’ she says.
’I used to dread going shopping and trying things on – and boots were out of the question because they wouldn’t fit over my calves.
’I’m really happy with my shape now. The loose skin isn’t perfect but I’d take that over the excess fat any day.
’The surgery was a no-brainer – I’d recommend it a thousand times over.
’In November, we went on a family holiday to Egypt and, for the first time in years, I felt comfortable wearing a bikini and shorts.
’I’m excited to wear my summer clothes and get my legs out, something teenage me never got to do.
‘In November 2025, I experienced my first holiday feeling confident enough to wear a shorter dress,’ says Carla
’The reaction from friends and family has been lovely. They can see how much happier and more confident I am.’
Isobel MacEwan, chair of the charity Talk Lipoedema, says awareness of the condition is still worryingly low – and believes that more patients should be offered liposuction surgery.
’Lipoedema is not consistently recognised across the NHS,’ she says. ’Many people are dismissed as overweight or obese and do not get the correct diagnosis or care.
’It can have a huge impact on mobility and quality of life, and for many, liposuction can be life-changing.’
She added that research is ongoing into weight-loss medications such as Mounjaro and Wegovy, which could one day help reduce inflammation and potentially lessen the need for surgery.
Sharie Fetzer, chair of Lipoedema UK, adds: ’Non-cosmetic liposuction for lipoedema has not yet been approved by NICE. However, Lipoedema UK is working closely with experienced surgeons and researchers to ensure that NICE has all the evidence it needs to approve specialist liposuction at the next review, hopefully next year.’
Carla says her message to others is simple.
’If your legs look like lipoedema and you think you’ve got it, you probably have,’ she says.
’Don’t be ashamed and don’t blame yourself. Do your research, see a proper lipoedema specialist and get a diagnosis – once you know what it is, you realise it’s not your fault and there are things you can do.’