Patients with lipoedema of the typus rusticanus Moncorps show a skin elasticity deficit of the skin of the calf. This is partly due to the derma oedema in the skin of these patients and seems partly to be due to an intrinsic connective tissue defect in the skin of such patients. The auteurs put forward the hypothesis that also present calf muscle pump dysfunction in these patients is the result of a connective tissue defect of the fascia of the muscular compartment, as an expression of a more generalized connective tissue defect.