Jack Crawford: Believe me, you do not want Hannibal Lecter inside your head.
Jack Crawford: Starling?
Clarice Starling: Sir?
Jack Crawford: Miggs is dead.
Clarice Starling: Dead? How?
Jack Crawford: Well, the orderly heard Lecter whispering to him all afterrnoon and Miggs crying. They found him at bed check. He swallowed his own tongue.
Hannibal Lecter: I do wish we could chat longer, but I'm having an old friend for dinner.
Clarice Starling: If you didn't kill him, then who did, sir?
Hannibal Lecter: Who can say. Best thing for him, really. His therapy was going nowhere.
Hannibal Lecter: A census taker once tried to test me. I ate his liver with some fava beans and a nice Chianti.
Answer: In Frederika's bedroom Clarice sees the dress being made and recognises that the pieces of material are the same shape as the pieces of skin missing from the victims' bodies. In the bank, where Clarice meets Frederika's friend, Stacy tells her the address of 'Mrs Lippman' whom Frederika used to work with. Presumably Buffalo Bill is related to, or is, Mrs. Lippman since that is where Clarice finds him.
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He's not Mrs Lippman. He did, however, kill her. As Clarice chases him through the cellar, the woman's decomposing body is in a tub.