A Case Series of Lymphatic Injuries After Suction Lipectomy in Women with Lipedema

Wright, Thomas F; Herbst, Karen L.

doi:10.12659/ajcr.935016

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…7 Despite the concern of possible lymphatic damage due to surgical trauma, only one case series was found that described lymphatic injuries in three lipedema patients after SAL. 8 Strong evidence supports that, when performed by an experienced team, tumescent liposuction can improve quality of life with lymphatic safety. 3,4,9 Notwithstanding, paucity of data suggests postsurgical lymphatic improvement.…”

Section: Discussionmentioning

confidence: 94%

Lymphatic Improvement after Suction-assisted Lipectomy in a Lipedema Patient

Vitorasso¹,

Silva

Batista³

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Summary: Lipedema is a chronic and progressive disease that may compromise lymphatic function. Although suction-assisted lipectomy (SAL) is considered a safe treatment for lipedema patients, the lymphatic repercussions of this surgical procedure are not fully understood. There is not enough evidence to support the role of SAL in lymphatic function treatment in lipedema. Here, we report a case of lymphatic drainage improvement after lipedema treatment with SAL. Tumescent SAL was performed in the deep subcutaneous layer, preserving the superficial and muscular lymphatic vessels. Pre- and postsurgical lymphoscintigraphy was equally documented under the Genoa protocol. A 34-year-old female patient presented with painful enlargement of the arms and lower limbs caused by lipedema. The patient had undergone conservative treatment with mild improvement in pain and heaviness. Lymphoscintigraphy showed slowed radiotracer progression on the left lower limb, collateral and tortuous lymphatic vessels on the right lower limb, and exuberant radiopharmaceutical concentration on the inguinal chain. Nine months after SAL was performed, the patient underwent another lymphoscintigraphy, which exhibited normalized radiopharmaceutical progression time and normal and symmetrical lymphatic vessel patterns. Collateral lymphatic paths and tortuosity vessels were no longer identified. Furthermore, the patient reported significant improvement in pain and the limb’s appearance. Tumescent SAL is not only efficient and safe in treating lipedema, but may also be responsible for improvement in lymphatic drainage in lipedema patients. Additional prospective studies are fundamental to reinforce the current evidence and possibly yield predicting information about the tumescent liposuction eligibility in the improvement of lymphatic drainage.

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Section: Discussionmentioning

confidence: 94%

Lymphatic Improvement after Suction-assisted Lipectomy in a Lipedema Patient

Vitorasso¹,

Silva

Batista³

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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“…After deduplication and screenings, 20 articles met the inclusion/exclusion criteria. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] ►Fig. 1 provides an overview of the PRISMA process for conducting this systematic review.…”

Section: Literature Reviewmentioning

confidence: 99%

Safety and Effectiveness of Liposuction Modalities in Managing Lipedema: Systematic Review and Meta-analysis

Mortada,

Alaqil,

Jabbar

et al. 2024

Arch Plast Surg

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Introduction Lipedema is a chronic, incurable disorder characterized by painful fat accumulation in the extremities. While the application of liposuction in lipedema management has become increasingly popular, the safety and effectiveness of this approach remain contentious. Our systematic review and meta-analysis aimed to assess various liposuction modalities in lipedema management to verify their safety and efficacy. Methods In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we performed a comprehensive literature review from inception until March 2023 using the following electronic databases: CENTRAL, MEDLINE, Google Scholar, and EMBASE. Results From the 562 initially identified articles, 20 met our inclusion/exclusion criteria for evaluation. Our review encompassed 14 prospective cohort studies, three retrospective studies, two case series, and one cross-sectional study. A meta-analysis of nine articles revealed a notable improvement in the quality of life, pain, pressure sensitivity, bruising, cosmetic impairment, heaviness, walking difficulty, and itching among lipedema patients who underwent liposuction. Although complications such as inflammation, thrombosis, seroma, hematoma, and lymphedema-related skin changes were reported, severe complications were rare. Crucially, no instances of shock, recurrence, or mortality were reported. Conclusion In conclusion, liposuction is a safe and beneficial therapeutic intervention for managing lipedema symptoms and enhancing quality of life. However, the impact of liposuction on secondary lymphedema remains unreported in the literature. Further high-quality, large-scale trials are necessary to assess the safety and effectiveness of different liposuction modalities. These studies will contribute valuable insights to optimize liposuction as a therapeutic option for individuals with lipedema.

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“…16,17 Lymphedema is a comorbidity, 18 and lymphatic injury can occur after liposuction. [19][20][21] Up to 50% of women with lipedema also have venous disease. [22][23][24] In this study, LRS uses suction lipectomy with techniques to protect lymphatic structures and can include manual extraction of fibrous tissues that remain after maximal debulking of tissue.…”

Section: Introductionmentioning

confidence: 99%

Lipedema Reduction Surgery Improves Pain, Mobility, Physical Function, and Quality of Life: Case Series Report

Wright,

Babula,

Schwartz

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Lipedema is a chronic inflammatory subcutaneous adipose-rich connective tissue disease affecting millions of women worldwide. Disproportionate fat accumulation on the extremities characterized by heaviness, tenderness, and swelling can affect function, mobility, and quality of life. Treatments include conservative measures and lipedema reduction surgery (LRS). Here, we report lipedema comorbidities and surgical techniques, outcomes measures, and complications after LRS. Methods: This is a single outpatient clinic retrospective chart review case series of comorbidities and complications in 189 women with lipedema. Bioelectrical impedance analyses, knee kinematics, gait, physical examinations, Patient-Reported Outcomes Measurement Information System, and RAND Short Form-36 questionnaires collected before and after LRS were analyzed for 66 of the 189 women. Hemoglobin levels were measured by transdermal hemoglobin monitor (Masimo noninvasive hemoglobin monitoring; Irvine, Calif.). Results: Common comorbidities in 189 women were hypermobile joints (50.5%), spider/varicose veins (48.6/24.5%), arthritis (29.1%), and hypothyroidism (25.9%). The most common complication in 5.5% of these women after LRS was lightheadedness with a 2-g reduction or more in hemoglobin. After conservative measures and LRS in 66 women, significant improvements (P ≤ 0.0009) were found for: (1) knee flexion (10 degrees); (2) gait; (3) Patient-Reported Outcomes Measurement Information System T-score (16%); (4) mobility questions: gait velocity, rising from a chair, stair ascent; (5) RAND Short Form-36 scores: physical functioning, energy/fatigue, emotional well-being, social function, general health; (6) and Bioelectrical impedance analyses total and segmental body fat mass. Conclusion: LRS provided significant improvements to women with lipedema using direct physical measurements and validated outcome measures, comparable to those seen after total knee replacement.

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A Case Series of Lymphatic Injuries After Suction Lipectomy in Women with Lipedema

Cited by 4 publications

References 24 publications

Lymphatic Improvement after Suction-assisted Lipectomy in a Lipedema Patient

Lymphatic Improvement after Suction-assisted Lipectomy in a Lipedema Patient

Safety and Effectiveness of Liposuction Modalities in Managing Lipedema: Systematic Review and Meta-analysis

Lipedema Reduction Surgery Improves Pain, Mobility, Physical Function, and Quality of Life: Case Series Report

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