Treatment of lipedema by low‐volume micro‐cannular liposuction in tumescent anesthesia: Results in 111 patients

Abstract

Lipedema is a painful disease of subcutaneous adipose tissue leading to bilateral increase of leg and/or arm volume, but sparing hands and feet. Although conservative treatment with complex decongestive therapy has been considered as the fundamental treatment, micro‐cannular liposuction in tumescent anesthesia has become a surgical option. We report on 111 patients mostly with advanced lipedema treated by this technique in our center between 2007 and 2018. The median age of the patients was 44 years. Eighty percent of patients had at least one comorbidity. There was an association of longstanding and advanced disease to obesity and diseases of the metabolic syndrome‐spectrum. The median total amount of lipoaspirate was 4,700 ml, with a range of 950–14,250 ml. The median reduction of limb circumference was 6 cm. The median pain level before treatment was 7.8 and 2.2 at the end of the treatment. An improvement of mobility could be achieved in all patients. Bruising was also reduced. Serious adverse events were observed in 1.2% of procedures, the infection rate was 0% and the bleeding rate was 0.3%. Liposuction is an effective treatment for painful lipedema. The procedure should be performed in specialized centers.

Disease progression and comorbidities in lipedema patients: A 10‐year retrospective analysis

“…With careful patient selection, several observational studies indicated that the surgical therapy was able to improve lipedemaassociated symptoms (pain perception, tension sensation, hematoma tendency, quality of life) as well as objectively measurable parameters such as leg circumference or extent of conservative therapy. [21][22][23][24][25] The results of this retrospective analysis underline this data. In addition, an improvement in menstrual irregularities could be observed.…”

“…1,20 Randomized controlled studies on the benefits of liposuction for lipedema are currently not available, but a number of selected observation studies have described evidence of permanent symptom reduction by removal of the pathological adipose tissue. [21][22][23][24][25] Furthermore, a reduction of menstrual disorders after surgical treatment has been reported. 5 Current publications have described a large number of associated comorbidities for patients with lipedema.…”

“…28 In addition, an elevated prevalence of hypothyroidism and migraine in lipedema patients has been reported. 5,21 Original articles on the subject of lipedema with a special focus on clinical course and associations with comorbidities have so far hardly been published. In the present work, relevant comorbidities and the disease-related medical history of surgically treated patients were collected from the patient collective of a specialized clinic for lipedema surgery over the past 10 years and retrospectively evaluated.…”

Lipedema: A Call to Action!

“…They described a median total amount of lipoaspirate of 4,700 mL, a median reduction of limb circumference of 6 cm, and a median pain level lowering from 7.8 to 2.2 at the end of treatment as well as improved mobility and bruising. Serious adverse events were observed in 1.2% of procedures, with infection and bleeding rates being 0% and 0.3%, respectively .…”

“…Moreover, no serious complication occurred following the procedure, with wound infection rates of 1.4% and bleeding rates of 0.3% . Very recently, Wollina et al reported on 111 patients mostly with advanced lipedema treated by microcannular liposuction in tumescent anesthesia between 2007 and 2018. They described a median total amount of lipoaspirate of 4,700 mL, a median reduction of limb circumference of 6 cm, and a median pain level lowering from 7.8 to 2.2 at the end of treatment as well as improved mobility and bruising.…”