Safety and Efficacy of Surgical Techniques in Treating Lipedema: Systematic Review

TL;DR

This review finds that liposuction is generally safe and effective for treating lipedema, improving pain and quality of life with few complications.

Contribution

The study systematically evaluates the safety and efficacy of liposuction techniques for lipedema, highlighting the need for standardized protocols.

Findings

Liposuction using tumescent infiltration reduced pain, BMI, and functional limitations in lipedema patients.

Complications such as hematomas and edema were uncommon, with sustained improvements over time.

Variability in anesthetic fluid composition and postoperative care was noted across studies.

Abstract

Lipedema is a chronic disorder characterized by abnormal subcutaneous fat accumulation, mainly in women's lower limbs. The aim of the study was to analyze the safety and efficacy of liposuction in treating lipedema. A systematic review was conducted in PubMed, Scopus, and MEDLINE until June 2024 using the terms “lipedema,” “liposuction,” “results,” and “complications.” Twenty-five studies were included (n = 2373 patients). Liposuction, mainly using the tumescent infiltration, reduced pain, BMI, and functional limitations, with improvements in mobility and quality of life. Mean aspirated fat volume was 3077 mL per session and 6111 mL per treatment course. Complications were uncommon (hematomas, edema, anemia, DVT, and rare methemoglobinemia). Moreover, improvements were maintained during the follow-up, suggesting that the beneficial results were sustained over time. Although 15 studies reported using tumescent, only 2 fully described the anesthetic fluid composition. Liposuction is a safe and effective treatment for lipedema, but variability in techniques and postoperative care highlights the need for standardized protocols and further research.

Level of Evidence: 4 (Therapeutic)

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