MON-116 Liposuction for Lipedema (Persistent Fat) in the US Improves Quality of Life

Abstract

Purpose: Lipedema is a common and painful fat disorder affecting the limbs of women leading to obesity; the fat cannot be lost by diet or exercise, called persistent fat. Lipedema is classified by stage. Stage 1: normal skin surface with enlarged hypodermis. Stage 2: uneven skin with indentations in fat and larger hypodermal masses. Stage 3: large extrusions of tissue drastically inhibit mobility. Lymphedema occurs at any stage, especially Stage 3, called lipo-lymphedema. Reduction of lipedema fat is achieved effectively only by removal of fat by lymph-sparing liposuction. Liposuction reduction of fat on the lower body improves mobility. Data from Europe demonstrate quality of life improves for women with lipedema after liposuction. There are no data on liposuction and lipedema in the United States (US). The purpose of this study is to determine how women with lipedema in the United States benefit or not from liposuction. Materials and Methods: Non-validated 183-item online questionnaire answered by women after undergoing liposuction for lipedema in the US. Results: One-hundred and eighty-nine women with lipedema consented and answered the questionnaire; the majority (51%) Stage 2. Women with Stage 1 and 2 had on average two procedures; women with Stage 3 or lipo-lymphedema had, on average, one additional procedure. Improvement in ambulation after liposuction was highest in patients with lipedema Stage 3 at 90.9% and lowest in Stage 1 at 71%, where ambulation pre-surgery tends to be less affected. Weight loss occurred in all groups 2-4 months after liposuction. Women from all stages reported growth of fat post-procedure outside areas of liposuction, highest in Stage 1 (62%) and lipo-lymphedema (70%). Growth of fat in liposuction areas occurred in ~1/2 of participants across all groups, most often in women in lipedema Stage 4 (71%). The complication of lymphedema after liposuction was not reported in Stage 1 but in two women with Stage 2, five with Stage 3, and three with lipo-lipedema. Improved quality of life after liposuction was significant in Stages 1-3 ranging from 81% improvement for Stage 1 to 86% for Stage 3, but only 70% for women with lipo-lymphedema. The perceived success of the procedure decreased with stage. Conclusion: Women with lipedema noticed improved ambulation after liposuction, likely due to removal of excess adipose tissue from the legs. Fat growth after liposuction was reported consistent with published data. Improvement in quality of life after liposuction agrees with European data, and greater perceived benefit in earlier stages emphasizes the importance of early detection of lipedema and earlier intervention with liposuction. Prospective studies are needed to assess quality of life, fat growth, weight loss and ambulation after liposuction in women with lipedema in the US.