Ten-Year Experience With the Surgical Treatment of Lipedema—Long-Term Follow-up After Multi-stage Liposuction

Abstract

PURPOSE: Liposuction is increasingly being utilized as an established surgical treatment of lipedema. Although conservative treatment is still considered as first-line treatment, removing the pathological adipose tissue with liposuction is possibly the only available therapy with long-term symptom reduction. However, data on long-term outcomes after surgical intervention in lipedema patients are lacking. METHODS: Between July 2010 and July 2019, 106 patients with lipedema underwent a total of 298 liposuction procedures. All patients completed a standardized questionnaire. Complaints associated with lipedema were assessed using a visual analogue scale score. The need for conservative treatment before and after surgery was compared using a composite complex decongestive therapy score. In cases where preoperative data were missing, retrospective acquisition was performed. Median follow-up time was 20.0 months (interquartile range, 10.3–42.0 months). RESULTS: The mean amount of lipoaspirate was 6354.73 ml (±2796.72 ml). No serious complications were observed following large-volume liposuction. Overall, a significant improvement of lipedema-associated symptoms could be observed. The need for conservative treatment was significantly reduced in long-time follow-up (complex decongestive therapy score reduction of 37.5%, interquartile range 0%–88.8%). In multigroup comparison, better results could be achieved when surgical treatment was performed at earlier stages. CONCLUSIONS: Liposuction of patients with lipedema is a safe treatment with long-lasting results in reducing the patient’s need for conservative treatment and improving lipedema-associated complaints. For an optimal outcome, surgical treatment should be considered at an early stage of the disease. Before performing liposuction, appropriate treatment of severe obesity is advisable.