Liposuction: surgery as a treatment option for lipoedema to reduce pain
The aim of liposuction (fat removal) is to remove or reduce the excess subcutaneous fat on the affected extremities and to sustainably reduce the disease. Liposuction can be considered if conservative therapy methods (without surgery) for lipoedema in the arms or legs do not have the desired success. Through liposuction, pain can be permanently relieved and the quality of life improved. In addition, it can lead to a correction of the axial misalignment of the legs and improve restricted mobility.
Liposuction is not a cure for lipoedema. That is why follow-up treatment and the commitment and discipline of the affected individuals are crucial for long-term therapeutic success – in conservative therapy, for example in nutrition and exercise.
When is liposuction useful for lipoedema?
As with any surgical procedure, there are risks. Therefore, after a comprehensive informed consent discussion, the doctor and patient may decide in favor of an operation – taking into account all medical or psychological risks.
If there is no improvement despite conservative treatment, liposuction can be considered as a surgical method for the lasting reduction of the affected subcutaneous fatty tissue of the lipoedema in the legs and arms. The following aspects, for example, play a role in the indication for liposuction:
- Documented pain that persists despite conservative therapy
- Complications, for example, restrictions on mobility and dermatological or orthopaedic secondary diseases such as skin infections, knee or hip arthrosis
- If necessary, preoperative decongestion of oedema caused by other diseases (e.g. lymphoedema)
- Before liposuction is considered on the arms or legs, the accompanying obesity should be treated first.
- Critical assessment of indications with a waist-height ratio (WHtR) over 0.55 and a BMI over 40 kg/m², for example: Is it really lipoedema? Or is it obesity?
- Strict assessment of indications for patients under the age of 18 so that other conditions – such as obesity – can be ruled out: Is it really lipoedema?
Before and after: preparation for liposuction, how is it performed and what happens next?
Depending on the extent of the liposuction, the person concerned will receive a local or general anesthetic. Various techniques are available to prepare the fatty tissue for the actual tissue- and lymph vessel-sparing suctioning, for example vibration-assisted or water-jet assisted systems. After that, a cannula is inserted through small incisions in the skin to suction out the loosened fat. The procedure is performed under therapeutic local anesthesia (TLA) or general anesthesia.
Usually, one to four sessions are necessary for the treatment of both legs and one to two sessions for the liposuction of both arms. The treatments take place at intervals of several months. It is possible that follow-up operations (lift operations) may be necessary or – as with any operation – complications may arise. Get insights into the experiences of lipoedema patient Tina Schwarz, who had a liposuction.
Aftercare to preserve surgery results
Complex physical decongestive therapy (CDT) is used to minimize fluid retention after liposuction. The intensity and duration of CDT will vary depending on postoperative findings. Compression therapy with medical stockings is a lifelong continuous treatment.
How much does liposuction cost? Does health insurance cover liposuction for lipoedema?
The decision as to whether a health insurance company will cover the costs of liposuction is made on a case-by-case basis, depending on the diagnosis and indication, as well as the current legal situation. Currently, the decision to cover the costs is at the discretion of the doctor.
Compression stockings by medi
When treating liposuction, medical compression stockings are an important part of the therapy. The following products from medi, for example, are suitable: mediven mondi, mediven cosy (lateral seam), mediven 550.
Your doctor makes the diagnosis and decides on the therapy. If necessary, your doctor can prescribe wound therapy products. The patient is advised by trained personnel (e.g. in a medical supply store, pharmacy, wound centre). After this, the patient receives products that are customised to meet their individual needs.
