Liposuction

Tumescent Liposuction

Lipoedema UK’s 2016 and 2017 conference programmes explored the use of liposuction for lipoedema patients.  In 2016, Professor Wilfred Schmeller, Dr Yvonne Frambach and Dr Axel Baumagartner from The Hanse Clinic. Lubeck Germany, Dr Harry Voesten from Holland and Miss Anne Dancey from the UK presented on their techniques and results for patients with lipoedema.  (For more about the conference, please visit our 2016 Conference page by clicking here).  Mr Vasu Karri a UK surgeon was one of our keynote speakers at our October 2017 event. 

Evidence is growing that liposuction can prove beneficial in reducing the size of the lipoedema areas and lessening the pain, however, it should only be undertaken by expert surgeons with knowledge of lipoedema and the lymphatic system.  Not all patients with lipoedema are suitable for liposuction and each case should be considered on an individual basis. Most patients require several operations to achieve the desired results and careful preparation and post -operative aftercare including wearing compression garment is a vital part of the treatment. Many patients also benefit from Manual Lymphatic Drainage Massage (MLD) to aid their recovery.

Mr Alex Munnoch, Consultant Plastic Surgeon & Clinical Lead, Ninewells Hospital, Dundee performs NHS liposuction on stage 2 and stage 3 patients with lipoedema and lymphoedema subject to the patient securing funding from their Clinical Commissioning Group.

Traditional liposuction or cosmetic liposuction is NOT recommended as it results in surgical traumatisation especially to the lymph vessels, this can lead to lip-lymphoedema and a worsening of the symptoms.

No two cases of lipoedema are the same and so if you are considering liposuction, it is important to spend time researching the methods used by each surgeon. Always ask for information on previous patents and their long term results. Whenever possible seek the support of your GP and referral to a Lymphoedema clinic prior to undergoing any surgery.  Following liposuction, some patients may be advised to continue wearing  compression garments for life and better surgical outcomes are achieved if patients can avoid putting on any non-lipoedema weight or excessive weight gain.

 

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The following are published  reports on liposuction for lipoedema patients:

Br J Dermatol. 2012 Jan;166(1):161-8.
Tumescent liposuction in lipoedema yields good long-term results.
Schmeller W, Hueppe M, Meier-Vollrath I.

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J Dtsch Dermatol Ges. 2011 Jan;9(1):33-40.
Liposuction is an effective treatment for lipedema-results of a study with 25 patients.
[Article in English, German]
Rapprich S, Dingler A, Podda M.

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Br J Dermatol. 2015; Nov; 1-8  Long-term benefit of liposuction in patients with lipoedema: A follow-up study after an average of 4 and 8 years  Baumgartner A, Hueppe M, Schmeller W.

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Research Gate – Conference Paper Long-Term Results of Liposuction in Patients with Lipoedema  Frambach Y, Baumgartner A, Hueppe M, Schmeller W.

To our knowledge, no practitioners in the UK have published results on liposuction for lipoedema and there are few centres in the UK that offer liposuction treatment for lipoedema. St George’s hospital do NOT currently have funding to offer liposuction to patients with lipoedema. Funding for liposuction on the NHS should be made by GP’s to their patient’s Clinical Commissioning Group (CCG).

Statement from Dr Kristiana Gordon, Consultant in Dermatology & Lympho-vascular Medicine regarding services for liposuction at St George’s on 13th November 2014.

“Lipoedema is a rare condition almost exclusive to females. It results in excessive abnormal fat deposition, typically affecting the legs but not the feet. The extra fat deposition results in heavy legs, that are tender, painful and bruise easily. There is usually a family history of lipoedema, suggesting that a genetic origin is likely. Onset of lipoedema is usually at puberty or other times of hormonal change. Although distinct from obesity, weight gain is a characteristic feature. Dieting often makes little change to the size of the legs.

Lipoedema is frequently mistaken for lymphoedema or obesity. Although the main abnormality is fat, some fluid accumulation can occur from an early stage. Over time lipoedema can become complicated by lymphoedema which will then manifest with pitting oedema in the feet (pure lipoedema does not affect the feet).

There is no cure for lipoedema at present. Liposuction may prove beneficial in reducing the size of the legs and lessening the pain. However, it should be undertaken by an expert surgeon with knowledge of lipoedema and the lymphatic system, in order to reduce the likelihood of post-operative complications. Liposuction this is not a cure and the condition is likely to recur if the patient gains weight. We currently recommend the post-operative use of compression stockings for life in order to prevent the development of a secondary lymphoedema.

Not all patients with lipoedema will be suitable for liposuction treatment.

St George’s is a tertiary referral clinic, which means they only accept referral letters from hospital consultants and cannot accept direct referrals from the patient’s GP (unless they reside in Wandsworth, London).

Please do not contact St Georges hospital directly.