A retrospective cohort study: Waterjet-assisted liposuction reduces inflammation but increases the risk of hypokalemia in patients with lipoedema

INTRODUCTION: Lipoedema is a congenital fat distribution disorder. It leads to a pathological increase in adipose tissue due to a hypertrophy and hyperplasia of the adipocytes. Currently, the disease affects approximately 10% of women. A common treatment of the disease is liposuction to remove the pathologic fat cells. PATIENTS AND METHODS: A total of 47 patients (mean age: 62.00 ± 12.96 years) were treated with the conventional tumescent liposuction and 25 patients (mean age of 45.16 ± 12.87 years) with waterjet-assisted liposuction (WAL), a gentle, tissue-conserving method that washes out fat cells. WAL is thought to cause less damage to surrounding tissue than tumescent liposuction and thus, less trauma. RESULTS: At the postoperative level, the C-reactive protein was significantly (p* = 0.0195) lower after WAL treatment, implying a lower inflammation level than after tumescent liposuction. Also, a decrease of electrolytes such as potassium in the blood serum was observed in some cases. The postoperative potassium level dropped by 0.30 ± 0.24 mmol/l, a value that was significantly lower in WAL-treated patients where the level dropped by 0.47 ± 0.31 mmol/l. The mean fat aspirate using the conventional tumescent method was 3302.13 ± 1345.89 ml and 3727.08 ± 151.96 ml with the WAL treatment. CONCLUSIONS: WAL is a tissue-conserving method that washes out fat cells with less trauma to surrounding tissue as observed with conventional tumescent liposuction. WAL causes a lower inflammation level but higher loss of potassium ions. This latter aspect needs attention after the liposuction treatment. TRIAL REGISTRATION: Waterjet-assisted liposuction reduces inflammation but increases the risk of hypokalemia when compared to conventional tumescent liposuction in patients with lipoedema, DRKS00034711. Registered July 17, 2024 - Retrospectively registered. Trial registration number DRKS00034711.