Observational Study of Ultrasound-Assisted Liposuction for Lower Limb Lipedema on 191 Female Patients

BACKGROUND: Lipedema, a chronic condition affecting 11% of women, causes abnormal fat buildup in the lower limbs, leading to disproportionate body shape and functional problems. Often misdiagnosed, its cause is unclear, and conservative treatments are typically tried first. If these fail, surgical options such as lymphatic-sparing liposuction, including ultrasound-assisted liposuction (UAL), may be considered for lower limb lipedema after 6 months of conservative treatment. METHODS: The authors' cohort included 191 patients with lower limb lipedema (stages 1 to 3) who underwent 2 stages of lymphatic-sparing UAL following 6 months of conservative treatment. Outcome measures included changes in pain assessment using visual analog scale scores, pannus thickness, aesthetic satisfaction, and the documentation of complications before and 12 months after the complete surgical treatment. RESULTS: The authors' protocol resulted in significant reductions in circumferences across all assessed regions ( P < 0.001), with an average decrease of -6.396 cm (range, -9.268 to -3.523 cm). Pain levels and sensitivity to touch, bruising, and other discomforts significantly decreased after liposuction (all P < 0.0001). Complication rates were within expected ranges, with no instances of postoperative phlebitis. All patients reported high levels of posttreatment satisfaction. CONCLUSIONS: The integration of a comprehensive medical protocol for managing lipedema, combined with the use of next-generation lymphatic-sparing UAL in 2-stage procedures for the lower limbs, shows promising potential. These findings highlight the effectiveness and safety of liposuction in treating lipedema, providing valuable insights for clinical practice. Long-term follow-up studies are necessary to confirm sustained efficacy.