Lipedema:

Lipedema is a fat distribution disorder that only affects women and which, unfortunately, is still not recognized – even by many doctors. It mainly manifests itself in the extremities, i.e., the arms and legs. The hands and feet are spared, often resulting in a collar-like thickening of the ankles and wrists. As the disease progresses, the tissue increases and hardens, leading to chronic changes. In addition to restricted movement, the disease is associated with pain and a tendency to develop hematomas.

This clinical picture is divided into 3 stages:

1. Stage: fine nodular skin surface
2. Stage: coarse nodular skin surface with severe dents
3. Stage: hardened, deformed tissue and pronounced fat deposits

The disease places a great physical and psychological strain on those affected, as in addition to physical suffering, patients often experience feelings of guilt and shame, which are often caused by their immediate environment. Contemptuous looks, nasty comments, and a general lack of understanding are commonplace, as it is assumed that people have become overweight simply by overeating. No one considers the possibility of a medical condition.

Lipedema often begins at the onset of puberty. Hormonal triggers (e.g., puberty, pregnancy, menopause) are often associated with the onset of the disease. Lipedema cannot be treated or cured with medication. Diets and exercise also have no effect on lipedema. However, any additional obesity should be reduced as much as possible.

There are conservative treatment options that can alleviate the symptoms. These include compression and lymphatic drainage, but these must be continued for life. However, lipedema cannot be permanently stopped or even cured by these methods.

Medical liposuction of diseased tissue is a beneficial treatment for many patients. Medically indicated liposuction, also known as liposuction for lipedema, is a procedure to remove excess pathological body fat that cannot be influenced by weight loss.

The fat removed by liposuction is permanently gone and will not return to the areas that have been operated on. For many patients, this can provide rapid relief from symptoms, especially if the diseased fat is removed at an early stage, thus preventing chronic changes.

Liposuction for lipedema is performed by our specialists in plastic and aesthetic surgery using the WAL technique (water-jet assisted liposuction) or the PAL technique (vibration-assisted liposuction). Both procedures

are extremely gentle on the tissue and effective. The excess and pathological body fat is loosened from the surrounding tissue by the water jet or vibration and removed, taking special care to protect the lymph vessels.

The treatment is usually performed under general anesthesia and requires an overnight stay in our clinic. The amount of diseased fat tissue removed depends on the individual circumstances, but volumes of five to seven liters per surgery are not uncommon on the legs.

After surgery, specially made compression garments are worn to relieve painful swelling of the operated tissue and promote rapid healing. These must be worn consistently for at least six weeks. Lymphatic drainage should also be started as soon as possible after the surgery to ensure drainage of the tissue and thus improve healing. Consistent skin care should be a matter of course. We will be happy to advise you on suitable products that will help your skin to firm up.

Patients often report relief or even freedom from symptoms in the areas where liposuction was performed shortly after surgery. Several surgical sessions are usually necessary until the patient is largely pain-free and the diseased tissue has been almost completely removed.
However, freedom from symptoms cannot be guaranteed.

We recommend allowing a healing period of at least three months between individual surgeries. In the case of a single procedure, the removal of up to six or seven liters of fatty tissue may require a longer recovery period before patients feel “fit” for the next procedure. The often very significant loss of volume can leave excess skin areas, which must then be specifically removed by means of a tightening surgery to restore a normal body silhouette. We will be happy to advise you on this if necessary.

We recommend that our patients take special measures after the procedure to support the surgical outcome.

These include:

• A healthy and individually tailored diet
• Regular lymphatic drainage and wearing compression garments
• Targeted sporting activities
• Close monitoring by our specialists

Affected patients should have undergone at least six months of conservative treatment (compression, lymphatic drainage). If these measures are ineffective, it may be possible to remove the diseased tissue.

In some cases, the costs may be covered by health insurance, but this must be applied for in advance with the relevant insurance company.