Surgery for Lipoedema

Lipoedema is a disorder of an increase in adipose tissue. It can be inherited and almost exclusively occurs in women.  Even though the upper body may be slim, the buttocks and/or legs retain large lipoedemic fat deposits.  This condition is occasionally accompanied by migrating pains, and often with lumpiness.

The ankles and feet nearly always remain unaffected, leading to a sharp change of profile between the lower leg and slim foot.  This is caused by congenital connective tissues which damage the smallest blood vessels, resulting in the accumulation of lipoedemic fat tissue in the lower half of the body. A tendency to bruise easily is also associated with this condition. Pain associated with tensing and straining can also occur.

Surgical Treatment

Although conservative therapies, such as compression treatment combined with lymph drains and movement therapy, can provide relief for sufferers of the condition, it is only in rare cases that the fat deposits disappear completely.

Candidates for liposuction are those who are in good health and for whom conservative therapies are unsuccessful.

Liposuction can improve appearance significantly, but should not be used when the legs are severely swollen or in cases of chronic lymphoedema. Lymphoedema is where there is swelling in the ankle area and back of the foot, and when this swelling is pressed, indented impressions are left behind. Only an occasional tendency to swell, especially when under physical stress, is not a criteria against the operation though.  Severely obese patients are also unsuitable for liposuction, as liposuction cannot be a substitute for dieting.  Also before embarking on this course of treatment, varicose veins should be removed six months in advance.  We also offer varicose vein stripping or varicose vein removal through small cuts made in the skin.  The advantage of having this done is that the same incision points can be used later on for the liposuction, especially if both procedures are carried out by the same surgeon.  In cases of badly damaged vein systems, especially blockages connected with the deep vein system in the legs, we dissuade the use of liposuction.  We can carry out an ultrasound examination of your legs in order to determine the condition of your vein systems.

Liposuction for Lipoedema – The Operation

The operation is carried out using a relatively large dose of local anaesthetic which is injected into the fat tissue while a supervising anaesthetist monitors your vital signs and dispenses pain relief. The patient remains relatively awake so they are able to move when asked to, and are able to use and tense some muscles as well as change and hold positions. This is especially important during liposuction of the buttocks and thighs, as this is important in attaining a good aesthetic result.  For liposuction performed solely on the lower leg, full anaesthetic can be administered, as the leg can be raised and manipulated by the surgeon or an assistant. The risk with a liposuction under 4 litres (which is our maximum removal amount), is no higher when performed under full anaesthetic.We closely monitor the patient during the first night after the operation and treat any signs of a circulatory reaction.

Liposuction is performed through small channels and uses ’vibration technology’ whereby an oscillating needle is powered by a motor on the handle of the instrument, which enables the machine to more easily liquefy and remove fat tissue.

Liposuction for Lipoedema - post-treatment

On the same day the operation is performed or later, excess fluid normally drains from the puncture points and this reduces the likelihood of bruises forming.  Stitching of the puncture points is not necessary, as the chances of conspicuous scarring are negligible. We recommend the patient wears a compression garment for between six weeks and three months after the operation in order to support the lymph drainage.

As soon as your circulatory functioning allows you to following the operation, if possible, try getting up and moving. Mostly, extra-special care need only be taken for a few days after the operation, and after about a week you should be able to resume work.

The Success of Liposuction in Treating Lipoedema:

Good aesthetic results can be attained with liposuction, however in some cases skin tightening is also needed, especially if the accumulated fat deposits have resulted in the skin being ’over-stretched’.