Our top 10 facts about lipoedema

It is not uncommon for lipoedema to be referred to as lymphoedema or other diseases or to be confused with them. These are basically different clinical pictures whose causes, diagnostic possibilities and therapies largely differ greatly from one another.

In contrast to lipoedema, lymphoedema has an identifiable cause, either congenital (primary) or acquired (secondary) damage to the lymph transport system. Only very rarely do we see a combination of lipoedema and lymphoedema, known as lipo-lymphoedema.

The word “oedema” in lipoedema should actually be deleted from the name of most stages, as most sufferers are in a stage in which the fat distribution disorder causes pain, but NO oedema is present (apart from exceptions and orthostatic oedema, especially in summer)

Many people refer to lipoedema as chronic progressive or chronic progressive. Chronic-progressive or chronic-progressive is intended to express the fact that an existing lipoedema worsens continuously and inexorably.

If we break this statement down into its components, then we are talking about the words chronic and progressive.

Chronic refers to the period of time. If lipoedema and its symptoms have been present for longer than 6 months, we can safely speak of a chronic disease.

Progressive means “advancing”. If we put the words “chronic” and “progressive” together again, then this should refer to a long-lasting disease in which the severity of the symptoms increases continuously over a long period of time. However, this course does not apply to the disease “lipoedema”. Instead, we believe that lipoedema should be understood as a “chronic, relapsing disease”.

In the case of pure lipoedema, lymphatic drainage treatment is generally not the preferred method for treating this condition. If lipoedema is present in combination with lymphoedema, lymphatic drainage treatment may be useful.

Compression therapy for lipoedema is individualized. If the legs are affected, we recommend compression treatment with flat-knit compression pants of compression class II. Treatment is usually covered by health insurance.

There are many different techniques for performing liposuction.

When it comes to the technique, we differentiate between the manual technique and the instrument-based technique. The manual technique, which varies from surgeon to surgeon, should respect and take into account the lymphatic channels during liposuction.

What about the instrument-based technique?

Classic liposuction
In classic liposuction, the cannulas are simply connected to a vacuum, which can be a very simple system.

Water-jet assisted liposuction (Bodyjet)
Waterjet-assisted liposuction uses a high-pressure water jet emitted from the suction cannula to loosen the fat tissue cells from the tissue complex.

Vibration-assisted liposuction (PAL power-assisted)
A vibrating suction cannula supports the release of the fat tissue cells from the tissue complex. All of the techniques mentioned are suitable for the long-term treatment of lipoedema, although we clearly prefer the PAL method for high-volume liposuction.

UAL ultrasound-assisted liposuction (UAL – VASER)
Ultrasound-assisted liposuction is a modern method for the intensive and thorough removal of fat cells for the best results.

With regard to the manual technique, we have established our own technique that has been continuously developed over the years. This has developed into our VAPP+ technique, which is presented in more detail in the Liposuction menu. The special feature of our technique is our own tumescent solution (solution for preparing the fatty tissue) and how the fatty tissue is prepared for liposuction. This enables us to perform liposuction with high volumes safely and without damaging the circulation. We will be happy to answer your questions about liposuction in a consultation.

There is no one-size-fits-all answer to this question. It depends on the initial situation. If there is pronounced obesity at the beginning of the treatment that is not treated and no treatment concept for obesity is planned, then liposuction is unlikely to be crowned with long-term success. It is precisely these patients who report that the abdomen or other areas begin to “grow” immediately after the operation. The excess calories are deposited differently than before the operation due to the altered number of fat cells and fat precursor cells and their distribution.

If the patient is only slightly overweight, taking into account the fat distribution disorder and is not obese, a simple change in lifestyle and diet in combination with liposuction as part of our complex surgical treatment can be the key to long-term success.

There is almost always a significant improvement or even a complete reduction in pain after treatment.

In our opinion, liposuction for lipoedema or pure lipohypertrophy has a very good long-term and sustainable prognosis. Successful treatment will certainly primarily improve the physical symptoms, including mobility and exercise capacity, but there will also be a significant improvement in body shape. The improved body shape almost always leads to mental stabilization, an increase in self-confidence and greater participation in social and working life. To answer the question of sustainability: the indication and the therapy plan must be right.

Large-volume liposuction can be useful for lipoedema sufferers, taking into account the risks. Lipoaspirate volumes of over 10 liters of pure fatty tissue can also be suctioned out. Such large-volume liposuctions must be well planned, the treatment is carried out on an inpatient basis and also involves risks, which we will be happy to explain to you in a personal consultation. For liposuctions covered by health insurance, the upper limit of the current guidelines is adhered to.

We perform liposuction on an outpatient basis up to a volume of 4 liters. Our experience has shown that inpatient treatment has many advantages for larger volumes. The biggest advantage is that we can check on your condition and support you accordingly in all your concerns. The small incisions for liposuction often cause you to lose fluid afterwards, which is often uncomfortable at home. If you stay in the clinic, you can leave the leaking solution in the hospital. Patients find it relaxing if they do not feel the pressure of having to go home immediately after the operation. The follow-up examination is also simplified in the first few days. We will see you every day without you having to be taken to or collected from the surgery. We therefore recommend treating liposuction from 3-4 liters on an inpatient basis for one night. The more voluminous the liposuction, the longer the stay should be planned. For liposuction of 8 liters or more of pure fat, we recommend a stay of 2-3 days.

The final component of our complex surgical treatment plan for lipoedema is the treatment of any excess skin and soft tissue. In many cases, this pillar of treatment should certainly not be neglected as the soft tissue regresses on its own to a certain extent.

If there is little excess skin to be expected, we recommend minimally invasive tightening using a radiofrequency device in combination with an inert gas plasma beam. The device we use for this is a high-frequency device and shows very good tightening results in our everyday clinical practice.

In the case of pronounced excess soft tissue, there is sometimes a medical indication for body contour restoration. This is particularly the case for patients with stage 3 or massive weight loss in conjunction with lipoedema. The most frequently performed lifting operations are thigh and upper arm lifts, although abdominoplasty, circular torso and buttock lift procedures are also used.

In the vast majority of cases, liposuction for lipoedema is a self-pay service. Health insurance only covers the costs in stage three and after an individual decision. We will be happy to inform you about the possible costs of liposuction treatment in a personal consultation. During this consultation, we will draw up a customized treatment plan and a corresponding cost breakdown.