International publications and recommended readings

Tumescent liposuction in lipoedema yields good long-term results

W. Schmeller, M. Hueppe and I. Meier-VollrathBrit J Dermatol 2012;166: 161-168

Summary

Background Lipoedema is a painful disease in women with circumscribed increased subcutaneous fatty tissue, oedema, pain and bruising. Whereas conservative methods with combined decongestive therapy
(manual lymphatic drainage, com- pression garments) have been well established over the past 50 years, surgical therapy with tumescent liposuction has only been used for about 10 years and long-term results
are unknown.

Objectives:

To determine the efficacy of liposuction concerning appearance (body shape) and associated complaints after a long-term period. Methods A total of 164 patients who had undergone conservative therapy over a period of years, were treated by liposuction under tumescent local anaesthesia with vibrating microcannulas. In a monocentric study, 112 could be re-evaluated with a standardized questionnaire after a mean of 3 years and 8 months (range 1 year and 1 month to 7 years and 4 months) following the initial surgery and a mean of 2 years and 11 months (8 months to 6 years and 10 months) following the last surgery.

Results:

 All patients showed a distinct reduction of subcutaneous fatty tissue (aver- age 9846 mL per person) with improvement of shape and normalization of body proportions. Additionally, they reported either a marked improvement or a com- plete disappearance of spontaneous pain, sensitivity to pressure, oedema, bruis- ing, restriction of movement and cosmetic impairment, resulting in a tremendous increase in quality of life; all these complaints were reduced signifi- cantly (P < 0Æ001). Patients with lipoedema stage II and III showed better improvement compared with patients with stage I. Physical decongestive therapy could be either omitted (22Æ4% of cases) or continued to a much lower degree. No serious complications (wound infection rate 1Æ4%, bleeding rate 0Æ3%) were observed following surgery.

Conclusions: 

Tumescent liposuction is a highly effective treatment for lipoedema with good morphological and functional long-term results.

Correspondence: 

Prof. Dr. W. Hanse-Klinik, St-Juergen-Ring 66, D-23564 Lübeck, Germany, (E-mail: ws@hanse-klinik.com)
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