CC BY 4.0 · Arch Plast Surg
DOI: 10.1055/a-2334-9260
Original Article

Safety and Effectiveness of Liposuction Modalities in Managing Lipedema: Systematic Review and Meta-Analysis

Hatan Hisham Mortada
1   Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, Riyadh, Saudi Arabia (Ringgold ID: RIN534884)
2   Department of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia (Ringgold ID: RIN37850)
Sultan Alaqil
3   College of Medicine, King Saud University, Riyadh, Saudi Arabia (Ringgold ID: RIN37850)
Imtinan Al Jabbar
4   College of Medicine, King Khalid University, Abha, Saudi Arabia (Ringgold ID: RIN48144)
Fatimah Alhubail
5   College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia (Ringgold ID: RIN114800)
Nicolas ABDULAZIZ Pereira
6   Specialized Center in Lymphedema and Lipedema, Hospital del Trabajador de Santiago, Chilie, Chile (Ringgold ID: RIN60753)
Joon Pio Hong
7   Department of Plastic and Reconstructive Surgery, Asan Medical Center, Songpa-gu, Korea (the Republic of) (Ringgold ID: RIN65526)
Feras Alshomer
7   Department of Plastic and Reconstructive Surgery, Asan Medical Center, Songpa-gu, Korea (the Republic of) (Ringgold ID: RIN65526)
› Author Affiliations

Introduction Lipedema is a chronic, incurable disorder characterized by painful fat accumulation in the extremities. While the application of liposuction in lipedema management has become increasingly popular, the safety and effectiveness of this approach remain contentious. Our systematic review and meta-analysis aimed to assess various liposuction modalities in lipedema management to verify their safety and efficacy. Methods In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we performed a comprehensive literature review from inception until March 2023 using the following electronic databases: CENTRAL, MEDLINE, Google Scholar, and EMBASE. Results From the 562 initially identified articles, 20 met our inclusion/exclusion criteria for evaluation. Our review encompassed 14 prospective cohort studies, three retrospective studies, two case series, and one cross-sectional study. A meta-analysis of nine articles revealed a notable improvement in the quality of life, pain, pressure sensitivity, bruising, cosmetic impairment, heaviness, walking difficulty, and itching among lipedema patients who underwent liposuction. Although complications such as inflammation, thrombosis, seroma, hematoma, and lymphedema-related skin changes were reported, severe complications were rare. Crucially, no instances of shock, recurrence, or mortality were reported. Conclusion In conclusion, liposuction is a safe and beneficial therapeutic intervention for managing lipedema symptoms and enhancing quality of life. However, the impact of liposuction on secondary lymphedema remains unreported in the literature. Further high-quality, large-scale trials are necessary to assess the safety and effectiveness of different liposuction modalities. These studies will contribute valuable insights to optimize liposuction as a therapeutic option for individuals with lipedema.

Publication History

Received: 29 September 2023

Accepted after revision: 19 May 2024

Accepted Manuscript online:
28 May 2024

© . The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

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