Abstract
Background 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
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, 3 retrospective
studies, 2 case series, and 1 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 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.
Level of Evidence I, risk/prognostic study.
Keywords
lipedema - liposuction - lipoedema - liposculpture - lipoplasty - quality of life
- suction-assisted lipectomy
