{"id":21378,"date":"2024-11-27T13:21:54","date_gmt":"2024-11-27T13:21:54","guid":{"rendered":"https:\/\/drpapaioannou.gr\/%category_slug%\/lipedema-therapy\/lipedema-treatment-with-liposuction\/"},"modified":"2025-10-31T11:45:44","modified_gmt":"2025-10-31T11:45:44","slug":"lipedema-treatment-with-liposuction","status":"publish","type":"surgeries","link":"https:\/\/drpapaioannou.gr\/en\/body-contouring\/lipedema-therapy\/lipedema-treatment-with-liposuction\/","title":{"rendered":"Lipedema Treatment with Liposuction"},"content":{"rendered":"\t\t
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To date, liposuction<\/strong> remains the most appropriate and widely accepted treatment for lipedema at any stage or severity within the medical community. Lipedema should be viewed as an aggressive, space-occupying condition, in which pathological tissue grows uncontrollably at the expense of the healthy tissues of the limbs. Treatment focuses on relieving and freeing the limbs from its spread<\/strong>.<\/p>

From this perspective, liposuction is the most direct, effective, and minimally traumatic method for removing lipedema tissue<\/strong>. It is important to note that liposuction does not replace a healthy diet and regular exercise. As with any surgical procedure, a discussion with your doctor is essential before making any decisions regarding liposuction.<\/p><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Liposuction for Lipedema: Safe and Effective Fat Removal
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The main feature of liposuction in lipedema patients is, first of all, the increased volume of fat removed. Typically, quantities exceed 5 liters of fat, which is why we use the term megaliposuction<\/strong>. <\/p>\n

To make this possible, more specialized liposuction equipment <\/strong>and technical expertise <\/strong>are usually required to perform these procedures safely. In the author\u2019s opinion, the available technical tools\u2014i.e., the liposuction devices\u2014are merely instruments that allow the surgeon to perform the procedure faster or more efficiently, and they are not as crucial as the surgeon\u2019s technical skills. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Anesthesia in Liposuction
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Regardless of the liposuction technique, anesthesia is almost exclusively general<\/strong>, mainly for safety and practicality.<\/p>

General anesthesia offers significantly higher safety levels compared to local anesthesia or sedation, for the following reasons: local anesthesia involves injecting an anesthetic, such as xylocaine or lidocaine, into the fat<\/strong>, which requires a specific concentration, quantity, and time to act.<\/p>

However, these drugs can have cardiotoxic effects and other side effects above certain doses, limiting the amount that can be administered to each patient. Additionally, local anesthesia requires 20\u201340 minutes <\/strong>to take full effect, which adds to the total operation time.<\/p>

For small liposuctions, local anesthesia is acceptable, but in lipedema, it is impossible and extremely risky to remove large volumes of fat with local <\/strong>anesthesia. Likewise, combining local anesthesia with sedation is also unsuitable, because in most cases the procedure requires a prone position, which increases risk under sedation due to limited access to the mouth and nose for proper ventilation if needed.<\/p>

For these reasons, general anesthesia combined with low-dose local anesthesia is the safest<\/strong>, fastest, and most effective method for performing liposuction in lipedema<\/a>.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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Enhance your silhouette as it deserves.<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Lipedema treatment focuses on body harmony\u2014without pain, swelling, or unnecessary exhaustion.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Techniques for Lipedema Treatment with Liposuction
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Often, the surgical technique of liposuction is mistakenly equated with the liposuction device. However, the surgeon\u2019s technique <\/strong>is decisive, not the device, since all offered liposuction technologies can provide excellent results in skilled hands. <\/p>\n

The main difference lies in the speed, precision, and efficiency <\/strong>that newer assisted-liposuction technologies offer, which can make one technique preferable over another.<\/p>\n

From the author\u2019s personal experience and general medical consensus, the two most suitable assisted-liposuction technologies are Microaire PAL<\/strong> (Power-Assisted Liposuction) and Water-Assisted Liposuction (WAL)<\/strong>, e.g., Bodyjet.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Power-Assisted Liposuction with Microaire PAL for Lipedema
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PAL<\/strong> has the advantage of being faster <\/strong>than WAL, allowing larger volumes to be removed in a shorter time and providing precision in shaping<\/strong>, i.e., liposculpture.<\/p>\n

The method works as follows: first, a solution of saline containing local anesthetic <\/strong>and hemostatic agents is injected into the areas to be treated using a pump.<\/p>\n

After allowing time for the hemostatic agents to take effect, removal begins with the vibrating cannula<\/strong>. The vibration mobilizes surrounding tissues more effectively while reducing resistance during liposuction, minimizing trauma to adjacent tissues.<\/strong><\/p>\n

The PAL mechanism <\/strong>works like an electric toothbrush: the vibration reduces the required back-and-forth movements, protecting the tissues. The suction of lipedema tissue and fat is performed via a vacuum pump <\/strong>connected to the PAL cannula handle. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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Water-Assisted Liposuction (WAL) for Lipedema
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Similarly, WAL (Bodyjet)<\/strong> works by preparing the tissues with a local anesthetic solution, as in PAL. The main difference lies in how the fat is released.<\/p>\n

A pulsed water jet is ejected <\/strong>from the cannula tip, breaking up fat and pathological tissue, which is then removed through the cannula.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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This method has advantages in terms of being minimally traumatic, but its drawbacks include longer procedure times <\/strong>and large fluid volumes required.<\/p>\n

These fluids cause more extensive swelling and discomfort during the initial hours post-surgery. However, Bodyjet is preferred in certain specialized cases.<\/strong><\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Liposuction for Lipedema in Our Clinic
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In our practice, the Microaire PAL technique is predominantly used<\/strong>, with Bodyjet applied only in specific cases. It should be emphasized that the technique does not ultimately determine the outcome; it is a tool for the surgeon. <\/p>\n

Reducing operative time and tissue trauma makes liposuction even safer and allows safe large-volume liposuctions<\/strong>. Other techniques, such as Vaser liposuction, have been tested with good results but increase operative time and cost without significant advantage over PAL, while some methods are entirely unsuitable because they cannot remove large volumes. Other techniques, such as Vaser liposuction, have also been tried with good results. However, they tend to increase the duration and cost of the procedure without offering any significant advantage compared to power-assisted liposuction (PAL). In addition, some techniques are entirely unsuitable, as they do not allow for the removal of large fat volumes.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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Liposuction: Strategies in Lipedema
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When evaluating a patient with lipedema, key questions include: how much lipedema can be removed, how large volumes need removal, whether one or multiple procedures are needed to achieve the desired result, and whether aesthetic and functional improvements are achievable.<\/p>

Conservative treatment <\/a>considerations also include total body weight, the patient\u2019s ability to lose weight before or after surgery, age, and the degree, extent, and location of lipedema.<\/p>

The goal of surgery is to remove as much lipedema tissue as possible, along with some healthy fat if feasible. In each procedure, the maximum fat removal ranges from 5 liters to 9\u201310 liters. However, larger volumes increase recovery difficulty, blood loss, hematocrit drop, and the likelihood of requiring transfusions.<\/strong> In each procedure, the maximum amount of fat that can be removed ranges from 5 liters up to 9\u201310 liters. However, the larger the amount removed in a single procedure, the more difficult the recovery becomes, the greater the blood loss and the drop in hematocrit, and the higher the likelihood that blood transfusions will be needed.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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In practice, removal of up to 5 liters is accompanied by a relatively smooth recovery, up to 7 liters allows for an acceptable recovery, and above 7 liters makes liposuction considerably more taxing and the recovery more difficult<\/strong>. For this reason, we generally prefer not to exceed 7 liters per procedure<\/p>\n

Therefore, in cases where lipedema affects larger volumes, it is preferable to perform more than one procedure.<\/p>\n

The way we select the areas for each session depends on the distribution of lipedema<\/strong>. Usually, if there are two procedures<\/strong>, we start the first session on the posterior side of the body, meaning the back of the thighs, calves, ankles, and possibly the arms, with possible extension to the inner thighs.<\/p>\n

In the second session<\/strong>, we complete the anterior part of the lower limbs, the calves, thighs, and knees, and possibly improve other areas as deemed necessary. Cases requiring more than two procedures are in grade 3 and higher lipedema<\/strong>, combined with obesity, where it may be necessary to treat the arms separately from the lower limbs. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Therapeutic strategy according to the grade of lipedema:
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