Efficacy of Liposuction in the Treatment of Lipedema: A Meta-Analysis

Abstract

Lipedema, a chronic and painful disorder primarily affecting women without a definitive cure, has traditionally been managed with conservative therapy, notably complete decongestive therapy, across many countries. Recently, liposuction has been explored as a potential surgical treatment, prompting this study to evaluate its effectiveness as possibly the first-line therapy for lipedema. Through extensive literature searches in databases such as CrossRef, Web of Science, PubMed, and Google Scholar up to December 2023, and using the Newcastle-Ottawa Scale for quality assessment, the study selected seven studies for inclusion. Results showed significant post-operative improvements in spontaneous pain, edema, bruising, mobility, and quality of life among lipedema patients undergoing liposuction. However, over half of the patients still required conservative therapy after surgery. Despite these promising results, the study suggests caution due to lipedema's complexity, significant reliance on self-reported data, and limitations of the studies reviewed. Thus, while liposuction may offer symptomatic relief, it should be considered an adjunct, experimental therapy rather than a definitive cure, emphasizing the need for a comprehensive approach to care.

Keywords: large-volume liposuction; lipedema; liposuction; liposuction complication; meta-analysis.

Figure 1. PRISMA flow diagram for study selection.

PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Figure 2. Forest plot comparing pre and post-operative complaint scores for spontaneous pain.

Witte et al. 2020 [27], Schmeller et al. 2012 [28], Kirstein et al. 2023 [29], Dadras et al. 2017 [30], Baumgartner et al. 2021 [31], Rapprich et al. 2010 [32], Wollina and Heinig 2019 [33]

Figure 3. Forest plot comparing pre and post-operative complaint scores for edema/swelling.

Witte et al. 2020 [27], Schmeller et al. 2012 [28], Kirstein et al. 2023 [29], Dadras et al. 2017 [30], Baumgartner et al. 2021 [31], Rapprich et al. 2010 [32], Wollina and Heinig 2019 [33]

Figure 4. Forest plot comparing pre and post-operative complaint scores for bruising.

Witte et al. 2020 [27], Schmeller et al. 2012 [28], Kirstein et al. 2023 [29], Dadras et al. 2017 [30], Baumgartner et al. 2021 [31], Rapprich et al. 2010 [32], Wollina and Heinig 2019 [33]

Figure 5. Forest plot comparing pre and post-operative complaint scores for mobility impairment.

Witte et al. 2020 [27], Schmeller et al. 2012 [28], Kirstein et al. 2023 [29], Dadras et al. 2017 [30], Baumgartner et al. 2021 [31], Rapprich et al. 2010 [32], Wollina and Heinig 2019 [33]

Figure 6. Forest plot comparing pre and post-operative complaint scores for quality of life impairment.

Witte et al. 2020 [27], Schmeller et al. 2012 [28], Kirstein et al. 2023 [29], Dadras et al. 2017 [30], Baumgartner et al. 2021 [31], Rapprich et al. 2010 [32], Wollina and Heinig 2019 [33]

Figure 7. Forest plot showing the proportion of patients using conservative therapy after liposuction.

Witte et al. 2020 [27], Schmeller et al. 2012 [28], Baumgartner et al. 2021 [31], Rapprich et al. 2010 [32]