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. 2024 Aug 6;51(5):510-526.
doi: 10.1055/a-2334-9260. eCollection 2024 Sep.

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

Hatan Mortada  1   2 , Sultan Alaqil  3 , Imtinan Al Jabbar  4 , Fatimah Alhubail  5 , Nicolas Pereira  6 , Joon Pio Hong  7 , Feras Alshomer  8
Affiliations

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

Hatan Mortada et al. Arch Plast Surg. .

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; lipoedema; lipoplasty; liposculpture; liposuction; quality of life; suction-assisted lipectomy.

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Conflict of interest statement

Conflict of Interest J.P.H. is an editorial board member of the journal but was not involved in the peer reviewer selection, evaluation, or decision process of this article. No other potential conflicts of interest relevant to this article were reported.

Figures

Fig. 1
Fig. 1
PRISMA flowchart illustrating the study selection process. The diagram outlines the number of studies identified, screened, assessed for eligibility, and included in the systematic review and meta-analysis, along with the reasons for exclusion at each stage. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-analyses.
Fig. 2
Fig. 2
Forest plot showing the quality of life levels before and after liposuction in patients with lipedema. The standardized mean difference and corresponding 95% confidence intervals (CIs) are presented for each study. The diamond represents the overall effect size. SD, standard deviation.
Fig. 3
Fig. 3
Forest plot illustrating the pain outcomes before and after liposuction in patients with lipedema. The standardized mean difference and its 95% confidence intervals (CIs) are displayed for each study. The diamond symbol represents the overall effect size. SD, standard deviation.
Fig. 4
Fig. 4
Forest plot showing sensitivity to pressure levels before and after liposuction in patients with lipedema. The standardized mean difference and corresponding 95% confidence intervals (CIs) are presented for each study. The diamond represents the overall effect size. SD, standard deviation.
Fig. 5
Fig. 5
Forest plot showing bruising levels before and after liposuction in patients with lipedema. The standardized mean difference and corresponding 95% confidence intervals (CIs) are presented for each study. The diamond represents the overall effect size. SD, standard deviation.
Fig. 6
Fig. 6
Forest plot showing cosmetic impairment levels before and after liposuction in patients with lipedema. The standardized mean difference and corresponding 95% confidence intervals (CIs) are presented for each study. The diamond represents the overall effect size. SD, standard deviation.
Fig. 7
Fig. 7
Forest plot showing the heaviness before and after liposuction in patients with lipedema. The standardized mean difference and corresponding 95% confidence intervals (CIs) are presented for each study. The diamond represents the overall effect size. SD, standard deviation.
Fig. 8
Fig. 8
Forest plot showing the difficulty in walking levels before and after liposuction in patients with lipedema. The standardized mean difference and corresponding 95% confidence intervals (CIs) are presented for each study. The diamond represents the overall effect size. SD, standard deviation.
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    Mortada H, Alhithlool AW, AlBattal NZ, Shetty RK, Al-Mekhlafi GA, Hong JP, Alshomer F. Mortada H, et al. Arch Plast Surg. 2025 May 15;52(3):185-196. doi: 10.1055/a-2530-5875. eCollection 2025 May. Arch Plast Surg. 2025. PMID: 40386000 Free PMC article.

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