Liposuction as treatment for lipedema using WAL-Method
– Disorders of the circulatory system present no problems
for the outpatient procedure.
Background: Surgical treatment of lipedema usually requires removing larger
amounts of fat tissue than aesthetically motivated surgeries.
Some recommend inpatient surgery, when the amount of fat tissue that is to
be removed exceeds 2000ml. For larger amounts than 4000ml fat tissue,
the patient should be held in an intensive care unit.
This is due to the dangers of circulatory system disorders. Social courts use
this argument, in order for insurance companies to be able to bear the costs
for stationary treatment.
Specialist literature contradicts itself about the kind and frequency of
complications after liposuction.
In particular, no reliable data is found about circulatory system disorders,
their frequency and course, therefore not justifying inpatient treatment.
130 liposuctions using the waterjet assisted
liposuction method between January 2012
and July 2013 were assessed by the patients
using a school grading system, concerning the
commonness of circulatory system disorders.
(Grade 1 = No anomalies up to 6 =
It was analyzed if circulatory system disorders
were related to the operated area, the age of
the patient or the amount of fat removed.
If they occurred within 24 hours of surgery
or between day 2 and 7 after surgery.
It was enquired, whether or
not the patients felt well supervised
at home and if they would do
outpatient surgery again.
The distribution of areas operated is as follows: 41 calves, 67 thigh, 8 buttocks and 14 arm surgeries were done.
Circulatory system disorders were the only complications that occurred.
18% (n=24) Circulatory system disorders graded 4 (collapse) occurred within the first
24 hours after surgery, one of which was
During the first week after surgery, three
patients were advised stationary treatment, two of which needed blood transfusion.
Three women were not satisfied with
the supervision at home. Only six women would not do outpatient surgery again.
The circulatory system disorders were regardless of the women’s ages, however
there were correlations between the
amount of fat removed from thighs and the
occurrence of circulatory system disorders.
Three of four patients, that eventually had
to be treated stationary, showed no signs of anomalies after 24 hours after surgery.
The outpatient waterjet assisted liposuction method is a save way to treat lipedema, even if large amounts of fat tissue are to be removed.
A reliable and instructed assistant is required
in order be able to assist during the first 24
hours of surgery in case of circulatory system