The first step in managing your fat disorder should always be conservative therapies including: dry brushing, MLD, compression, a healthy eating plan low in processed carbohydrates and refined sugars, exercise, CDT, supplements, and medications. However, liposuction may be necessary if you are in significant pain, have experienced altered mobility and/or gait, or feel strain on any joints such as the knee. Keep in mind that liposuction is surgery so there are risks involved including post-operative pain, bleeding, and infection.

Liposuction for lipedema is NOT a cosmetic procedure. In fact, due to potential skin retraction problems, the cosmetic results may not be great. But liposuction can offer pain relief to those patients with lipedema and Dercum’s Disease. However, it must be done in a way that causes as little damage to the lymphatic system as possible so finding a surgeon experienced in liposuction as a treatment for fat disorders is critical.

No one really understands why liposuction works to relieve pain since the total body mass removed may be a very small percentage. Some experts believe that the procedure changes your metabolic processing with weight loss typically occurring for the first 18 months following surgery. There are two main liposuction techniques that are effective for those with fat disorders: the tumescent technique and water assisted liposuction (WAL.)

The tumescent technique is commonly done under local anesthesia. During this procedure, the surgeon saturates the tissue with fluid and anesthesia before liposuctioning the fat. WAL, or the water-assisted liposuction technique, is a specific type of tumescent liposuction. Less fluid is used initially, but the cannula that suctions the fat has a water jet attached which facilitates removing the fat cells without causing as much damage. This, too, can be done under local anesthesia. 

Tumescent, WAL (and a host of others) are actually the device to perform the liposuction.  What is most important is not the device itself but rather who the surgeon is, how they are trained, their experience with fat disorders and their results.  If you are considering liposuction, do your research. Review their educational and training background.  Are they board certified?  Research the differences in the training requirements for each board certification (there are differences).   Who has experience treating patients with lipedema and Decrum’s Disease? Join a Facebook group (see below) and hear from other patients.  Schedule a consultation with the one or two whose philosophy aligns with yours.

During your consultation, make sure to ask the following:

  • How many procedures do you recommend and how would they be broken up to improve my recovery?
  • May I speak with one of your lipedema patients about her experience?
  • How do you define a successful procedure - reduced pain, cosmetic results, slowing the disease progression?
  • Do you recommend losing weight before the surgery? After?
  • Will you test my lymphatic function before surgery? If so, how?  If no, why not?  
  • How is liposuction on lipedema fat different from liposuction with regular fat?
  • Am I a good candidate?
  • What risks should I be aware of?
  • What will recovery be like? How long might it take?
  • What are your pre-operative instructions?  What are you post-operative instructions?
  • How much will my procedures cost? Do you take insurance?  Are there other costs I should include in my budget?

Liposuction Support Group on Facebook:  

Liposuction for Lipedema