Q: I have been told lipedema reduction surgery is not a good idea as it will come back in two years and be worse than before. What is your experience?
Response from Dr. Wright: Lipedema reduction surgery reduces the amount lipedema tissue. It will not completely eliminate it. In most cases, lipedema pain, swelling and bulk stays reduced for many years (and possibly your whole life). However, it is possible lipedema can become worse. This is usually associated with hormonal changes and other health stressors.
The best evidence for persistent benefit of lipedema reduction surgery is a study conducted by Baumgartner, and etal in 2019 which reported positive effects of liposuction last 12 years after surgery without relevant worsening.
However, in the U.S., lipedema reduction surgery results seem more mixed. A self-reported survey published by Dr. Herbst Wright, and others in 2021, showed more patients with regrowth (or new growth) over time. However, adherence by patients in the in U.S. to diet and compression is worse, and surgeons sometimes do very different procedures to reduce lipedema tissue. At Laser Lipo and Vein Center, my team follows European liposuction reduction techniques to treat lipedema and lymphedema. These methods include taking extra precautions to protect the lymphatic system, and helping patients adhere to strict lifestyle measures such as diet, compression and manual lymphatic drainage therapy to help create best possible outcomes after liposuction.
Here are some additional findings from the survey on plastic and reconstructive surgery in the U.S. we found:
Subjects: 148 women answered the 166-item questionnaire after undergoing lipedema reduction surgery in the USA. Overall, women who completed the survey reported improvements from the reduction surgery
- Quality of life improved in 84% and pain improved in 86% of patients
- The ability to walk without the need for any kind of assistance improved most in lipedema Stage 3 (96%)
- Areas where patients lost lipedema tissue reduction surgery. 44% under the knees, 38% in the ankle cuff, 37% in inner knee fat, and 23% in lower arm fat
- Of the 108 women who could not wear boots on their legs before surgery, 71 were able to wear boots post procedure (66%)
- Dress size significantly decreased 2 sizes (n = 133), pant size significantly decreased 3 sizes
- Weight loss occurred in all stages by 3 months after surgery
- About 30% of women without lymphedema were able to stop wearing compression garments within 3 months after their procedure as they no longer felt the need to wear compression or were no longer required to or both
- Most participants (92%) reported feeling their body was misshapen before lipedema reduction surgery; after the procedure, 77% indicated they felt their body was in a better shape
- Complications after lipedema reduction procedures included growth of loose connective tissue within and outside treated areas, tissue fibrosis, anemia, blood clots, and lymphedema
- 84% of women wanted more lipedema reduction surgery, and 90% indicated if they were given the chance to have the same lipedema reduction surgery procedure(s) over again, they would
 Baumgartner A, Hueppe M, Meier-Vollrath I, Schmeller W. Improvements in patients with lipedema 4, 8 and 12 years after liposuction. Phlebology. 2021 Mar;36(2):152-159. doi: 10.1177/0268355520949775. Epub 2020 Aug 26. PMID: 32847472.
 Herbst, Karen & Hansen, Emily & Salinas, Leopoldo & Wright, Thomas & Larson, Ethan & Schwartz, Jaime. (2021). Survey Outcomes of Lipedema Reduction Surgery in the United States. Plastic and reconstructive surgery. Global open. 9. e3553. 10.1097/GOX.0000000000003553.