Liposuction reduced pain in women with lipoedema, trial finds
A large, randomized trial found substantially greater pain relief with liposuction than with conservative therapy in female patients, although adverse events were more common.
Liposuction significantly reduced leg pain and improved quality of life among women with lipoedema, according to the first large multicentre randomized trial to compare the procedure with standard conservative treatment.
The study, published in The Lancet, enrolled 453 women with stage I, II, or III lipoedema at 11 centres in Germany. Lipoedema is a chronic disorder of subcutaneous adipose tissue that predominantly affects women, typically causing disproportionate fat accumulation in the legs and sometimes the arms, along with pain, tenderness, and an increased tendency to bruise.
Participants first received up to seven months of conservative therapy, which included lymphatic drainage, compression, and exercise. Investigators then randomly assigned 410 patients, in a 2-to-1 ratio, to undergo liposuction or continue conservative treatment.
After 12 months, 190 of 278 patients assigned to liposuction (68%), reported a reduction of at least two points in leg pain on a 10-point scale. The same improvement was reported by 10 of 132 patients receiving conservative therapy (8%). Quality-of-life measures also showed greater improvement following liposuction.
“Our data show for the first time that liposuction for lipoedema can achieve a very significant and clinically relevant reduction in pain,” Professor Dr. Oliver A. Cornely, MVZ Dermatology Practice Düsseldorf, said in a news release.
The study showed, however, that benefits were accompanied by greater risks. Adverse events were reported in 124 of 265 patients (47%) who underwent liposuction compared to 30 of 145 patients (21%) receiving conservative therapy. Serious adverse events occurred in 8% and 3% of patients, respectively.
“At the same time, we must clearly state the surgical risks. It is not a trivial intervention, but an effective and yet invasive treatment option that must be carefully weighed and monitored,” Dr. Cornely added.
The findings suggest that liposuction may offer a clinically meaningful option for appropriately selected patients whose symptoms persist despite conservative treatment. However, the investigators emphasized the need for individualized risk-benefit assessments.
Follow-up is continuing for 36 months to determine whether the improvements are sustained and to identify possible late complications. Further research is also needed to clarify long-term safety and compare surgical techniques.
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