Non-Cosmetic Liposuction

For some people with Lipoedema, non-cosmetic liposuction may be appropriate.

Cosmetic or non-cosmetic liposuction – what’s the difference?

Conventional cosmetic surgery is not suitable for patients with Lipoedema and may cause long-term damage to areas affected by Lipoedema.

Non-cosmetic liposuction for Lipoedema, also called Lipedema Reduction Surgery (LRS), differs from cosmetic surgery in technique. It requires specialised training. A surgical treatment option, non-cosmetic liposuction involves using specialist suction techniques to remove the abnormal build-up of fatty tissue from affected areas. Surgeons and their teams must be trained and experienced in treating patients with Lipoedema.

What does non-cosmetic liposuction involve?

Liposuction can be performed under general or local anaesthetic, depending on the technique. Different liposuction techniques include tumescent, water-jet assisted and vibration liposuction, all of which use blunt suction cannulas, which are gentler on the lymphatic vessels. Each specialist surgeon/clinic will have their own specific technique, assessment criteria and clinical procedures in place.

Liposuction procedures are not without risk, both post-operatively and in the longer term. Patients considering it should research their surgeon’s experience and the facilities carefully, in order to make certain they provide adequate standards of care, and to ensure the procedures offered are appropriate for their individual needs.

A patient’s age, the condition of their skin and tissues and weight gain can have an impact on the results of liposuction, and post-operative pain and swelling are inevitable, and may take months to resolve. Some patients may need life-long compression therapy to maintain results.

Anyone considering surgery should undertake non-surgical (conservative) treatments for at least six months prior to surgery, including compression therapy as recommended by their surgeon.

After surgery, patients should plan adequate recovery time. This will involve planning a patient’s homecoming, putting in place support from family or neighbours, and ensuring there are easy meals available. Many surgeons recommend a post-operative course of Manual Lymphatic Drainage (MLD) treatments to reduce post-operative swelling and hasten recovery. It is always advisable to research reputable MLD clinicians who are experienced in treating Lipoedema patients, and to prebook the sessions recommended (and factor this in as an additional cost).

Liposuction for Lipoedema is rarely a one-off operation, as most surgeons prefer to treat different areas of the body at a time. (The reasons for this include allowing the body to recover and the skin to retract. There are also recommendations relating to quantities of fat that should be removed during a single operation.) Post-operative recovery can be more time-consuming depending on the area treated.

Even after liposuction, Lipoedema remains a long-term condition requiring careful management. Maintaining the results of any successful liposuction treatments can depend on sustaining a health weight and lifestyle.

Is liposuction for Lipoedema available in the UK on the National Health Service (NHS)?

No, not at the moment. The NHS does not currently undertake this procedure for Lipoedema, but it may be available for individuals with lymphoedema where deemed appropriate.

The UK Best Practice Guidelines for the Management of Lipoedema describes non-surgical liposuction as appropriate for some people with Lipoedema. There is evidence that liposuction can reduce tissue bulk, pain and bruising, and improve mobility, function and quality of life. There is also evidence of longer-term benefits. However, in 2022 The National Institute for Health and Care Excellence (NICE) published interventional procedures guidance, Liposuction for Chronic Lipoedema, which states that the evidence on the efficacy and safety of liposuction for chronic Lipoedema is inadequate.

The NICE committee has confirmed that Lipoedema is still under-recognised and can be ‘extremely debilitating’. NICE also subsequently called for further research into the treatment of chronic Lipoedema (to read the 2022 press release, click here). NICE acknowledges that its guidance will be reviewed when data on a randomised controlled trial in Germany is published (possibly in 2025), or when further evidence on the efficacy and safety is available.

It’s essential that anyone considering liposuction does their own further research into the procedure. It’s important to consider the likely benefits and risks, as well as the different techniques available and where clinics are located, plus the cost. For example, the quantity of fat a surgeon promises to remove during one operation is not the only factor to consider, and it is unrealistic to expect the same results as photographs that might be displayed on social media.

There are a few private surgeons in the UK offering non-cosmetic liposuction. Many women with Lipoedema also seek private surgery overseas, particularly in Germany, where there is a wide range of surgeons who are experienced in non-cosmetic liposuction for Lipoedema patients.

Lipoedema UK’s campaigning role

Since 2014 and the publication of our ground-breaking Lipoedema UK Big Survey, we have been working with renowned surgeons and collecting stories and patient data from hundreds of patients who have or have not had surgery. Despite the challenges of multiple, time-consuming operations, many involving trips abroad and challenging post-operative recoveries, most patients report positive outcomes when they have chosen properly trained surgeons with resources and experience of their specific stage of Lipoedema and patient criteria.

Lipoedema UK devoted considerable resources to preparing evidence for the NICE Review Committee in 2021. Dr Kristiana Gordon, our Patron, and Sharie Fetzer, our Chair, were called as expert witnesses at the first Committee session. We continue to seek new evidence to satisfy NICE’s concerns.

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