Ultrasound Assisted Liposuction with VASER for lower limb lipedema: a single-center cohort of 191 female patients.

[INTRODUCTION] Lipedema, a chronic condition affecting 11% of women, causes abnormal fat buildup in the lower limbs, leading to disproportionate body shape and functional problems. Often misdiagnosed, its cause is unclear, and conservative treatments are typically tried first. If these fail, surgical options like lymphatic-sparing liposuction, including ultrasound-assisted liposuction (UAL), may be considered for lower limb lipedema after six months of conservative treatment.

[MATERIALS AND METHODS] Our cohort included 191 patients with lower limb lipedema (stages 1-3) who underwent two stages of lymphatic-sparing UAL following six months of conservative treatment. Outcome measures included changes in pain assessment using visual analog scales, pannus thickness, aesthetic satisfaction, and the documentation of complications before and 12 months after the complete surgical treatment.

[RESULTS] Our protocol resulted in significant reductions in circumferences across all assessed regions (p < 0.001), with an average decrease of -6.396 cm [-9.268; -3.523]. Pain levels, sensitivity to touch, bruising, and other discomforts significantly decreased following liposuction (all p < 0.0001). Complication rates were within expected ranges, with no instances of postoperative phlebitis. All patients reported high levels of post-treatment satisfaction.

[CONCLUSION] The integration of a comprehensive medical protocol for managing lipedema, combined with the use of next-generation lymphatic-sparing UAL in two-stage procedures for the lower limbs, shows promising potential. These findings highlight the effectiveness and safety of liposuction in treating lipedema, providing valuable insights for clinical practice. Long-term follow-up studies are necessary to confirm sustained efficacy.Level of evidence: II.