Liposuction reduced pain for 68.3% of surgical patients

After several months of conservative pretreatment, patients at 11 sites in Germany were randomized in the LIPLEG trial to continued conservative therapy or liposuction. At 12 months, 68.3% of the surgical group had achieved clinically relevant pain reduction—at least two points on a 10-point scale—versus 7.6% in the conservative group. Published in The Lancet, the trial included 410 patients with stage I to III lipedema.

Lipedema is a chronic, painful fat-distribution disorder that almost exclusively affects women. Liposuction removes the abnormally increased fatty tissue locally, while conservative treatment relies on lymphatic drainage, compression and exercise. The study also found a marked improvement in quality of life. Oliver A. Cornely, scientific director of the Clinical Trials Center Cologne, described the pain reduction as clinically significant.

The result is not a risk-free substitution. Adverse events occurred more often in the liposuction group, and serious complications were observed only in the surgical arm. Researchers are continuing to follow participants for 36 months to examine whether the benefits last and whether late complications emerge; they also say further work is needed to compare surgical techniques.

For patients, the practical change is a clearer basis for discussing surgery when conservative care has provided limited relief. In Germany, the Joint Federal Committee decided in 2025 to include liposuction for lipedema in statutory health insurance coverage under defined conditions. The new publication provides an important basis for decisions about coverage and could contribute to a reassessment of treatment strategy, while individual risk-benefit decisions require careful assessment.