{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:12:24Z","timestamp":1791875544658,"version":"4.3.4"},"reference-count":43,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T00:00:00Z","timestamp":1716854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background\u2003Lipedema is a chronic, incurable disorder characterized by painful fat accumulation in the extremities. While the application of liposuction in lipedema management has become increasingly popular, the safety and effectiveness of this approach remain contentious. Our systematic review and meta-analysis aimed to assess various liposuction modalities in lipedema management to verify their safety and efficacy.<\/jats:p>\n                  <jats:p>Methods\u2003In-line with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, we performed a comprehensive literature review from inception until March 2023 using the following electronic databases: CENTRAL, MEDLINE, Google Scholar, and EMBASE.<\/jats:p>\n                  <jats:p>Results\u2003From the 562 initially identified articles, 20 met our inclusion\/exclusion criteria for evaluation. Our review encompassed 14 prospective cohort studies, 3 retrospective studies, 2 case series, and 1 cross-sectional study. A meta-analysis of nine articles revealed a notable improvement in the quality of life, pain, pressure sensitivity, bruising, cosmetic impairment, heaviness, walking difficulty, and itching among lipedema patients who underwent liposuction. Although complications such as inflammation, thrombosis, seroma, hematoma, and lymphedema-related skin changes were reported, severe complications were rare. Crucially, no instances of shock, recurrence, or mortality were reported.<\/jats:p>\n                  <jats:p>Conclusion\u2003Liposuction is a safe and beneficial therapeutic intervention for managing lipedema symptoms and enhancing quality of life. However, the impact of liposuction on secondary lymphedema remains unreported in the literature. Further high-quality, large-scale trials are necessary to assess the safety and effectiveness of different liposuction modalities. These studies will contribute valuable insights to optimize liposuction as a therapeutic option for individuals with lipedema.<\/jats:p>\n                  <jats:p>Level of Evidence\u2003I, risk\/prognostic study.<\/jats:p>","DOI":"10.1055\/a-2334-9260","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T19:18:05Z","timestamp":1716923885000},"page":"510-526","source":"Crossref","is-referenced-by-count":16,"title":["Safety and Effectiveness of Liposuction Modalities in Managing Lipedema: Systematic Review and Meta-analysis"],"prefix":"10.1055","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1283-4136","authenticated-orcid":false,"given":"Hatan","family":"Mortada","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia"},{"name":"Department of Plastic Surgery & Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7548-4984","authenticated-orcid":false,"given":"Sultan","family":"Alaqil","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3698-8562","authenticated-orcid":false,"suffix":"Medical St","given":"Imtinan Al","family":"Jabbar","sequence":"additional","affiliation":[{"name":"College of Medicine, King Khalid University, Abha, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2043-648X","authenticated-orcid":false,"suffix":"Medical St","given":"Fatimah","family":"Alhubail","sequence":"additional","affiliation":[{"name":"College of Medicine, King Faisal University, Al Ahsa, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8859-8005","authenticated-orcid":false,"given":"Nicolas","family":"Pereira","sequence":"additional","affiliation":[{"name":"Specialized Center in Lymphedema and Lipedema, Cl\u00ednica Nea, Hospital del Trabajador, Regi\u00f3n Metropolitana, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6208-9704","authenticated-orcid":false,"given":"Joon Pio","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9282-3845","authenticated-orcid":false,"given":"Feras","family":"Alshomer","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, King Saud Bin Abdulaziz University for Health and Sciences, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,8,6]]},"reference":[{"key":"ref1","first-page":"184","article-title":"Lipedema of the legs: a syndrome characterized by fat legs and orthostatic edema","volume":"15","author":"E U Allen","year":"1940","journal-title":"Proc Staff Mayo Clin."},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.7326\/0003-4819-34-5-1243","article-title":"Lipedema of the legs; a syndrome characterized by fat legs and edema","volume":"34","author":"L E Wold","year":"1951","journal-title":"Ann Intern Med"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1111\/j.1365-2133.2009.09413.x","article-title":"Lipoedema: from clinical presentation to therapy. A review of the literature","volume":"161","author":"S I Langendoen","year":"2009","journal-title":"Br J Dermatol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"389","DOI":"10.2147\/IJWH.S106227","article-title":"Lipedema: diagnostic and management challenges","volume":"8","author":"A Warren Peled","year":"2016","journal-title":"Int J Womens Health"},{"key":"ref5","first-page":"396","article-title":"Lipedema-pathogenesis, diagnosis, and treatment options","volume":"117","author":"P Kruppa","year":"2020","journal-title":"Dtsch Arztebl Int"},{"issue":"21","key":"ref6","doi-asserted-by":"crossref","first-page":"11720","DOI":"10.3390\/ijms222111720","article-title":"Lipedema and the potential role of estrogen in excessive adipose tissue accumulation","volume":"22","author":"K Katzer","year":"2021","journal-title":"Int J Mol Sci"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"268","DOI":"10.3390\/jpm12020268","article-title":"A multi-gene panel to identify lipedema-predisposing genetic variants by a next-generation sequencing strategy","volume":"12","author":"S Michelini","year":"2022","journal-title":"J Pers Med"},{"key":"ref8","first-page":"417","volume-title":"Textbook of Lymphology: For Physicians and Lymphedema Therapists","author":"M F\u00f6ldi","year":"2006"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1111\/j.1758-8111.2012.00045.x","article-title":"Lipedema: an overview of its clinical manifestations, diagnosis and treatment of the disproportional fatty deposition syndrome - systematic review","volume":"2","author":"I Forner-Cordero","year":"2012","journal-title":"Clin Obes"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1097\/PSN.0000000000000245","article-title":"Lipedema: a commonly misdiagnosed fat disorder","volume":"38","author":"M Caruana","year":"2018","journal-title":"Plast Surg Nurs"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"20","DOI":"10.3390\/ijerph20031925","article-title":"Younger women with lipedema, their experiences with healthcare providers, and the importance of social support and belonging: a qualitative study","volume":"20","author":"V Christoffersen","year":"2023","journal-title":"Int J Environ Res Public Health"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1007\/s13555-018-0241-6","article-title":"Exploration of patient characteristics and quality of life in patients with lipoedema using a survey","volume":"8","author":"J RM Romeijn","year":"2018","journal-title":"Dermatol Ther (Heidelb)"},{"issue":"10","key":"ref13","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1177\/02683555211015887","article-title":"Standard of care for lipedema in the United States","volume":"36","author":"K L Herbst","year":"2021","journal-title":"Phlebology"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"e14364","DOI":"10.1111\/dth.14364","article-title":"Cause and management of lipedema-associated pain","volume":"34","author":"H Aksoy","year":"2021","journal-title":"Dermatol Ther"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"S30","DOI":"10.12968\/bjcn.2016.21.Sup4.S30","article-title":"Specialist approaches to managing lipoedema","author":"A Fetzer","year":"2016","journal-title":"Br J Community Nurs"},{"issue":"71","key":"ref16","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"M J Page","year":"2021","journal-title":"BMJ"},{"issue":"09","key":"ref17","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1046\/j.1445-2197.2003.02748.x","article-title":"Methodological index for non-randomized studies (minors): development and validation of a new instrument","volume":"73","author":"K Slim","year":"2003","journal-title":"ANZ J Surg"},{"issue":"02","key":"ref18","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1136\/bmjebm-2017-110853","article-title":"Methodological quality and synthesis of case series and case reports","volume":"23","author":"M H Murad","year":"2018","journal-title":"BMJ Evid Based Med"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1007\/s00105-022-05075-5","article-title":"Komplikationen und deren Management bei der chirurgischen Behandlung der Lipohyperplasia dolorosa","author":"M Cornely","year":"2022","journal-title":"Dermatologie (Heidelb)"},{"issue":"03","key":"ref20","doi-asserted-by":"crossref","first-page":"529e","DOI":"10.1097\/PRS.0000000000008880","article-title":"A 10-year retrospective before-and-after study of lipedema surgery: patient-reported lipedema-associated symptom improvement after multistage liposuction","volume":"149","author":"P Kruppa","year":"2022","journal-title":"Plast Reconstr Surg"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"e935016","DOI":"10.12659\/AJCR.935016","article-title":"A case series of lymphatic injuries after suction lipectomy in women with lipedema","volume":"23","author":"T F Wright","year":"2022","journal-title":"Am J Case Rep"},{"issue":"02","key":"ref22","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1177\/0268355520949775","article-title":"Improvements in patients with lipedema 4, 8 and 12 years after liposuction","volume":"36","author":"A Baumgartner","year":"2021","journal-title":"Phlebology"},{"issue":"03","key":"ref23","doi-asserted-by":"crossref","first-page":"326","DOI":"10.36849\/JDD.5828","article-title":"High volume liposuction in tumescence anesthesia in lipedema patients: a retrospective analysis","volume":"20","author":"M Sandhofer","year":"2021","journal-title":"J Drugs Dermatol"},{"issue":"06","key":"ref24","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1111\/iwj.13608","article-title":"Liposuction treatment improves disease-specific quality of life in lipoedema patients","volume":"18","author":"T Schlosshauer","year":"2021","journal-title":"Int Wound J"},{"issue":"04","key":"ref25","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1177\/0268355519885217","article-title":"Does tumescent liposuction damage the lymph vessels in lipoedema patients?","volume":"35","author":"C B van de Pas","year":"2020","journal-title":"Phlebology"},{"issue":"09","key":"ref26","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1016\/j.bjps.2020.03.002","article-title":"Water-jet-assisted liposuction for the treatment of lipedema: standardized treatment protocol and results of 63 patients","volume":"73","author":"T Witte","year":"2020","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"06","key":"ref27","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1097\/PRS.0000000000006280","article-title":"New insights on lipedema: the enigmatic disease of the peripheral fat","volume":"144","author":"A T Bauer","year":"2019","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref28","doi-asserted-by":"crossref","first-page":"e12820","DOI":"10.1111\/dth.12820","article-title":"Treatment of lipedema by low-volume micro-cannular liposuction in tumescent anesthesia: results in 111 patients","volume":"32","author":"U Wollina","year":"2019","journal-title":"Dermatol Ther"},{"issue":"04","key":"ref29","doi-asserted-by":"crossref","first-page":"324","DOI":"10.5999\/aps.2017.44.4.324","article-title":"Liposuction in the treatment of lipedema: a longitudinal study","volume":"44","author":"M Dadras","year":"2017","journal-title":"Arch Plast Surg"},{"issue":"05","key":"ref30","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1111\/bjd.14289","article-title":"Long-term benefit of liposuction in patients with lipoedema: a follow-up study after an average of 4 and 8 years","volume":"174","author":"A Baumgartner","year":"2016","journal-title":"Br J Dermatol"},{"issue":"03","key":"ref31","doi-asserted-by":"crossref","first-page":"121","DOI":"10.12687\/phleb2265-3-2015","article-title":"Treatment of lipoedema using liposuction","volume":"44","author":"S Rapprich","year":"2015","journal-title":"Phlebologie"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"35","DOI":"10.2147\/CCID.S56655","article-title":"Treatment of elderly patients with advanced lipedema: a combination of laser-assisted liposuction, medial thigh lift, and lower partial abdominoplasty","volume":"7","author":"U Wollina","year":"2014","journal-title":"Clin Cosmet Investig Dermatol"},{"issue":"01","key":"ref33","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1111\/j.1610-0387.2010.07504.x","article-title":"Liposuction is an effective treatment for lipedema-results of a study with 25 patients","volume":"9","author":"S Rapprich","year":"2011","journal-title":"J Dtsch Dermatol Ges"},{"issue":"02","key":"ref34","first-page":"151","article-title":"Microcannular tumescent liposuction in advanced lipedema and Dercum's disease","volume":"145","author":"U Wollina","year":"2010","journal-title":"G Ital Dermatol Venereol"},{"issue":"02","key":"ref35","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s00266-008-9214-y","article-title":"Water jet-assisted liposuction for patients with lipoedema: histologic and immunohistologic analysis of the aspirates of 30 lipoedema patients","volume":"33","author":"J J Stutz","year":"2009","journal-title":"Aesthetic Plast Surg"},{"issue":"01","key":"ref36","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1007\/7140.2006.00006","article-title":"Tumescent liposuction: a new and successful therapy for lipedema","volume":"10","author":"W Schmeller","year":"2006","journal-title":"J Cutan Med Surg"},{"issue":"01","key":"ref37","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1111\/j.1365-2133.2011.10566.x","article-title":"Tumescent liposuction in lipoedema yields good long-term results","volume":"166","author":"W Schmeller","year":"2012","journal-title":"Br J Dermatol"},{"issue":"04","key":"ref38","doi-asserted-by":"crossref","first-page":"e3553","DOI":"10.1097\/GOX.0000000000003553","article-title":"Survey outcomes of lipedema reduction surgery in the United States","volume":"9","author":"K L Herbst","year":"2021","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"02","key":"ref39","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1097\/01.ASW.0000363503.92360.91","article-title":"Lipedema: a frequently misdiagnosed and misunderstood fatty deposition syndrome","volume":"23","author":"C E Fife","year":"2010","journal-title":"Adv Skin Wound Care"},{"issue":"03","key":"ref40","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1046\/j.1439-0353.2004.04051.x","article-title":"[Lipoedema\u2013current status, new perspectives]","volume":"2","author":"I Meier-Vollrath","year":"2004","journal-title":"J Dtsch Dermatol Ges"},{"issue":"02","key":"ref41","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1097\/01.PRS.0000101506.84361.C9","article-title":"Tumescent and dry liposuction of lower extremities: differences in lymph vessel injury","volume":"113","author":"J N Hoffmann","year":"2004","journal-title":"Plast Reconstr Surg"},{"key":"ref42","volume-title":"Liposuction for the Treatment of Lipedema: A Review of Clinical Effectiveness and Guidelines","author":"K Peprah","year":"2019"},{"issue":"11","key":"ref43","first-page":"971","article-title":"The safety of liposuction: results of a national survey","volume":"28","author":"T S Housman","year":"2002","journal-title":"Dermatol Surg"}],"container-title":["Archives of Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2334-9260.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T05:29:14Z","timestamp":1730784554000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2334-9260"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,28]]},"references-count":43,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2024,9,27]]},"published-print":{"date-parts":[[2024,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2334-9260","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2234-6163","2234-6171"],"issn-type":[{"value":"2234-6163","type":"print"},{"value":"2234-6171","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,5,28]]},"published":{"date-parts":[[2024,5,28]]}}}