Clinical outcomes reported after technology-assisted lipedema surgery: a systematic review of operative platforms and disease-stage patterns

Ciudad P.; Vaca B.; Escandón J.M.; Mayer H.F. · European Journal of Plastic Surgery (2026) · DOI: 10.1007/s00238-026-02554-z

Resumen

Background: Lipedema is a chronic fibro-adipose disorder associated with pain, disproportionate limb enlargement, functional limitation, and impaired quality of life. Surgery has shifted toward technology-assisted approaches, but interpretation across platforms remains limited by inconsistent terminology, diagnostic criteria, outcome reporting, treatment-course definitions, and stage stratification. This review mapped reported outcomes across technology-assisted surgical platforms, emphasizing stage patterns, treatment burden, volume-related outcomes, complications, and lymphatic-related reporting. Methods: A systematic review with descriptive quantitative synthesis was conducted in PubMed/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library from inception to March 2026. Eligible reports included adults with lipedema undergoing liposuction or lipedema reduction surgery with extractable clinical, patient-reported, functional, volumetric, imaging-based, or safety data. Operative platforms were classified by dominant mechanism, and infiltration strategies were treated as technical modifiers. Results: Sixteen reports were retained, and eight primary datasets contributed extractable numerical data. Pain reduction was the clearest descriptive signal, decreasing from 6.47 to 1.39 after water-jet-assisted liposuction, 6.60 to 2.70 after power-assisted liposuction, and 7.08 to 1.85 after selective microcannular/hybrid surgery. Quality of life, mobility, swelling, limb burden, and patient-reported function generally improved, but instruments and recovery endpoints were heterogeneous. Aspirated volume was not pooled. Most complications were minor, although high-volume ultrasound-assisted cohorts showed anemia/transfusion and reintervention signals. Conclusions: Low-certainty evidence suggests clinically relevant improvement after lipedema surgery. Current evidence supports descriptive evidence mapping rather than platform ranking; surgical planning should remain individualized, stage-oriented, and guided by lymphatic-sparing principles. Level of evidence: Not ratable. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2026.

Instituciones: Universidad Nacional Federico Villarreal