Lipedema: A Call to Action! (Buso G et al., 2019)
Authors: Giacomo Buso, Michele Depairon, Didier Tomson, Wassim Raffoul, Roberto Vettor and Lucia Mazzolai,
Wiley Online Library Obesity, 27, 10, (1567-1576), (2019).
Below is an excerpt of the most salient parts in regard to reimbursement for liposuction for lipedema.
For patients with minimal or no improvement following conservative approaches, the following two surgical options may be considered: liposuction and lipectomy (94).
Notably, techniques employed in lipedema patients differ from those adopted for cosmetic purposes (15, 66, 95). Following introduction of Tumescent Local Anesthesia (TLA), super‐TLA, and vibrating cannulas, this risk has considerably decreased. Several investigations have shown that TLA is highly effective in terms of both cosmetic and functional outcomes.
Schmeller et al. (15) described an average reduction of 9,846 mL of subcutaneous fatty tissue after treatment, with an additional amelioration of sensitivity to pressure, edema, bruising, functional limitation, and cosmetic complaint (P < 0.001). Moreover, no serious complication occurred following the procedure, with wound infection rates of 1.4% and bleeding rates of 0.3% (15). Very recently, Wollina et al. (97) reported on 111 patients mostly with advanced lipedema treated by microcannular liposuction in tumescent anesthesia between 2007 and 2018. They described a median total amount of lipoaspirate of 4,700 mL, a median reduction of limb circumference of 6 cm, and a median pain level lowering from 7.8 to 2.2 at the end of treatment as well as improved mobility and bruising. Serious adverse events were observed in 1.2% of procedures, with infection and bleeding rates being 0% and 0.3%, respectively (97).
Unfortunately, lipedema surgical treatments are still too often not reimbursed by health insurance companies, thus representing an expensive option for the overwhelming majority of patients (74). In addition, despite several promising short‐term results, only a few studies have evaluated the long‐term efficacy of TLA for lipedema treatment (15, 98, 99).
Total Research Papers below: Eight (8) (15, 66, 74, 94, 95, 97, 98, 99)
15) (Schmeller W et al., 2012)
66) (Rapprich S et al., 2011)
74) (Halk AB et al., 2017)
94) (Warren AG et al., 2007)
95) (Stutz JJ, 2009)
97) (Wollina U et al., 2019)
98) (Baumgartner A et al., 2016)
99) (Peled AW et al., 2012)
Liposuction as surgical option (94)
Need for medical carrier reimbursement (74)
Long-Term efficacy Studies (15, 98, 99).
Tumescent Local Anesthesia (TLA), different than Cosmetic (15, 66, 95).
Highly effective outcomes (15) Improvement
(97)
15. Schmeller W, Hueppe M, Meier‐Vollrath I. Tumescent liposuction in lipoedema yields good long‐term results. Br J Dermatol 2012; 166: 161‐ 168.
Wiley Online Library CAS PubMed Web of Science®Google Scholar
66. Rapprich S, Dingler A, Podda M. Liposuction is an effective treatment for lipedema‐results of a study with 25 patients. J Dtsch Dermatol Ges 2011; 9: 33‐ 40.
Wiley Online Library PubMed Web of Science®Google Scholar
74. Halk AB, Damstra RJ. First Dutch guidelines on lipedema using the international classification of functioning, disability and health. Phlebology 2017; 32: 152‐ 159.
Crossref PubMed Web of Science®Google Scholar
94. Warren AG, Janz BA, Borud LJ, Slavin SA. Evaluation and management of the fat leg syndrome. Plast Reconstr Surg 2007; 119: 9e‐ 15e.
Crossref CAS PubMed Web of Science®Google Scholar
95. Stutz JJ, Krahl D. Water jet‐assisted liposuction for patients with lipoedema: histologic and immunohistologic analysis of the aspirates of 30 lipoedema patients. Aesthetic Plast Surg 2009; 33: 153‐ 162.
Crossref CAS PubMed Web of Science®Google Scholar
97. Wollina U, Heinig B. Treatment of lipedema by low‐volume micro‐cannular liposuction in tumescent anesthesia: results in 111 patients. Dermatol Ther 2019; 32: e12820. doi:10.1111/dth.12820
Wiley Online Library PubMed Web of Science®Google Scholar
98. Baumgartner A, Hueppe M, Schmeller W. Long‐term benefit of liposuction in patients with lipoedema: a follow‐up study after an average of 4 and 8 years. Br J Dermatol 2016; 174: 1061‐ 1067.
Wiley Online Library CAS PubMed Web of Science®Google Scholar
99. Peled AW, Slavin SA, Brorson H. Long‐term outcome after surgical treatment of lipedema. Ann Plast Surg 2012; 68: 303‐ 307.