A recent study, published in September in the scientific journal The Lancet, suggests that liposuction has the potential to alleviate discomfort in women diagnosed with lymphedema, a chronic condition characterized by disproportionate fat accumulation, mainly concentrated in the legs and occasionally in the arms.
The analysis followed 410 women with the disease over one year. The data revealed that 68% of the participants who underwent surgery reported a decrease of at least two points in pain intensity, using a scale of zero to ten. In contrast, only 8% of women who maintained exclusively conservative clinical treatment showed this reduction.
Clinical Study Conducted in Germany
The results were obtained through a clinical trial conducted in 11 centers located in Germany. Of this group of 410 participants, 278 were operated on with liposuction combined with clinical treatment, while the remaining 132 followed only with conservative management.
Despite these positive findings, specialists warn that it cannot yet be categorically stated that the surgical procedure should be integrated into the treatment protocol. Vascular surgeon Andressa Cristina Sposato Louzada, from Einstein Israelite Hospital, emphasizes that the study marks a significant advance by showing that liposuction can reduce pain and improve quality of life, but stresses that the results must be analyzed considering the risks, the lack of long-term data, and the inherent limitations of the research.
Pain Relief Mechanisms
Louzada explains that the improvement in pain may result from various processes that are not yet fully understood. She details that the affected adipose tissue exhibits structural changes related to inflammation, fibrosis, and alterations in microcirculation. Partial removal of this tissue can decrease pressure on neighboring structures and the mechanical overload of the limbs, thus facilitating movement.
Lymphedema is a chronic illness that primarily affects women and can manifest or worsen during phases of hormonal change, such as puberty, pregnancy, and menopause. In addition to the volumetric increase of the limbs, symptoms include pain, increased sensitivity to touch, a feeling of heaviness, and a propensity to form bruises. The vascular surgeon clarifies that, unlike obesity, where fat is distributed more generally, lymphedema has a specific distribution pattern, often disproportionate to the trunk.
Although some estimates suggest that lymphedema may affect about 10% of women, there is no official population data established to define the true prevalence of the disease. Diagnosis depends on the patient's clinical evaluation and physical examination. Andressa Louzada adds that, although imaging tests can help investigate other associated conditions, there is no single test capable of confirming lymphedema with complete accuracy.
Therapeutic Approaches
The initially recommended treatment is always conservative and must be adapted to each individual. It includes regular physical exercise, nutritional guidance, weight control when necessary, the use of compression stockings, and physiotherapy to optimize mobility and manage associated edema. The doctor observes that lymphatic drainage can help control swelling, but it cannot eliminate the characteristic adipose tissue of the pathology.
Liposuction is not the first therapeutic choice; it is generally considered when the patient experiences persistent pain that does not improve satisfactorily with clinical treatment, or when there are functional limitations that impair locomotion. Louzada reinforces that there is no fixed treatment period applicable to all cases, as the decision is always personalized, considering the symptoms, clinical status, and involved risks.
It is essential to understand that surgery does not constitute a cure for lymphedema. Since the disease is chronic and its mechanisms are not yet fully understood, it cannot be guaranteed that fat removal will permanently interrupt its progression or prevent the emergence of new signs.
Risks and Future Perspectives
Like any surgical intervention, the procedure carries risks. In the study, 47% of the operated patients suffered some adverse event. Possible complications include bruising, fluid accumulation, infections, changes in sensitivity, anemia, and asymmetries in body contour. Among the most serious incidents are deep vein thrombosis, pulmonary embolism, hemorrhages, and lymphatic lesions.
Additionally, the duration of benefits remains uncertain, as the follow-up lasted only 12 months. Therefore, it is necessary to obtain a deeper understanding of the long-term results, identify which patients benefit the most, and verify whether surgery effectively alters the evolution of the disease, the vascular surgeon states. It is concluded that the main advance lies in recognizing that liposuction can be an effective therapeutic alternative for carefully selected patients, and not merely an aesthetic act.
