Table of Contents
Requirements for your lipedema operation
The right indication
When should lipedema be operated on? Before we get started and energetically remove your lipedema, we need to be sure that your conservative therapy has been fully exhausted. The most important elements of conservative lipedema treatment for us are manual lymphatic drainage (MLD), flat-knit compression garments, but also exercise and dietary changes.
If conservative therapy has not led to sufficient relief of your symptoms, surgical therapy may be the right way for you.
lipedema operations can be standardized to some extent, but ultimately, they are always highly individual. You personally have your very own situation, with your very own tissue and your very own ideas of what you want to achieve with our help.
We therefore make the decision together. Through our consultations and physical examinations we have got to know you so well that we understand you and your situation 100% and can assess it well. Our clinical experience and the possibilities of modern diagnostics available to us in our specialist clinic for lipedema help us to do this. We discuss with you specifically what results we can achieve based on your physical situation. After all, realistic expectations are a basic prerequisite for the right indication for lipedema surgery.
Do I need to prepare for my liposuction for lipedema?
Yes, absolutely! You can contribute a lot to achieving the best possible results together!
The most important preparation you will have is a well-fitting pair of class II flat knit compression pants, which have all the features needed for a circulation stabilising function after your lipedema liposuctions.
You will go through all the other necessary preparations with us using our lipedema surgery checklist. We will calmly discuss everything that is necessary and help you with it.
In our experience, you only need manual lymph drainage (MLD) shortly before your respective operations to soften the tissue. This is because MLD only drains the congestion for the moment. The existing lipedema itself cannot be improved by MLD.
How do we help you prepare for your lipedema surgery?
Our special 360-degree service: all necessary examinations and preparations can also be performed directly by us in our clinic.
When your surgery dates are approaching, you will be called by our patient management one week in advance to go through our checklist again, which you are already familiar with through surgery planning and preparation. Our med-plast anesthesiologists will also call you again before each surgery date to coordinate your upcoming anesthesia care with you.
Procedures of your liposuction for lipedema
On the day of your lipedema surgery
You come to our clinic on the 3rd floor at your agreed time to the registration desk, where you have also been advised. Here, the colleagues from patient management first check your fully completed documents. Then you will be taken to the ward of our clinic on the 2nd floor. There you can say goodbye to your relatives, and you will be taken over by our cordial ward staff. One thing is for sure: you will feel at home! There are beautiful and cosy 2-bed rooms with atmospheric dimmable lighting and a view of Wittenbergplatz. First, the procedure will be explained to you, you will change your clothes, a medical question check will follow as well as the ordering of your meal later.
A med-plast theatre nurse or anaesthetist will then place the venous access for the medication to put you to sleep. Your plastic surgeon will then mark you in a separate photo room. There you will have another photo documentation and a bio-impedance measurement. Now you can start right away!
In the operating room - how does it work?
You will be accompanied by one of our med-plast specialist nurses or carers to one of our 3 operating theatres. After comfortable positioning on one of our highly comfortable operating tables, we cover you and connect you to electronic monitoring. Shortly afterwards, you will be gently put to sleep by means of very gentle medication via your venous access, while the operating theatre nurse holds a mask with pure oxygen over your mouth and nose. Steffi, the operating theatre manager, always strokes your cheek. You can feel absolutely safe. Because your entire surgical team is with you, you will never wake up in between or feel any pain. After your operation, we walk with you to your warm and comfortable hospital bed in your room.
Why do lipedema operations take place under anaesthesia?
Almost all of our patients want a sound and deep sleep during their operations. Without feeling pain, of course. We understand that and are happy to do exactly as requested.
There are exceptions, but as a rule we see no reason why our patients should be awake during this type of operation. Feeling pain during the operation makes no sense from our point of view either, of course. On the contrary, we have built a clinic with hospital accreditation where all the necessary technology and sufficient staff are available throughout to be able to offer the best possible medicine. Of course, there are exceptions that require analgosedation, i.e. twilight sleep. This will of course be carried out if indicated or at the patient’s personal request.
Nowadays, anaesthesia is very gentle and safe. In our med-plast clinic, your anaesthetist will not leave your side during your operation. We take a critical view of the often-heard justification for the active cooperation of patients. Sufficient operating theatre staff are available in our med-plast clinic for changes in positioning.
Our patients should finally be able to let go – from the operation onwards, we take over the responsibility completely. Our surgeons also prefer you to sleep through the night, because they want to be able to concentrate fully on your operation. If you are afraid of anaesthesia or if there are medical reasons why you should not be given anaesthesia, we will of course find an individual solution with you. Otherwise: Sleep well!
How do we operate on lipedema?
Germany is the world leader in lipedema surgery. Nowhere else is there so much experience and scientific knowledge in this field. Other European countries are therefore waiting for the results of our GBA study to also be sure whether liposuction for lipedema sustainably improves the clinical picture compared to conservative therapy.
Without anticipating the result: We are certain that with the right indication and the right surgical method, liposuction for lipedema brings about a lasting improvement in the symptoms of the disease, such as pain and restricted movement, as well as a general increase in the quality of life.
The following procedures are important to us:
- Circular, complete removal of the jocular tissue
- Three-dimensional OP method
- Integration of all areas of the body affected by lipedema
- Gentle technique, we prefer the water jet method WAL
- As much as possible, as little as necessary: We go to your limits in terms of the volume of fat to be suctioned without endangering your medical safety.
A prior statement or standardized specification of a number of liters to be removed or even of a percentage of your body weight is, in our opinion, professionally impossible and, if implemented consistently, even medically very dangerous. Rather, the individual compensation mechanisms of each individual patient are in the foreground. For example, a patient weighing 50 kg in stage 1 can never tolerate a removal of >5 litres (!) as well as a patient weighing 100 kg in stage 2 can never tolerate a removal of >10 litres. Both would correspond to the performance promise "removal of 10% of your body weight".
Our preferred method of lipedema surgery: WAL
Our preferred method of lipedema surgery: WALGood “craftsmen” like surgeons can basically achieve very good results with different tools.
Lipoedema can be operated on well with a water jet and/or vibration. The combination of different techniques is optimally adapted to the individual tissue situation. Laser, ultrasound, laser lipolysis or plasma can also be used. The multitude of possible combinations offers the best conditions for optimal results. For our specialised plastic surgeons, the waterjet is currently the basic tool for our lipedema operations.
This so-called “water jet assisted liposuction”, WAL for short, uses the gentle power of water to gently detach fat cells from their connective tissue bond. The blunt tip of the fine suction cannulas has a double lumen, which enables the simultaneous process of detaching and suctioning the fat cells.
Advantages of the WAL Method
Through the pulsating water jet, the cannula gently makes its way without damaging other structures (lymphatic channels, blood vessels, nerves and connective tissue). As a result, less pain, swelling, and haematoma are to be expected.
These advantages lead to the possibility of removing many litres of fat in a single operation.
Less stressful amounts of fluids are needed. The shorter operating times also reduce the side effects of the required anesthesia.
Due to the simultaneous process of irrigation and suction, your body tissues have only brief contact with the irrigation solution and its medication additives (adrenaline and xylocaine).
Due to the fact that no flotation is necessary, the surgeon can feel the tip of the cannula at any time during the operation and check its guidance. This enables precise fine modelling.
How am I doing after lipedema surgery?
While still on the operating table, you slowly wake up. Your compression garments have already been put on by our operating theatre staff. Still tired from the anaesthetic, we support you continuously until you reach your bed.
Our med-plast ward team has taken over you in the meantime and monitors your well-being seamlessly.
But of course you have had a major physical procedure, the side effects of which, such as pain or poor circulation, are treated professionally.
As soon as you are fit enough, there is soup and you can drink. This is followed by a structured and individualised circulation activation programme such as stand-up training, movement exercises or the first manual lymphatic drainage after your lipoedema operation.
Don’t worry: you will be amazed at how well you feel just two hours after your lipedema liposuction! And the first look in the mirror immediately rewards many patients with tears of joy!
The atmosphere on the ward is calm, familiar but professional. Some of our patients feel so comfortable with us that they almost regret not being able to come back after their last operation.
Since you are in a specialised lipedema clinic, you are among like-minded people! This often creates a very positive and close atmosphere. Through immediate mobility, contacts are made not only with the neighbouring patient but also on the ward corridor or in the other rooms. We are often amazed at how well our patients are already networked with each other in advance.
The night after your operation - inpatient at med-plast
During the individual ward rounds of our med-plast surgeons, your surgical procedure is discussed again, and all questions are clarified. An evening meeting with a cozy get-together in the reception area often rounds off the eventful day. The night nurses take over until the morning. We wish you a pleasant night!
The morning after your lipedema operation
From 8:00 a.m. onwards, the medical discharge visit takes place and the family members collecting the patient are present in the waiting area of the ward. We will provide you with all the necessary aids and medicines for stabilising the circulation and pain therapy. Including ready-to-use syringes for thrombosis prophylaxis. And if there are any questions – we are available around the clock. International patients usually go to one of the surrounding hotels right next to our clinic before their return flight.
And what happens next?
The next few days are challenging for many patients: organise support from your partner, family or friends in advance. Circulation stabilisation, flat knit compression, thread traction and MLD are the big topics and require a lot of time and sometimes stamina. But it is worth it! Don’t be disappointed that the swelling increases at first and the haematomas look worse and worse. From the third week after the lipoedema operation, everything becomes visibly and noticeably better.
You can also use the possibility of our clinic’s own closed Facebook group. Here, experiences can be shared in the community and you can get tips, encouragement and support. Our entire team is available to answer any medical questions you may have.
Can any doctor operate on lipedema? Legally, any licensed doctor can operate on lipedema. However, lipedema surgery is liposuction, which requires a lot of experience in dealing with circulatory complications due to the large amounts of body fat to be removed. As a rule, specialists in plastic and aesthetic surgery have the best qualifications for this type of operation, in addition to a feeling for body image. However, there are also specialists in other fields who have proven experience with lipedema operations. In any case, we recommend a clinic specializing in lipedema with inpatient admission and operations under anesthesia. Check the recommendations and experiences of other patients in the lipedema community and finally: trust your gut feeling!
Why should I have my lipedema operation at med-plast?
The med-plast Lipedema Clinic was founded specifically for the surgical treatment of lipedema. Around the lipedema specialist Dr. med. Frank Labschies, a large and very experienced team of plastic surgeons, anaesthetists and specialists trained in intensive care medicine has grown in recent years to do the best possible justice to every operation for lipedema.
The med-plast clinic is a private hospital licensed by the state of Berlin according to §30 GewO. All processes, the entire infrastructure and the specialist staff are geared towards liposuction for lipedema.
The clinic is subject to constant quality management and is regularly inspected by the state hospital supervisory authority.
For many years now, with over 1,000 inpatient operations per year, we know our stuff! Our good reputation brings patients from all over the world to our clinic in the capital Berlin – even from Australia!
Our operations provide the basis for your best possible result. By only specialists in plastic and aesthetic surgery who have already performed hundreds of lipedema operations at med-plast. Your result should not only be pain-free in the long term – but also look as good as possible!
We have all the relevant technology at our disposal and apply it individually as an additional aid depending on your tissue situation. In combination with our experience, we would like to achieve your best possible result together with you. For your new quality of life.
Our services go beyond quality, safety and comfort – we live a professional and trusting atmosphere. The warmth and good humour in our daily clinic routine transfers to many of our patients’ own zest for life. They meet like-minded people, can network and more often even make new friends for life!
Whether 24 h availability after the operation, wound checks, thread traction or the standard follow-up check after one year: we do not leave you alone!
Even many years after the completion of your successful operations, we are interested in you! Because your feedback is our most valuable asset for the necessary quality control and further development in lipedema surgery.
Because right from our first contact, we pick you up exactly where you are at the moment with your physical and mental situation. We at med-plast know our stuff, and we know that you are not alone with your lipedema symptoms!
Operating process
What result can I expect in the long term after lipedema surgery?
Numerous advantages are achieved through the surgical removal of the diseased fatty tissue by means of liposuction:
- Volume reduction with improvement of lymphatic drainage (“no pressure = no congestion”).
- Thus, no or little pain (relief of the pressure receptors + reduction of inflammation).
- Improving appearance (“Wear boots!”).
- Freedom of movement, motivation for sport and good nutrition.
- Consequential damage to the joints and knock knees can be avoided.
- The progression is stopped! (“What’s gone won’t come back!”).
Costs of lipedema surgery
Unfortunately, the statutory health insurance companies only cover the surgical therapy liposuction for lipedema in extremely rare cases. Nevertheless, we are happy to support you in your application for cost coverage by preparing a detailed medical report for submission to your health insurance company.
As a private hospital, we are unfortunately unable to bill the health insurance funds directly for patients with statutory health insurance who have a confirmed stage III and expressly request surgical treatment.
Privately insured patients are often reimbursed at least part of their costs as self-payers.
You should discuss the extent to which you can claim the expenses for a lipedema operation as an extraordinary burden on your tax return with your tax advisor or the tax office in advance.
The costs of lipedema surgery are very individual. For a lipedema operation in our specialist clinic including anaesthesia and inpatient stay, self-pay costs start at 5,000€. As a rule, two to four operations lead to a complete and best possible treatment result. The expected costs will be explained to you as part of the individual treatment plan.
We have often been able to save an entire operation during the course of treatment – simply because we always get the maximum out of it and were thus able to achieve our set goals earlier!
