Treatment for Lipedema

Medically Reconstructive Lymph Sparing Liposuction Treatment for Lipedema
Surgical treatment of lipoedema is available primarily in Germany, in the UK and elsewhere mostly in Europe, usually using tumescent or water jet assisted (WAL) lymph sparing liposuction to remove liopedemic fat.  Research shows lymph sparing liposuction yields good long term results in reduction of lipoedema pain and in stopping the progression of lipoedema. The need for conservative therapies such as MLD and compression can be greatly reduced in almost all patients, and in some cases, conservative therapies can be eliminated after lymph sparing liposuction.

Compression garments and Lymphedema decongestive therapies can be helpful.

Manual Lymphatic Drainage (MLD): is a unique, therapeutic method of stimulating the movement of fluids in the tissues. The gentle, rhythmic, pumping, massage movements follow the direction of lymph flow and produce rapid results. It assists the cutaneous lymphatics in picking up and removing not just fluids, but all the waste products, protein particles and debris from our system. It also is successful in breaking fibrosis and fibrotic areas of a lymphodemous limb.

This treatment was created and developed by Danish therapists Dr. Emil Vodder and his wife, Estrid, in the 1930’s and was introduced in Paris in 1936. They are also credit with creating a specialty of medicine called Lymphology.

Comprehensive Decongestive Therapy (CDT) is used primarily in the treatment of lymphedema and venous insufficiency edema. It is a combination of MLD, bandaging exercises and skin care. CDT may also involve breathing exercises, compressive garments and dietary measures. A frequent indication for CDT is lymphedema caused by irradiation or surgery due to cancer. It can relieve edema, fibrosis and the accompanying pain and discomfort.

Supplements can be helpful. 

Selenium has been shown to decrease edema in tissue. Anticipate a possible increase in pain or decreased well-being as the toxins come out of the tissue. However, if you don’t feel good taking the selenium, then stop it. You can get sodium selenite solution from Life Extension at 50 mcg per drop (you take 5-10 drops). Many other internet sites also sell the liquid. You can buy 250 mcg tablets from Twin Labs (try iHerb).

If the lymphatics are dysfunctional in lipedema, for which we have proof, especially in the skin where the collectors are enlarged, fluid and proteins will move sluggishly through the system and deposit, similar to arterial disease. To try and unclog proteins that have accumulated into the lymphatics, consider taking enteric coated enzymes that bypass the acidity of the stomach. Enzymes intended for systemic absorption must be absorbed as a whole enzyme.

Enzymes do not have toxicity levels like vitamins. Take one capsule of the enzyme mixture of your choice every three hours on day 1, every two hours on day 2 and then hourly for days 3-8. Take a good MVI with minerals during this time. Eat a primarily liquid diet of soups, steamed vegetables, protein drinks, applesauce and low carbohydrate puddings. Avoid oils and fats as oils are absorbed into intestinal lymphatics and detract from the goal of cleaning out the lymphatics. Symptoms such as headache, fatigue, upset stomach and diarrhea may occur. If at any point you start to feel ill, you should decrease the number of capsules taken daily. Drink plenty of water. Your daily therapy with Wobenzyme will be one every morning or one morning and evening.

Omega fatty acids
Omega Fatty Acids improve the function of the immune system. Choose omega-3 oils based on the International Fish Oils Standards, an independent Canadian company that tests fish oils. Choose an oil with a 5-star rating for ultra-refined super concentrated fish oils with a minimum 60 percent combine EPA/DHA concentration, a dioxin and furan levels less than 50% of WHO standard and an exceptional product batch.

Anti-inflammation Diet and Supplements
Since inflammation is one of the causes for edema, it’s possible that anti-inflammation support could be helpful. There are no studies as to its success but holistic practioners seem to report good results.

Reducing Inflammation – the Natural Approach
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Anti-Inflammatory Diet & Pyramid
Andrew Weil, M.D.
click here for website

Stefan Rapprich, M.D.

Surgeon and Senior Consultant
Department of Dermatology and Klinikum Darmsdadt GmbH

Heidelberger Landstraße 379
64297 Darmstadt Eberstadt (Germany)
Tel: +49 (0)6151-1074160
[email protected]

Dr. Stefan Rapprich has been treating lipedema patients with liposuction.  His treatment is referred to as liposuction using tumescent local anesthesia with a vibrating micro cannula.  The patient is actually awake and assists during the procedure, and his data suggest that he can remove and prevent the return of lipedema with almost no side effects, based on 15 years of practicing this procedure. Your surgeon can review your case and consult with Dr. Rapprich.

Liposuction is an effective treatment for lipedema – results of a study with 25 patients.
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Stefan Rapprich, Anne Dingler, Maurizio Podda
Department of Dermatology, Darmstadt Hospital, Germany
Journal of the German Society of Dermatology (2011).

Tumescent liposuction in lipoedema yields good long-term results.
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W. Schmeller, M. Hueppe* and I. Meier-Vollrath
Hanse-Klinik, St-Juergen-Ring 66, D-23564 Lu¨beck, Germany
*Department of Anaesthesiology, University of Luebeck, Ratzeburger Allee 160, D-23538 Luebeck, Germany
Wilfried Schmeller: [email protected]

Tumescent liposuction is a highly effective treatment for lipoedema with good morphological and functional long-term results.

Lipoedema Liposuction Treatment Clinic

Luebeck, Germany

The Hanse-Klinik is a private clinic specialized in liposuction for Lipoedema. It was founded in 2002 in Luebeck, to offer high quality treatment by liposuction with the most modern standards available.

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Water Jet Assisted liposuction (WAL) for lipedema patients does not damage lymphatic or capillary systems
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J. J. Stutz Æ D. Krahl

Lipoedema is a fat distribution disorder causing massive, bilaterally symmetrical enlargement of the lower and in some cases the upper extremities in women. The atraumatic, anatomically appropriate procedure of water jet-assisted liposuction available today represents a promising treatment for these patients who generally suffer from severe subjective and objective impairment. Liposuction treatment can bring long-term improvement if the operative technique focuses on lymph vessel preservation. Immunohistologic analyses show minimal evidence of lymph vessel structures in lipoaspirates. The histologic analysis of the aspirates documents a relatively specific removal (‘‘apheresis’’) of primarily intact lipocytes with low vascular amount.

Lymph/Lipoedema Treatment in its Different Approaches
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1st Jobst Scientific Symposium 2008 with the following articles:

Liposuction as a treatment for lipoedema.
Professor Dr Wilfried Schmeller

Liposuction as a treatment for lymphoedema.
Dr Håkan Brorson, Dr Carolin Freccero

Multidisciplinary operative options.
Dr Harry Voesten

Facts about lipoedema and lymph/lipoedema.
Professor Dr Etelka Földi

A touching account of how Vaser/Tumescent Liposuction changed/transformed a Lipedema victim’s life (April 2012)

I cannot recommend Vaser (Tumescent Liposuction) too highly and while I realize that results doubtless vary with the individual, dependent on all sorts of factors, not least patient expectations, I am happy for my results to be used to help others who are in a similar position to where I found myself 6 months ago.


Additional Resources

Jeffrey Klein, M.D. – USA

Vaser Liposuction in UK

The Lipedema Project has evolved from the early work of Lipedema Simplifed and has more extensive information about lipedema. Please visit to learn more.