A major clinical trial has found that liposuction can significantly reduce pain among women living with lipoedema. German researchers compared liposuction with complex decongestive therapy, a non-surgical treatment commonly used to manage the condition. The multicentre randomised controlled trial included 410 women with stage I, II or III lipoedema. Researchers recruited participants from 11 hospitals across Germany.
The findings appeared in The Lancet in September 2026. Researchers randomly assigned 278 women to receive liposuction and 132 to continue complex decongestive therapy. Patients receiving liposuction underwent up to four procedures using the wet-technique approach. The control group continued physiotherapist-led decongestive therapy for 12 months.
Researchers assessed whether patients experienced at least a two-point reduction in leg pain after one year. The results showed a substantial difference between the two treatment groups. Around 68 per cent of patients receiving liposuction achieved a pain reduction of at least two points. Only eight per cent of patients receiving conservative therapy achieved the same improvement.
Average pain scores among liposuction patients fell by 3.74 points during the study. Scores dropped from 6.2 to approximately 2.6. Meanwhile, average pain scores in the control group increased slightly from 6.2 to 6.6.
Benefits seen across lipoedema stages
Researchers found that patients experienced improvements across all three stages of lipoedema. Women with stage I lipoedema recorded an average pain reduction of 3.87 points. Those with stage III disease recorded a 3.67-point reduction.
Patients receiving liposuction also reported improvements in quality of life, bruising, movement restrictions and mental health. However, researchers highlighted potential risks associated with the surgical procedure.
Nearly half of the liposuction group reported adverse events following treatment. Researchers considered most of these events unrelated to the procedure. Some patients experienced complications including abscesses, erysipelas, seroma, thrombosis, pulmonary embolism and postoperative pain. Researchers therefore stressed that clinicians should carefully weigh the procedure’s benefits against its potential surgical risks.
Researchers plan longer follow-up
Lipoedema causes abnormal fat accumulation, swelling, pain and bruising, particularly around the legs. Conservative treatments can include compression garments, exercise, massage and lymphatic drainage.
The latest findings provide stronger clinical evidence supporting liposuction as a treatment option for eligible patients. However, researchers currently have only one year of follow-up data.
The team plans to follow participants for another 36 months. Researchers will assess whether benefits continue and identify possible long-term adverse effects.
Also read: Galderma reports positive Restylane Volyme results