Liposuction - Lipoedema

Liposuction is an operation which involves a suction technique to remove fat from certain areas of the body which haven’t responded to exercise and diet. As liposuction is normally seen as a cosmetic procedure, it is not normally available through the NHS. However, liposuction can sometimes be used by the NHS to treat certain health conditions.

Lipoedema:

Lipoedema is a long-term condition where an unusual build-up of fat in the legs, thighs and buttocks, and sometimes in the arms, occurs which makes them increase in size. The condition usually only affects women, although in rare cases it can also affect men.

Causes of lipoedema:

The cause of lipoedema is not known, however in some cases there's a family history of the condition and the genes inherited from your parents play a role. Lipoedema tends to start at puberty or at other times of hormonal change, such as during pregnancy or menopause. This suggests that hormones may also have an influence, however the build-up of fat cells is often worse in obese people. Lipoedema is not caused by obesityand can affect people who are a healthy weight.

Treatments:

There's been little research into lipoedema, so there's some uncertainty about the best way to treat the condition. If you have lipoedema it's important to avoid significant weight gain and obesity because putting on weight will make the fatty swelling worse. Compression tights are helpful for some people because they support the fatty swelling and may reduce the pain. Liposuction can be a surgical option for the removal of fat.

Non-surgical treatments

Non-surgical treatments can sometimes help to improve pain, tenderness and prevent orreduce lipoedema by improving the shape of affected limbs – although they often have littleeffect on the fatty tissue.Several different treatments are designed to improve the flow and drainage of fluid in bodytissues, such as:

  • Compression therapy – wearing bandages or garments that squeeze the affected limbs
  • Exercise – usually low-impact exercises, such as swimming and cycling
  • Massage – techniques that help encourage the flow of fluid through your body.

Treatments which won’t help

Some treatments used for some types of tissue swelling are generally unhelpful for lipoedema. Lipoedema doesn't respond to:

  • Raising the legs
  • Diuretics (tablets to get rid of excess fluid)
  • Dieting – this usually tends to result in a loss of fat from areas which are not affected bylipoedema.

Eligibility criteria:

Due to a lack of evidence, liposuction for patients with lipoedema is Not Routinely Commissioned.

This means the patient’s NHS commissioning organisation (CCG), who are responsible for purchasing healthcare services on behalf of the population, will only fund the treatment if
an Individual Funding Request (IFR) application has exceptional clinical need and the CCG supports this.

Advice and further guidance:

Treatment policy for patients covered by NHS Birmingham and Solihull CCG

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