Lipoedema
Lipoedema is a relatively common but often misunderstood condition that predominantly affects women. It usually appears for the first time during puberty and is closely linked to hormonal changes such as pregnancy and menopause. First described in 1940 by doctors at the Mayo Clinic (USA), lipoedema has only recently begun to receive the attention it deserves.
what is lipoedema?
Lipoedema is an abnormal and symmetrical build-up of fat, most commonly affecting the legs and sometimes the arms. This condition can cause pain, tenderness, and a feeling of heaviness in the affected areas, often making daily life more difficult.
Unlike typical weight gain, lipoedema fat is resistant to diet and exercise and usually affects both sides of the body equally. There is currently no specific test to confirm lipoedema — diagnosis is made through clinical assessment, medical history, and recognition of characteristic signs and symptoms.
Common Signs & Symptoms
- Disproportionately large lower body compared to the upper body
- “Cuffing” at the ankles or wrists where fat abruptly stops
- Legs or arms that bruise easily and feel painful or heavy. Pain may range from none to severe and its frequency may be constant, intermittent, or only when the fat is palpated.
- Feet and hands that remain unaffected
- Difficulty walking or joint problems such as knock knees or flat feet
- Unusual nodular and/or fibrotic texture within the fat that can feel like rice, peas, or walnuts beneath the surface of the skin
- Emotional challenges, including low self-esteem and depression due to body changes and inability to lose weight through diet and exercise.
Many women describe feeling as if their body is in “two halves,” with a slim upper body and a much larger lower body. Difficulty exercising or finding clothes that fit can further impact confidence and mental well-being.
Why Liposuction Is Effective Management for Lipoedema
Over recent years, management of lipoedema has advanced considerably. Research shows that liposuction (or liposculpture) is the most effective surgical method to reduce symptoms and improve quality of life.
Liposuction is the only “surgical” method that removes the abnormal lipoedema fat cells. Studies demonstrate that it can significantly reduce pain, improve mobility, and decrease the need for ongoing conservative therapy.
This procedure is most suitable for women with Stage 1 or Stage 2 lipoedema, before irreversible lymphatic damage occurs, and before skin is irreversibly stretched and requires surgical excision. Early intervention is important — it can help prevent disease progression, improve long-term outcomes, and reduce the need for intensive decongestive therapies later on.
The “Lymph-Sparing” Liposuction Technique
Modern lymph-sparing tumescent local anaesthetic (TLA) liposuction is specifically designed to protect the delicate lymphatic system. Medical studies have confirmed that liposuction using TLA is considered a reliable and safe procedure if it is performed by an experienced liposuction proceduralist and the guidelines of care are strictly followed.
Weight Management & Medical Therapies
When secondary obesity co-exists with lipoedema, additional medical support can be helpful.
GLP-1 receptor agonist medications have shown promising results for weight loss and also have anti-inflammatory effects, which may complement lipoedema management.
In certain cases, bariatric surgery (e.g. sleeve gastrectomy) may also be appropriate. These options should always be discussed with your healthcare provider to ensure the best individualised procedure plan.
Living Well with Lipoedema
After liposuction, many patients report dramatic improvements in mobility, comfort, and body confidence. Medical studies confirm this. While some may continue to use compression or supportive therapies, most find their symptoms greatly reduced and their quality of life significantly enhanced.
Early diagnosis and proactive management — especially with modern, lymph-sparing liposuction — offer the best chance of preventing progression and restoring comfort and confidence.
If you think you may have lipoedema or want to learn more about liposuction as management options, contact our team today for a consultation. Please also refer to our LIPOEDEMA INFO PDF information leaflet for additional information with supporting medical evidence.
Be Sculptured founder Dr Meaghan Heckenberg is a highly qualified and experienced lipoedema proceduralist working in Sydney and on the Gold Coast.
With Registration in General Practice and a Diploma in Obstetrics and Gynaecology, she gained further qualifications in cosmetic medicine and holds Fellowship of the Australasian College of Cosmetic Surgery and Fellowship of Lipoplasty Surgery. She is one of only a very small, select group of doctors in Australia with these credentials.
Meaghan has dedicated her career at Be Sculptured to tumescent liposculpture performed under local anaesthetic, and she is highly experienced, having performed more than 1500 procedures of this type. Meaghan’s passion for changing bodies, shapes, and proportions is unrivalled and her level of experience, dedication, and patience in her work to achieve the very best outcomes for each of her patients is second to none. Meaghan’s care for her patients is further informed by her own experience having tumescent liposculpture herself, and it is underpinned by her adherence to the highest of industry standards and personal commitment to continuing professional development and education.
Lipoedema Surgery - What to Expect
Modern lipoedema surgery at Be Sculptured involves tumescent liposculpture.
Unlike traditional liposuction, which is carried out under a general anaesthetic and has risks including those associated with general anaesthesia as well as severe bruising, the tumescent technique is performed with a local anaesthetic. This is used to numb the tissues over the area of concern. This method allows for significant constriction of the blood vessels, which vastly reduces blood loss during the procedure and helps to minimise bruising after the procedure. Recovery times and patient discomfort tend to be lessened with this technique.
Patients undergoing liposculpture at Be Sculptured require day-only hospital admission do require a GP referral (per Australian regulations from 1st July 2023). They can walk out after the procedure.
Cosmetic outcomes may be improved with this approach to care. This is because, as the patient can stand up near the end of the procedure, the proceduralist will check for the effect of gravity on the body and make final adjustments to enhance the outcome.
Understanding Cosmetic and Plastic Surgery Training: What Patients Should Know
Australian plastic surgeons go through a structured training pathway that mainly focuses on reconstructive and medically necessary procedures within public hospital settings. However, cosmetic procedures like liposuction are usually not performed in these public hospitals. This means that experience in procedures such as liposuction is often gained through extra training and supervised practice in private clinics, outside of standard plastic surgery core training.
Because of this, having a plastic surgery qualification does not automatically mean a doctor is highly experienced in cosmetic procedures like liposuction. These procedures require specific hands-on training and skill development that goes beyond general plastic surgery training.
There is sometimes confusion in the public about who is most qualified to perform cosmetic procedures. This has led to the incorrect belief that only plastic surgeons are properly trained in aesthetic procedures. In fact, many doctors who are not plastic surgeons but work in cosmetic medicine and surgery have undergone extensive, specific training and have significant experience in performing these procedures.
What matters most is not the title of the doctor, but their individual training, experience, and results. When choosing a practitioner for a cosmetic procedure, patients should look into their specific qualifications, ask about their experience with the procedure, and view before-and-after results to ensure they are in safe, capable hands.
Comprehensive Care at Be Sculptured
Pre- and Post-Operative Care
- Please advise the doctor at the initial consultation whether you take regular medications and follow advice regarding these before the procedure.
- DO NOT use Aspirin or Anti-Inflammatory (NSAID) medications for 2 weeks before the procedure.
- DO NOT take Fish Oil, Omega-3, large amounts of Vitamin E, or mega-dose multivitamins for 1 week before the procedure (these can worsen bruising).
- AVOID ALCOHOL for 2 days before the procedure.
- Have the prescription filled by 2 days before the procedure. Take the antibiotic capsules as directed.
- Purchase some antibacterial soap (Sapoderm or Gamophen) from your pharmacy (or hypoallergenic soap if skin is sensitive) to use when showering for 48 hours before the procedure.
- AVOID CAFFEINE drinks for 24 hours before the procedure.
- Follow the diet and fasting instructions given at your Consultation on the night before and the day of the procedure.
- Arrive at the clinic 30 minutes before your appointment time.
- Have somebody drive you home and stay with you overnight.
- DO NOT drive, work, operate machinery, or sign important documents for 24 hours after the procedure (due to the sedation medication used).
- DO NOT drink alcohol for 24 hours.
- DO NOT use Aspirin or Anti-Inflammatory (NSAID) medications for 2 weeks after the procedure.
- Take prescribed medications as directed.
- Eat a light diet for the first few days and moderate fluid intake.
- Bruising will increase for 2-3 days and improve thereafter.
- Wear compression garments as instructed.
- Attend your post-procedure follow-up appointment.
Book a Consultation
Be Sculptured has two clinics, located in Bondi Junction, NSW and in Southport, QLD. Please contact us here to book a consultation at either location. Alternatively, you are welcome to call us during business hours on 0484 898 977 or email [email protected].
before & after photos
We do not provide before and after photos on our website. Photos can be viewed on Dr Meaghan’s Instagram.
Medical Research
Liposuction for lipoedema has been an extensive area of medical research. Study findings are reported in international peer reviewed medical journals. These are made available to you and may be accessed below:
Since 2005, surgical treatment with liposuction has been included in the lipoedema treatment guidelines in Germany. ReichSchupke S, Schmeller W, Brauer WJ, Cornely ME, Faerber G, Ludwig M, Lulay G, Miller A, Rapprich S, Richter DF, Schacht V, Schrader K, Stücker M, Ure C. S1 guidelines: Lipedema. J Dtsch Dermatol Ges. 2017 Jul;15(7):758-767.
Dadras M, Mallinger PJ, Corterier CC, Theodosiadi S, Ghods M. Liposuction in the Treatment of Lipedema: A Longitudinal Study. Arch Plast Surg. 2017 Jul;44(4):324-331
Dadras M, Mallinger PJ, Corterier CC, Theodosiadi S, Ghods M. Liposuction in the Treatment of Lipedema: A Longitudinal Study. Arch Plast Surg. 2017 Jul;44(4):324-331. “Liposuction in the Treatment of Lipedema: A Longitudinal Study”. In this study in 2017, it was concluded that liposuction is effective in the treatment of lipedema and leads to an improvement in quality of life and a decrease in the need for conservative therapy. Due to the development of secondary lymphoedema and the irreversible damage to the lymphatic system that occurs in later stages of the disease, liposuction should be implemented as part of the standard therapy for lipoedema at early stages. This will prevent disease progression, improve quality of life, and reduce the need for decongestive therapy.
Herbst KL, Kahn LA, Iker E, Ehrlich C, Wright T, McHutchison L, Schwartz J, Sleigh M, Donahue PM, Lisson KH, Faris T, Miller J, Lontok E, Schwartz MS, Dean SM, Bartholomew JR, Armour P, Correa-Perez M, Pennings N, Wallace EL, Larson E. Standard of care for lipedema in the United States. Phlebology. 2021 Dec;36(10):779-796. doi: 10.1177/02683555211015887. Epub 2021 May 28. PMID: 34049453; PMCID: PMC8652358. .These American guidelines improve the understanding of the loose connective tissue disease, lipedema, to advance our understanding towards early diagnosis, treatments, and ultimately a cure for affected individuals.
Mortada H, Alaqil S, Jabbar IA, Alhubail F, Pereira N, Hong JP, Alshomer F. Safety and Effectiveness of Liposuction Modalities in Managing Lipedema: Systematic Review and Meta-analysis. Arch Plast Surg. 2024 Aug 6;51(5):510-526. doi: 10.1055/a-2334- 9260. PMID: 39345998; PMCID: PMC11436335. This study concluded that liposuction is a safe and beneficial therapeutic intervention for managing lipedema symptoms and enhancing quality of life.
Rafael Carvalho, Lipedema: A common though often unrecognized condition. Chinese Journal of Plastic and Reconstructive Surgery, Volume 6, Issue 3,2024,Pages 149-153,ISSN 20966911,https://doi.org/10.1016/j.cjprs.2024.06.005. Lipedema is a condition that mainly affects women and is characterised by an abnormal and disproportionate fat deposit in the extremities, along with symptoms such as pain and bruising. It can significantly impact mobility, humour, and quality of life in some patients. A careful clinical examination is essential to establish the diagnosis and differentiate it from other conditions, such as lymphoedema and obesity.
Halk AB, Damstra RJ. First Dutch guidelines on lipedema using the international classification of functioning, disability and health. Phlebology. 2017 Apr;32(3):152-159. doi: 10.1177/0268355516639421. Epub 2016 Jul 9. PMID: 27075680.
Boeni, Roland MD*,†; Waechter-Gniadek, Paul v.†. Safety of Tumescent Liposuction Under Local Anesthesia (TLA) in 9,002 Consecutive Patients. Dermatologic Surgery 47(5):p e184-e187, May 2021. | DOI: 10.1097/DSS.0000000000002987.Liposuction in TLA is a reliable and safe procedure if it is performed by an experienced surgeon and the guidelines of care are strictly followed.
Faerber G, Cornely M, Daubert C, Erbacher G, Fink J, Hirsch T, Mendoza E, Miller A, Rabe E, Rapprich S, Reich-Schupke S, Stücker M, Brenner E. S2k guideline lipedema. J Dtsch Dermatol Ges. 2024 Sep;22(9):1303-1315. doi: 10.1111/ddg.15513. Epub 2024 Aug 27. PMID: 39188170. This is a groundbreaking document – published May 2024. The German Federal Joint Committee has recognised lipoedema as a medical condition and is supporting patients having liposuction as a treatment using certain criteria. In July 2025, there was a decision made for reimbursement for liposuction.
Sandhofer, Matthias MD; Hanke, C. William MD; Habbema, Louis MD; Podda, Maurizio MD; Rapprich, Stefan MD; Schmeller, Wilfried MD; Herbst, Karen MD; Anderhuber, Friedrich PhD; Pilsl, Ulrike PhD; Sattler, Gerhard MD; Sandhofer, Martina MD; Moosbauer, Werner MD; Sattler, Sonja MD; Schauer, Patrick MD; Faulhaber, Jörg MD; Maier, Sabine MD; Barsch, Martin MD; Mindt, Sonani MD; Halk, Anne B. MD. Prevention of Progression of Lipedema With Liposuction Using Tumescent Local Anesthesia: Results of an International Consensus Conference. Dermatologic Surgery 46(2):p 220-228, February 2020. This study concluded that Lymph-sparing liposuction using tumescent local anaesthesia is currently the only effective treatment for lipedema.
Baumgartner A, Hueppe M, Schmeller W. Long-term benefit of liposuction in patients with lipoedema: a follow-up study after an average of 4 and 8 years. Br J Dermatol. 2016 May;174(5):1061-7. In this study in 2016, it was concluded that their results demonstrate for the first time the long-lasting positive effects of liposuction in patients with lipoedema.
Peprah K, MacDougall D. Liposuction for the Treatment of Lipedema: A Review of Clinical Effectiveness and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2019 Jun 7. This study looked at 5 different studies and concluded that the clinical guideline recommends that tumescent liposuction, performed by a skilled healthcare professional at a specialised facility, be considered the treatment of choice for patients with a suitable health profile and/or inadequate response to conservative and supportive measures.
Forner-Cordero I, Muñoz-Langa J. Is lipedema a progressive disease? Vasc Med. 2025 Apr;30(2):205-212. doi: 10.1177/1358863X241306415. Epub 2025 Jan 20. PMID: 39831319. Lipedema was seen to be stable in two-thirds of the patients. Age was not related to progression. Progression was related to WHtR increase, which is an indicator of abdominal fat gain. This demonstrates the relationship between fat gain and lipedema progression.
Czerwińska M, Gruszecki M, Rumiński J, Hansdorfer-Korzon R. Examining the characteristic features of lipedema and the usefulness of BMI and WHtR in clinical evaluation. BMC Womens Health. 2025 Jul 3;25(1):292. doi: 10.1186/s12905-025-03834- 9. PMID: 40611043; PMCID: PMC12225527. WHtR should be considered as a tool in identification of obesity among lipedema population.
Venkataram J. Tumescent liposuction: a review. J Cutan Aesthet Surg. 2008 Jul;1(2):49-57. doi: 10.4103/0974-2077.44159. PMID: 20300344; PMCID: PMC2840906.