/ Treatments / Lipoedema


We have good news!

We have expanded for you so that we can specialize entirely in lipedema there. For that we need space and time. And that’s exactly why we opened a new clinic wing on our premises, the Luisenflügel. The LipoKlinik is now housed here with two additional, state-of-the-art operating rooms and recovery room.

To the LipoKlinik website

Lipoedema is a pathological change in adipose tissue that can lead to a significant reduction in quality of life as it progresses. As a rule, only women with lipedema are affected.

The starting point of the disease is usually an initial hormonal change, such as the onset of puberty, pregnancy or – rarely – menopause: during these hormonal upheaval phases in women, there is a surge of fatty tissue in typical areas of the disease: thighs, lower legs, inside of the knees , Hips, buttocks and arms too.

The affected fat cells appear to be pumped up due to the accumulation of lymphatic fluid associated with the disease. With advanced lipedema, e.g. in stage 3, grotesque body shapes with overhanging skin-fat flaps can arise, which are then also associated with considerable pain in addition to the restriction of movement.

How do you recognize lipedema?

An increase in the circumference of the legs and arms beginning with puberty, pregnancy or menopause is suspect. The skin is irregular on its surface and very sensitive to touch. Hands and feet are still slim. Exercise and a healthy diet have no significant effect on the development of the body’s silhouette. Blue spots appear quickly, even with the slightest trauma. Another person in the family is also affected by this appearance.

All patients who come to our specialist clinic in order to receive the best possible treatment should have received the specialist diagnosis “lipedema” from a phlebologist, vascular surgeon or another specialist familiar with this clinical picture before the first consultation appointment. Ideally, you should also be provided with flat-knit compression garments and wear them consistently.

By making a diagnosis with a specialist, other causes of weight gain such as venous insufficiency with the help of sonography and other clinical examination methods are excluded. If you have varicose veins accompanying your lipedema, vein stripping or some other type of obliteration of the varicose veins should be performed before lipedema surgery.

How are lipedema divided?

From the experienced surgeon in the Park-Klinik Birkenwerder near Berlin, liposuction is a very low-risk procedure, however, it is not possible to exclude developing skin retractions or contour irregularities (dents).

3 stages are divided:

  1. Stage: Formation of orange peel (minor dents)
  2. Stage: Development of larger dents (mattress skin)
  3. Stage: large, harder flaps of skin and ridges, which even cover the hands and back of the feet

In addition, depending on the severity, there are 5 types:

  1. Type: limited to the buttock-hip region
  2. Type: up to the knees and fat rag on the knee inside
  3. Type: to the ankles
  4. Type: only hands and feet are not affected
  5. Type: Water retention (edema) even in the hands and back of the feet, fingers and toes (lipolymph edema), damage to the larger lymphatics

The partial bruising that occurs during liposuction disappears after a few weeks.

What does this therapy look like?

The gentle Waterjet Assisted Liposuction (WAL) removes the diseased lipoedema fat cells without destroying the connective tissue structures, blood vessels, lymph channels and nerves. This can be aesthetically quite beautiful results on the affected body regions.

On the day of the operation, the surgeon first marks the operating area with a pen. About a few tiny small punctures then a saline solution is injected. It also contains adrenaline and a local anesthetic. The solution quenches the bleeding that occurs during aspiration, soothes the pain of the patient and causes the fat cells stored there to swell, making them easier to remove. Using a small cannula, you can then aspirate up to 9 liters of fat cells, lymph and blood from the subcutaneous fatty tissue.

The operations take about 120 minutes each. An anesthetist is always present accompanying the operation and can offer either a drowsy sleep or a general anesthetic if necessary. As a rule, one night is planned in the clinic. For further safety and avoidance of complications, maximum fat removal of up to 10% of body weight should not be exceeded. Also, the operated body surface must be kept as low as possible, which is why lipoedema must always be operated in several steps.

How does water jet assisted liposuction (WAL) work?

In the WAL, the gentle power of the water is used by a pulsating jet of water to gently remove fat cells from their connective tissue network. The blunt tip of the fine aspiration cannula has a double lumen, which allows the simultaneous operation of dissolving and suction of the fat cells.

What is LASER tightening?

Since January 2022 we have been offering our patients an optional LASER tightening (in addition to waterjet-associated liposuction). With this method, the fat cells are destroyed with controlled and precise laser energy and liquefied by the heat (fat melting). Depending on the size of the area to be treated, the liquefied fat is broken down by metabolism or sucked out manually.

The thermal effect of the laser also promotes the formation of the skin’s own collagen. In this way, the LASER tightening not only reduces fat, but also tightens the subcutaneous connective tissue.

More infos about LASER tightening

What results can I expect after a lipoedema operation?

Numerous benefits are achieved by surgical removal of diseased adipose tissue:

  1. Volume is significantly reduced, lymph can flow again
  2. Pain is significantly alleviated or eliminated
  3. The appearance becomes more beautiful and garments, such as Worn boots again
  4. The mobility increases, sport, everyday life are possible again without problems
  5. Consequential damage to the joints and X-legs can be avoided
  6. The progression of the disease is stopped

What can be done to prevent lipedema?

The best therapy for lipoedema is the elimination or reduction of the cause of the discomfort, and these are the diseased fat cells. Water-jet-associated liposuction gently removes a great many pathologically altered fat cells from the tissue and thus significantly improves the lymphatic drainage and thus the drainage of the tissue.

This therapy must always take place in combination or / and following an essential conservative therapy using flat-knit compression and manual lymphatic drainage. In addition to surgical and other conservative measures, we strongly recommend that you respect healthy eating habits and support the outcome of the operation through sports such as, ideally, water sports, walking, cross-country skiing or walking.

Can every surgeon operate on lipoedema?

Do not rely on “your” surgeon’s choice for “5 star” internet ratings. Make sure at first contact, whether your surgeon enough time and can answer all your questions. There should also be expertise in the field of liposuction by WAL, as this method is the drug of choice in the treatment of the disease. The experience in this area of expertise should be credible.

At best, the surgeon will also bring with you a passion and enthusiasm for the method of treatment, which should also be noticeable to you in contact. Liposuctions are not easy operations! It takes experience, passion and sensitivity to achieve the best possible result.

And then?
The supply of a previously measured compression corset takes place immediately after the operation nor in the operating room a, in addition, an elastic winding of the extracted region is still made. On the second day after the operation, patients recover their own flat knitwear and start manual lymphatic drainage therapy again. The typical lipoedema pain is usually gone immediately, hematoma and swelling are temporary. Immediately the relief is literally palpable, and the new life can begin.

Advantages of WAL

  • Through the pulsating jet of water, the cannula smoothly makes its way without injuring other structures (lymph channels, blood vessels, nerves and connective tissue), the tissue is spared.
  • The surgeon only has to use a small amount of force, so you have less pain, swelling and hematoma as a patient. Overall, this leads to a faster convalescence.
  • With the WAL, no uncomfortable infiltration of large quantities of liquid and long exposure times is necessary, as with the tumescence method (tumescere = swell up), this leads to a time savings and thus to shorter anesthetic times.
  • Because of the unnecessary flooding, the surgeon can feel the tip of the needle at any time during the operation and control its movements. This allows precise fine modeling and results are predictable.
  • Due to the simultaneous process of irrigation and suction, your body tissue only has contact with the rinsing solution and its medication additives (adrenaline) for a short time, which is a tighter stimulus for your body.
  • The hoses used are disposable materials, the fat is obtained in a closed system (LipoCollector®). Absolute sterility is guaranteed

All these advantages lead to the fact that with lipoedema also large quantities of fat can be taken.

Surgery information

Surgery duration:
about 180 minutes

1st treatment from 4700 €
any further treatment from 3900 €

plus 1500 € (optional)
If an additional LASER lipolysis treatment is desired. More info

All prices without VAT, plus anesthesia

Twilight sleep or general anesthesia
1 night inpatient
After treatment:
Plasters remain for 1 week, compression wash should be worn for four weeks, bruising and swelling may fade after a few days, re-presentation if needed

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    Dr. med. Ursula Tanzella and Dr. med. Klaus Ueberreiter would be pleased to advise you personally.

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