Pain Reduction Following Liposuction for Lower Limb Lipedema: A Systematic Review and Meta-analysis

Lipedema is a chronic disorder of adipose tissue marked by disproportionate fat accumulation in the extremities and persistent pain, which significantly impairs quality of life. Although liposuction has been adopted as a therapeutic intervention beyond aesthetic purposes, the extent and long-term persistence of pain reduction after surgery have not been fully quantified.

This systematic review and meta-analysis followed PRISMA guidelines. Multiple electronic databases were searched from inception to September 2025. Eligible studies included adult patients with lipedema who underwent lower limb liposuction and reported both preoperative and postoperative pain outcomes. Pain scores, measured by the Visual Analog Scale or Numeric Rating Scale, were pooled using random-effects and reported as standardized mean differences (SMDs). Analyses were stratified by short-term (≤ 6 months) and long-term (> 6 months) follow-up. Subgroup analyses examined outcomes by liposuction technique.

Ten studies comprising 901 patients were included. Liposuction was associated with a significant reduction in pain at ≤ 6 months postoperatively (SMD - 1.72, 95% CI - 2.18 to - 1.27). Pain reduction persisted at long-term follow-up (> 6 months; SMD - 1.96, 95% CI - 3.05 to - 0.88). Subgroup analyses demonstrated pain reduction across all evaluated techniques; however, the current evidence is insufficient to determine the superiority of any specific technique. Overall, 87.7% of patients reported improvement in postoperative pain.

Liposuction for lower limb lipedema is associated with substantial and sustained pain reduction across various surgical techniques. Despite heterogeneity and the predominance of observational data, these findings support liposuction as an effective therapeutic intervention for pain related to lipedema.

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