Lipedema treatment: LIPLEG study shows liposuction benefits amid new German regulations

A multicenter randomized study known as the LIPLEG study, published in The Lancet, has demonstrated that liposuction provides significantly greater pain reduction and improved quality of life for women with lipedema compared to continued conservative therapy. The study, conducted across 11 locations in Germany with 410 patients, found that 68.3% of operated patients achieved a clinically relevant pain reduction, compared to only 7.6% in the conservative treatment group. However, adverse events were more frequent in the surgical group.

Parallel to these clinical findings, new regulatory changes in Germany are impacting the treatment of lipohyperplasia dolorosa (LiDo). A new ‘four-eyes principle’ introduced by the Federal Joint Committee (G-BA) now prohibits specialists in plastic, reconstructive, and aesthetic surgery from providing the initial diagnosis if they are also the performing surgeon. This mandatory separation of the diagnostic and operative roles represents a systemic shift in quality assurance, moving away from the previous practice where dermatologists or plastic surgeons often performed both functions.