Liposuction for chronic lipoedema
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3 Committee considerations
The evidence
3.1 NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 9 sources, which was discussed by the committee. The evidence included 8 before-and-after studies. It is presented in the summary of key evidence section in the interventional procedures overview. The committee also considered safety data from a coroner's regulation 28 letter. Other relevant literature is in the appendix of the overview.
3.2 The professional experts and the committee considered the key efficacy outcomes to be: patient-reported outcomes including quality of life, and reduction in the volume of lipoedema.
3.3 The professional experts and the committee considered the key safety outcomes to be: pain, bleeding, infection, fat embolism, deep vein thrombosis, fluid imbalance and toxicity from local anaesthetic.
3.4 There were 29 commentaries from patients who have had this procedure that were discussed by the committee.
Committee comments
3.5 The committee was delighted to receive detailed patient commentary and input from patient organisations. The patient commentary was mostly positive about the procedure and highlighted the serious nature of lipoedema. The committee recognised that there were currently limited treatment options for this condition and that there was a need to define the most safe and effective treatment for it. This underpinned the recommendation for further research.
3.6 The committee noted that this condition is distinct from obesity.
3.7 The committee noted that liposuction is not a curative procedure and multiple procedures may be needed.
3.8 The committee was informed that several different liposuction techniques are used and that they may have different safety and efficacy profiles.
3.9 The committee encourages the creation of a registry for all patients having liposuction for chronic lipoedema to facilitate research.
Tom Clutton-Brock
Chair, interventional procedures advisory committee
October 2021
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