Anemia increases postoperative risks in lipoedema patients after liposuction

High-volume liposuction significantly increases the likelihood of secondary complications in anemic lipoedema patients. This is the key finding of an internationally recognized study conducted by Karl Landsteiner University of Health Sciences (KL Krems). Based on the analysis of more than one hundred cases of lipoedema, it was clearly demonstrated that patients’ blood parameters have a substantial impact on postoperative safety after high-volume liposuction. In contrast, the volume of fat removed was of lesser significance. These insights may contribute to refining treatment strategies and enhancing patient safety in lipoedema surgery.

Lipoedema, a chronic disorder of the subcutaneous fatty tissue, affects almost exclusively women and results in painful swelling and restricted mobility. Treatment with high-volume liposuction often provides relief but carries risks, particularly due to blood loss and the consequent postoperative anemia (a deficiency of red blood cells/hemoglobin). To enhance the safety of these procedures, researchers at KL Krems have investigated the correlation between preoperative anemia in certain patients and postoperative complications.

The challenge: Anemia

Our findings reveal that preoperative anemia is the primary risk factor for postoperative complications. Patients with low hemoglobin levels prior to surgery faced a significantly higher risk of complications.”

Dr Tonatiuh Flores, project leader and physician, Clinical Division of Plastic, Aesthetic, and Reconstructive Surgery, KL Krems

The retrospective analysis encompassed 121 lipoedema surgeries, categorizing patients into two groups (liposuction < 5 liters and > 5 liters). It was observed that the volume of liposuction had no significant impact on the complication rate, whereas there was a direct correlation between preoperative hemoglobin levels and subsequent complications.

The solution: Optimal preoperative care

The study underscores the importance of preoperative optimization. Prim. Assoc. Prof. Dr Klaus F. Schrögendorfer, senior author and head of the Clinical Division of Plastic, Aesthetic, and Reconstructive Surgery, adds: “Meticulous patient selection and optimization of hemoglobin levels before surgery are crucial to minimizing risk. The findings support the approach of addressing preoperative anemia before undertaking high-volume liposuction.”

This research marks another vital step towards enhancing the safety and efficacy of lipoedema treatment. Earlier this year, Dr Flores' team demonstrated that managing patients' vitamin D levels also contributes to better outcomes. Vitamin D levels are often low and further depleted by liposuction. With these study, KL Krems reaffirms its pioneering role in patient-centered research. The results could inform new standards in surgical treatment and improve patients’ quality of life.