Aesthetic Plast Surg. 2026 Sep 10. doi: 10.1007/s00266-026-06238-8. Online ahead of print.
ABSTRACT
BACKGROUND: Lipedema is a chronic adipose tissue disorder that may involve the upper extremities, particularly in advanced disease stages, leading to pain, heaviness, and functional complaints. While liposuction is an established treatment for symptom relief and volume reduction, its impact on objective upper-limb function-especially shoulder mobility-has not been systematically evaluated.
METHODS: A prospective observational cohort study was conducted in female patients with upper-extremity lipedema undergoing circumferential arm liposuction. Active shoulder range of motion (ROM), including abduction, flexion, and external rotation, was assessed preoperatively and at 1, 3, 6, and 12 months postoperatively using standardized digital goniometry. Upper-limb disability (QuickDASH), pain, perceived heaviness, and upper-arm circumference were also recorded. Outcomes were analyzed over time and stratified by lipedema stage.
RESULTS: Sixty-eight patients completed the 6-month primary follow-up. Mean active shoulder abduction improved significantly from 132.4° ± 13.8° at baseline to 154.7° ± 11.5° at 6 months and remained stable at 12 months (p < 0.001). Composite shoulder ROM demonstrated a similar progressive improvement. Patients with Stage II and III lipedema exhibited greater absolute functional gains, achieving postoperative ROM values comparable to those observed in earlier stages. QuickDASH scores, pain, and perceived heaviness decreased significantly over time (p < 0.001). Upper-arm circumference reduction correlated moderately with improvements in shoulder abduction (r = 0.42, p < 0.01). Measurement reliability was excellent (ICC ≥ 0.93).
CONCLUSIONS: Upper-extremity liposuction for lipedema is associated with significant and durable improvements in shoulder mobility and upper-limb function. Beyond symptom relief and contour improvement, surgical debulking appears to restore functional movement, supporting the concept of upper-extremity lipedema as a functional disorder. Objective assessment of shoulder mobility should be considered an important outcome measure in the surgical evaluation of lipedema.
LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
PMID:42722924 | DOI:10.1007/s00266-026-06238-8