Lipedema in Cologne: Effective treatment for fat distribution disorder
Lipedema is a disorder of fat distribution. This disorder is a chronic condition characterized by a noticeable increase in subcutaneous fat tissue. In most cases, fat deposits are found primarily on the legs, and less frequently on the arms. Fat distribution is always symmetrical. In addition, the affected areas of the body tend to retain water in the tissue. This leads to edema, which exacerbates the condition alongside the fat.
Lipedema is present when, in addition to an increase in fatty tissue, symptoms such as an unpleasant feeling of tension or pressure occur regularly. Increased sensitivity of the skin to touch can also be a symptom of lipedema. An important characteristic of lipedema is the disproportionate ratio of the torso to the legs: those affected often have a rather slim upper body and wide, more massive legs. This leads to a disproportionate ratio.
On this page, we would like to inform you about the various options for lipedema treatment in Cologne. At the PALMKLINIK, we can offer you lipedema treatment using liposuction or decongestive therapy. To find the treatment that is right for you, please arrange a non-binding consultation at our PALMKLINIK in Cologne.
Overview:
- What you need to know: Lipedema surgery – liposuction
- What causes lipedema?
- Lipedema and treatment options
- Decongestive therapy
- Water jet-assisted liposuction (fat removal using a water jet)
- Advantages of water jet-assisted liposuction
- Results and recovery after lipedema surgery
- Frequently asked questions about lipedema treatment with liposuction
What you need to know: Lipedema surgery – liposuction
| Surgery duration | 1 – 3 hours |
| Hospitalization | 1 day |
| Aftercare | Compression, 1 week of thrombosis prophylaxis, rest, decongestant measures, lymphatic drainage recommended |
| Anesthesia | Local anesthesia, but general anesthesia is also available upon request. |
| Socially presentable | After a week |
| Sport | Possible after wound healing is complete (10–14 days), mobilization strongly recommended |
What causes lipedema?
Lipedema occurs almost exclusively in women, often between the ages of 20 and 60. Men are rarely affected. In women, lipedema often begins shortly after puberty, after pregnancy, or with menopause. This suggests that hormonal factors also play a role in its development. However, the exact causes of lipedema have not yet been fully researched. Hereditary predisposition and the hormonal changes already mentioned are likely to play a role in the development of the disease.
Unhealthy eating habits and obesity can exacerbate the disease, but they do not have a significant influence on its development.
We can discuss whether you have lipedema (if you have not yet been diagnosed) and which treatment options are suitable for your individual case in a personal consultation.
Lipedema and treatment options
Lipedema cannot yet be cured. Treatments therefore aim to alleviate the symptoms and prevent additional fat deposits. Compression therapy, regular lymphatic drainage, exercise, and physical activity are the central elements of treatment. To prevent lipedema from worsening, it is important for overweight patients to lose weight. Liposuction is very effective in treating lipedema. This procedure involves surgically reducing the pathological fat deposits. This procedure provides long-term improvement.
Decongestive therapy
Complex physical decongestive therapy consists of a decongestive phase and a maintenance phase. The primary goal of the first phase is to remove accumulated fluid and thereby reduce tissue swelling. The second phase aims to maintain and further optimize the decongestion results achieved. Both phases involve various therapeutic procedures that can lead to the desired success in the treatment of lipedema:
- Manual lymphatic drainage: This is a form of physiotherapy treatment that stimulates and promotes the removal of lymph fluid. The stored fluid is moved to the functional part of the lymphatic system and removed from there.
- Compression therapy: This supports lymph drainage and also prevents the edema from filling up again.This is where the pressure exerted on the tissue from outside comes into play. As a result, more fluid is absorbed and transported. The tissue fluid is pushed toward the intact vessels.
- Skin care: Since the skin of lipedema patients is under a lot of stress, a good skincare routine is very important.
- Movement exercises: Targeted movement exercises help to reduce swelling. By exercising the muscles, the natural muscle pump is activated and the
stored tissue fluid can be drained more effectively. The most effective approach is a combination of compression and movement. For this reason, movement exercises should always be performed while wearing compression stockings or bandages. - Self-management: For successful therapy, it is important to be consistent in implementing the measures. Therapy is time-consuming and complex and must be carried out practically throughout one’s entire life. This makes it all the more important to understand the purpose of the measures and how they work in order to remain motivated.
Water jet-assisted liposuction (fat removal using a water jet)
The removal of fat cells using liposuction is the only method that provides long-term relief for those affected. Since the fatty tissue is reduced, the treatment results are permanent.
One type of liposuction we offer is water-assisted liposuction (WAL).. The WAL is a modern, gentle alternative to conventional liposuction: The treatment is performed under local anesthesia with twilight sedation; general anesthesia is also possible on request.
One or more incisions are made in the skin and then water is injected into the tissue in bursts: using a fine cannula inserted into the area to be treated, a computer-controlled water fan first loosens the fat cells and then sucks them out of the tissue. The fat deposits and the water introduced are thus flushed out of the body. After the treatment, the wounds are closed again.
Advantages of water jet-assisted liposuction:
- Protection of tissue, vessels, and nerves
- Possible without general anesthesia
- Short implementation time
- Short inpatient stay
- Short recovery time, quickly ready for work
- Low correction rate
- Low risk and low pain
- Extraction of fat for autologous fat injection
Outstanding professional expertise
Dr. Lijo Mannil is an officially certified WAL expert in liposuction and lipofilling. This distinction from Human Med AG confirms his many years of experience and specialization in water-jet-assisted liposuction, as well as his commitment to the highest quality of treatment and patient safety.
Results and recovery after lipedema surgery
Liposuction using the WAL method is a low-risk procedure. As with any procedure, in very rare cases the wounds may become infected, which in turn can lead to swelling, pain, and possible scarring. The procedure may also cause redness, swelling, and bruising. These areas usually heal on their own within a few days.
A few weeks of physical rest is recommended, but in most cases, you can resume your normal work routine after just one week. After WAL, you will wear compression garments to protect the areas and promote natural shaping. The final results can only be admired once the swelling has subsided.
Frequently asked questions about lipedema treatment with liposuction
You probably have many questions about lipedema treatment with liposuction. To help you make your decision, we have answered the most frequently asked questions below. However, please do not hesitate to contact us if you have any questions about lipedema. Feel free to arrange an initial consultation at the PALMKLINIK with no obligation.
What is lipedema?
Lipedema is a disorder of fat distribution that occurs predominantly in women. It causes a significant increase in fat cells in areas of the body such as the arms, legs, hips, and buttocks. Due to the nature of the fat cells, the affected areas of the body often take on an appearance similar to cellulite.
Lipedema – when is surgery necessary?
In order to determine whether liposuction is necessary and appropriate for you, we will take plenty of time for a detailed consultation. Together, we can discuss which treatment is right for you. At the same time, there are specific indications for lipedema surgery, which we will explain to you during the consultation.
How much does lipedema surgery cost?
Mit welchen Kosten Sie rechnen müssen, hängt davon ab, welche Zone behandelt wird, in welchem Stadium Sie sich befinden (wie viel Fett muss abgesaugt werden?) und mit welchem Verfahren wir die Fettabsaugung durchführen. Sie können mit Kosten ab 5.000€ rechnen.
What should you bear in mind after lipedema surgery?
After the operation, it is important to take it easy. You will also be given compression garments. Thrombosis prophylaxis lasts for about a week. Measures to reduce swelling, such as arnica capsules and lymphatic drainage, also play an important role in aftercare.
Can lipedema treatment also be carried out for those with statutory health insurance?
Yes, from January 1, 2026, liposuction for lipedema will be covered by statutory health insurance as a standard benefit at all stages. This means that you will receive medically necessary help without high out-of-pocket costs, regardless of the severity of your condition.
In order for liposuction for lipedema to be covered by health insurance, patients must meet certain requirements.
- Only 6 months of conservative therapy (compression, lymphatic drainage, exercise) – without sufficient effect.
- Do not gain weight during this period.
- BMI 32–35: Surgery only if the waist-to-height ratio is correct.
- BMI over 35: first lose weight (obesity treatment), then possibly surgery.
- Psychological factors must be taken into account.
- Other causes (e.g., lymphedema, vein problems) must be ruled out.
At PALMKLINIK, we can provide you with comprehensive advice on lipedema and work with you to determine whether you meet the requirements for coverage by statutory health insurance. Dr. Mannil will not only accompany you as an experienced contact person, but can also refer you to suitable hospitals where the procedure can be performed, if necessary. In addition, Dr. Mannil also performs surgery himself at selected clinics.