No liposuction for overweight people

Liposuction carries risks and, in the worst case, can lead to death

Liposuction seems to be an alternative for sports and healthy eating against unwanted love handles for more and more people. There is very little medical need. However, the intervention involves considerable risks. Above all, overweight people should refrain from liposuction, as it does not serve to reduce weight, experts advise. Affected people should first slim down the unnecessary finds with exercise and a diet.

Liposuction for unwanted love handles There are love handles like the so-called riding pants on the thighs or the “love handles” on the flanks that cannot be trained away with sport. Some people are so bothered by it that they venture to the cosmetic surgeon. As a rule, the choice falls on so-called liposuction, liposuction. People who are overweight should refrain from doing so.

"Liposuction is not for overweight people, it is not used to reduce weight," emphasizes Lutz Kleinschmidt from the German Society for Aesthetic Plastic Surgery (DGÄPC). Liposuction should only be considered when exercise and diet no longer reduce weight. Patients Kleinschmidt explains that those with liposuction should have a body mass index (BMI) between 19 and 25. According to their own information, the specialist would not carry out this treatment for very obese people.

Liposuction and Skin Tightening Professor Günter Germann from the German Society of Plastic, Reconstructive and Aesthetic Surgeons (DGPRÄC) explains the connection between liposuction and skin tightening: "Liposuction is always an integral part of an upper arm, thigh or abdominal wall tightening." A tightening for example, in some cases after strong weight loss.

In the case of liposuction, according to Germann, fat is sucked out through a cannula and a large wound is also created by the surgeon, through which the skin is to be tightened naturally during the healing process when contracted. However, an improvement in the body contour cannot always be achieved. "In many situations, suction alone is enough, sometimes it is just an attempt, and the skin stays limp without retreating," explains Germann, whose private clinic is part of reconstructive medicine at Heidelberg University Hospital. Then surgical skin tightening can be considered.

Liposuction is rarely medically necessary. In most cases, liposuction is performed solely for aesthetic reasons. However, there are also medical indications. "If there is too much volume in the reconstructive area of ​​so-called flap plasties after tissue transplants, for example if skin and fat tissue has been transferred from the upper to the lower leg, suction is now a means of reducing this," reports the doctor.

With so-called lipedema - these are pathological changes in the vessels with water accumulation in the fatty tissue - liposuction can also be suitable from a medical point of view. Vascular expert Professor Etelka Földi from the German Society for Phlebology sees a wide range of applications for liposuction in order to prevent complaints of bone structure in the case of impending X-legs. Then fat is sucked off at knee height. "However, liposuction in lipedema does not replace the conservative therapy of sports, compression stockings and lymphatic drainage", Földi. The doctor was involved in drafting the treatment guidelines for lipedema.

There are many risks associated with liposuction. This is no different than in other operations, as the doctor emphasized. The greatest danger is that dents form where the fat has been sucked out. Inflammation or embolism in the fat can also occur. But that rarely happens. "Swelling and bruising are considered normal complications. This actually affects all patients," reports Kleinschmidt. It is also possible that an asymmetrical result will result. Surgeons avoid this by accurately comparing the amount of fat that is extracted from the right and left thighs, for example. Despite numerous precautions, it can happen again and again that an intervention is necessary about three months later to make corrections.

Partly fatal consequences of an intervention According to a survey conducted by the University of Bochum as part of a doctoral thesis, between 1998 and 2002 there were 75 serious complications in a total of 2,275 liposuctions in Germany, Austria and Switzerland. 23 patients died as a result of the procedure. For example, serious germ infections of the skin and subcutaneous layers, blood poisoning, damaged gall bladders, gas fire infections and other damage have occurred. Most of the undesirable effects occurred within the first 24 hours after the operation. Often, however, follow-up examinations are only agreed 14 days after the operation. Therefore, the doctor advises in her dissertation, "Doctors should routinely examine the patients within the first 24 hours after the operation." In addition, liposuction should not take place at the same time as further interventions. "The amount extracted should never be more than four liters."

After liposuction, all those operated on must wear compression corsets and be physically gentle for up to 14 days. This also means that sport and active exercise must also not be carried out for at least two weeks. According to the experts, a repeated intervention on the same part of the body is "at the earliest six months of the previous operation possible". If surgery is performed elsewhere, another intervention is possible after three months.

In principle, health insurance companies do not cover any treatment costs. Health insurance companies generally do not pay the costs of liposuction. Every intervention must therefore be carried out of your own pocket. The treatment costs are based on the effort that has to be done. For example, Dr. suggests suctioning on the outside and inside of the thighs. Kleinschmidt between 4000 and 6000 euros. If more parts of the body are to be treated, 10,000 euros can quickly be raised.

The health insurers do not pay even if the patients suffer from lipedema or have a “pillar leg” genetic predisposition. According to Földi, the studies on liposuction in lipedema are very confusing ”. However, health insurance companies only pay if there is clearly a disease and scientifically proven treatment. “In all other cases, patients have to bear the costs all by themselves. Steffen Hausmann, an insurance expert, emphasizes that the intervention is cosmetic. (sb)

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Image: Martin Büdenbender /

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