Postoperative Seroma in Lipedema Surgery: A Retrospective Analysis of 93 Cases from a Single Surgical Team
Estudo retrospectivo de 93 mulheres submetidas a lipoaspiração para tratamento de lipedema entre abril de 2019 e janeiro de 2024, todas operadas pela mesma equipe na mesma instituição. O desfecho principal foi a formação de seroma no pós-operatório.
Dezessete pacientes (18,3%) desenvolveram seroma. O fator associado com maior peso foi o volume aspirado em relação ao peso corporal (7,27% nas que tiveram seroma contra 5,84% nas que não tiveram, p = 0,005). Procedimentos menores realizados no mesmo ato cirúrgico também aumentaram a incidência (p = 0,035). Nenhum seroma ocorreu entre as pacientes operadas com lipoaspiração assistida por ultrassom. As demais complicações foram raras: uma infecção e um hematoma (1,07%).
Referência completa
Amato FCM, Amato LGL, Amato ACM, Benitti DA. Postoperative seroma in lipedema surgery: a retrospective analysis of 93 cases from a single surgical team. Aesthetic Plast Surg. 2026;50(13):5164-70. doi:10.1007/s00266-026-05774-7
Abstract
Background. Lipedema is a chronic adipose tissue disorder characterized by abnormal and disproportionate fat accumulation in the extremities, leading to pain, edema, and functional impairment. Liposuction has become a central component of surgical management. However, postoperative complications, particularly seroma formation, remain a concern.
Objectives. To evaluate the incidence of postoperative seroma and associated risk factors in patients undergoing liposuction for lipedema treatment, based on procedures performed by a single surgical team in a single institution.
Methods. This retrospective observational study included 93 female patients who underwent liposuction for lipedema between April 2019 and January 2024. Data collected included demographic variables, body mass index (BMI), anesthesia type, volume of aspirated fat, percentage of body weight removed, use of adjunct technologies (ultrasound or laser), association with other surgeries such as varicose vein surgery, and prior conservative treatment. The primary outcome was the development of postoperative seroma. Statistical analysis included Chi-square and Student’s t-tests and multivariable logistic regression, with significance set at p ≤ 0.05.
Results. Among 93 cases, 17 patients (18.3%) developed postoperative seroma. Higher volumes of aspirated fat (% body weight) were significantly associated with seroma formation (7.27% vs. 5.84%, p = 0.005). Concomitant minor procedures were also linked to increased seroma incidence (p = 0.035). No seromas occurred in patients treated using ultrasound-assisted liposuction. Minor complications included one infection and one hematoma (1.07%).
Conclusions. Liposuction for lipedema is a safe and effective surgical option with a low rate of major complications, but seroma remains a relatively frequent postoperative finding. Higher aspirated fat volumes relative to body weight and the presence of concomitant procedures increase the risk of seroma. No seromas were observed in the ultrasound-assisted group; however, this difference did not reach statistical significance and should be considered only as hypothesis-generating. Further studies are needed to validate these findings and guide surgical decision-making.
Level of evidence. IV.
Original abstract as published in Aesthetic Plastic Surgery.