Shockwave therapy in lipedema patients: A prospective study

<b>Background:</b> Postoperative fibrosis is a common and significant complication following liposuction for lipedema, often leading to tissue induration, pain, and compromised aesthetic results. This fibrosis can jeopardize the overall success of the procedure by reducing skin elasticity and altering the intended body contour.<b>Objective:</b> This study aims to evaluate the efficacy of early shockwave therapy (SWT) initiated 1 week after surgery to reduce postoperative fibrosis and preserve the functional and aesthetic outcomes of liposuction in lipedema patients. <b>Methods:</b> A prospective study was conducted on 50 female patients with stage II-III lipedema who underwent power-assisted liposuction (PAL). Patients received SWT sessions three times per week for 3 weeks, starting 7 days postoperatively. Outcomes were compared to a control group of 25 patients who did not receive SWT. Primary endpoints included fibrosis severity assessed by ultrasound elastography, skin elasticity measurements, and patient-reported outcomes on pain and satisfaction. The SWT group exhibited a significant reduction in fibrosis (2.1 ± 0.3 vs 3.8 ± 0.5, <i>p</i> < .001), improved skin elasticity (1.5 ± 0.2 mm vs 1.0 ± 0.3 mm, <i>p</i> < .01), and lower pain scores (2.3 ± 0.8 vs 4.7 ± 1.2, <i>p</i> < .001) compared to the control group. <b>Results:</b> Patient satisfaction was also higher in the SWT group (92% vs 68%, <i>p</i> < .01). <b>Conclusion:</b> Early postoperative shockwave therapy is an effective and safe treatment to reduce fibrosis after liposuction for lipedema. By modulating fibroblast activity, reducing pro-inflammatory cytokines, and improving tissue perfusion, SWT preserves the surgical outcomes and enhances patient satisfaction. These findings suggest that integrating SWT into postoperative protocols could be a valuable strategy to optimize liposuction results in lipedema patients.