Surgical Treatment of Lipedema

Surgical Treatment of Lipedema | UpViser Spain

Why is Water-Assisted Liposuction (WAL) without Tumescence the Primary Choice for the Surgical Treatment of Lipedema?

March 2024

Welcome to the blog!

Today we’re going to talk about a revolutionary technology with a long track record in the field of aesthetic and reconstructive plastic surgery: water-assisted liposuction, also known as the WAL technique (Water Assisted Liposuction) from the German manufacturer Human Med AG, which many of you also know as "body-jet®".

We’ll discover in this article why this technique is the most advanced option for women suffering from lipedema and considering undergoing a liposuction procedure.

Lipedema is a chronic condition that mainly affects women and is characterized by abnormal fat accumulation in the limbs - legs and arms. This can cause pain, swelling, and mobility limitations, significantly affecting the quality of life of those affected. Liposuction has become the most effective treatment for controlling the progression of lipedema, and among liposuction techniques, the WAL technique stands out as the preferred and most effective choice for many surgeons.

The WAL technique has been used to treat lipedema for almost fifteen years, with Germany at its epicenter. Awareness of this disease and its treatments has been more widely recognized in Germany for several decades, to the point that today, lipedema surgery is partially covered by the German healthcare system if certain requirements are met; and soon it will be in Norway and Switzerland. This knowledge has been gradually transmitted to other countries until, upon arriving in Spain, UpViser Spain began collaborating with several pioneering plastic and vascular surgery teams in this field, establishing in 2021 in Essen, Germany, the first official center for surgical education in lipedema open to anyone who wishes to learn how to treat this condition; from the first visit to the subsequent recovery with cold chamber without manual lymphatic drainage, previously passing through the surgical phase. This center is led by Dr. Michael Offerman, a phlebologist expert and connoisseur of this pathology for more than 20 years. This year 2024 will be his last year of work, and we will be able to see him visiting all the friends with whom he has had the pleasure of sharing knowledge over all these years.

For the past seven years, UpViser Spain has been working on raising awareness about lipedema, especially in the field of plastic surgery. UpViser has co-organized two biannual international conferences on lipedema in Barcelona (2020-2022) together with the Ana Torres Institute, also from Barcelona, as well as numerous webinars and workshops to raise awareness about this condition in Spain. Following this path, UpViser Spain is developing a new formula to be able to collaborate in its awareness and treatments, which will be unveiled soon by more experts in the field - national and international - where patients (mainly women) will be able to find support on their journey.

Why is the WAL technique from body-jet® the best option?

Here’s why:

  1. Less invasive: One of the key advantages of the WAL technique is that it is a less invasive procedure. It uses a stream or spray of water to gently separate and remove fat, which means smaller incisions and less damage to surrounding tissues. This translates into less pain, inflammation control, and reduced recovery time for patients.
  2. Precise results: the WAL technique allows surgeons to work precisely to remove fat from specific areas. This is crucial for people with lipedema, as careful fat removal can help improve the shape and function of affected limbs.
  3. Fewer bruises: The WAL technique significantly reduces the risk of bruising and hematoma compared to other forms of tumescent liposuction. For women with lipedema, this is especially important, as they tend to have a higher tendency to bruise due to the extreme sensitivity of lymphatic vessels.
  4. Faster recovery: Thanks to the lower invasion and reduced risks of complications, patients undergoing liposuction with WAL technology may experience a faster recovery and return to their daily activities more quickly, which has been clinically proven (see scientific literature here:
  5. Spinal anesthesia: the WAL technique allows the surgeon to use spinal anesthesia for liposuction, allowing the patient to recover earlier as there are fewer remnants of medications in her body.
  6. Long-lasting results: The results of water-assisted liposuction are long-lasting, meaning that patients can enjoy the long-term benefits of improved appearance and mobility, always combined with the advice of their medical team.

En resumen, la técnica WAL es la opción de liposucción ideal para las mujeres que padecen lipedema. Ofrece una forma menos invasiva y más segura de eliminar la grasa acumulada, mejorando la calidad de vida de las pacientes. Si estás considerando una operación de liposucción para tratar el lipedema, no dudes en consultar a un cirujano/a con experiencia en la tecnología WAL.

¡Por supuesto, no olvidemos mencionar los beneficios que la técnica WAL brinda a los cirujanos interesados en esta tecnología!

Además, destacamos que la técnica WAL es excelente no solo para la liposucción en pacientes con lipedema, sino también en procedimientos de transferencia de grasa –también llamado lipofilling.

Beneficios para los Cirujanos:

  1. Precision and control: the non-tumescent WAL technique allows surgeons to work with exceptional precision. The water jet technology facilitates the removal of fat from specific areas, resulting in total control over the procedure. This is essential for achieving high-quality aesthetic results.
  2. Less fatigue: The use of WAL can reduce surgeons’ fatigue compared to other liposuction techniques after the learning curve. The water-assisted system facilitates more efficient fat removal, decreasing strain on the surgeon’s hands and arms since it is the stream or spray of water that helps to open the subcutaneous tunnels.
  3. Lower risk of complications: Thanks to its gentle and less invasive approach, the non-tumescent WAL technique presents a lower risk of complications during and after the procedure. Surgeons can feel more confident using this technology while providing their patients with a more comfortable and safe experience.
  4. Reduced operation time: The precision of the non-tumescent WAL technique allows for more efficient fat extraction without the need for further processing other than natural "decantation"; it does not require washing or centrifugation. This reduces the operation time compared to techniques that are tumescent from the start. This benefits both surgeons and patients, as it shortens anesthesia time and the overall duration of the procedure.
  5. Versatility in fat transfer: In addition to being ideal for liposuction, the WAL technique is an excellent option for fat transfer. Surgeons can collect fat in a collector or closed system (single-use or reusable) - and only through natural decantation and without centrifugation - obtaining fat with high cellular viability thanks to not having subjected it to any stress during its cleaning or purification as is normally done with the tumescent technique. This fat is subsequently used in breast lipofilling procedures, breast reconstruction with fat, hybrid augmentation, buttock augmentation, facial rejuvenation, or other fat transfer surgeries. Therefore, this expands treatment opportunities and meets the demands of patients seeking natural results.

In conclusion, the WAL technique not only benefits patients suffering from lipedema but also offers significant advantages to plastic surgeons. It provides them with a more precise and efficient tool for performing liposuction and fat transfer procedures, improving the quality of care and patient satisfaction.

If you are a surgeon interested in implementing WAL technology into your practice, or if you already use it and want to learn more about its advantages and applications, do not hesitate to contact us at We are here to provide you with the support and information you need to offer your patients the best possible results.

At, we pride ourselves on being at the forefront of the medical industry, and we are here to support you in your quest for knowledge and professional excellence.

Visit for valuable resources and to stay up to date with the latest trends in liposuction technology and its application in the treatment of lipedema, lipofilling, and regenerative medicine.

Welcome to, your reliable source of information on body-jet®, WAL, water-assisted liposuction, lipotransfer, and its use in the treatment of lipedema in English!

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