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Prof. asoc. Dr. Gress

Plastic Surgeon

Professor Gress is one of the
top specialists internationally

Lipedema is a pathological, presumably
hereditary change in adipose tissue
that cannot be treated with diet

When people experience diet-based weight gain, fat cells enlarge and multiply. Lipedema is the term for a pathological, presumably hereditary change in the fatty tissue that cannot be treated by diet.

The painful increase in fatty tissue affects almost exclusively women and occurs mostly on the hips and legs, less frequently on the arms, stomach or neck.

The most effective treatment method is liposuction of the fatty tissue. A lipedema treatment by liposuction with Prof. Gress in Munich will eliminate or substantially reduce your symptoms, making your body slimmer and more attractive in those problem areas. Most of all, you will feel like you have a new start on life.

Fat cells absorb more water from the connective tissue, increase in size and, due to the higher pressure, disrupt the lymph flow; this can increase swelling to the extent that it affects the arterial and venous blood supply to the tissue. This increase in tissue fluid is known as edema (hence: lipedema). It leads to hardening (fibrosis) and internal scarring in the subcutaneous fatty tissue, which can be felt as hardened areas under the skin, and it is also painful.

In addition to increased tenderness, there is often a feeling of cold and heaviness in the affected body region.

By far the most effective therapy is liposuction (please see details under Liposuction)

With liposuction, a large part of the pathologically altered fat cells are suctioned, the painful pressure on the tissue is eliminated; with a new, aesthetically restored figure, you can let go of the substantial emotional stress you experienced because of your body.

After a more extensive liposuction procedure, it is possible that the skin does not shrink back and lie smoothly against the body. There can be an excess of skin on the legs, arms and abdomen. This excess must then be removed; otherwise, like an excessively large piece of clothing, it will sag from the body.

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The goal is to decongest the tissue by improving the lymphatic drainage. This can be achieved by means of classic lymph drainage (twice a week) and by wearing special compression undergarments and bandages. Adequate exercise, especially swimming and cycling, is essential, as is a low-salt, alcohol-free diet. Vegetables and fruit should be part of your daily diet. Do not eat after 7:00 pm. Smoking is prohibited.

Lipedema, Grade I, 6 months after liposuction
Lipedema, Grade II, abdomen and thighs, liposuction …
Results after 12 months

Frequently asked questions about lipedema

Liposuction for lipedema is usually performed in twilight sleep at our clinic in Munich without a hospital stay. Following liposuction, you can rest and recover for a while at the clinic before being picked up. For major liposuction procedures, we recommend one night of inpatient care.

Whether or not an inpatient stay is necessary depends primarily on the expected amount of liposuction: The upper limit of an outpatient liposuction is 4 liters. An inpatient stay is necessary for larger amounts. The upper limit is 6-8 liters per procedure.

There are no medications that help with lipedema. Diuretics, i.e. dehydrating drugs, must be absolutely avoided, as they further enhance circulation.

A health regimen should last for three to four weeks; it can provide slight relief, particularly with regard to tenderness in the tissue. Conservative treatment with a health regimen will not produce a visible change in the shape of the area affected.

Development of lipedema is associated with major hormonal fluctuations, such as during puberty and menopause. Other hormonal diseases, such as hypothyroidism, are not proven to cause lipedema.

Pressure on tissue can increase the permeability of small blood vessels, which makes one more prone to bruising.

There are a number of different methods and devices for liposuction: laser, ultrasound, water jet, etc, and no method has clear advantages over others. Ultimately, it comes down to the skill of the surgeon. What use is a golden chisel to a sculptor if he doesn’t possess the talent to create a beautiful sculpture?

We use a hyperosmolar tumescent infiltration technique. It involves infiltration of the tissue with saline fluid. The slightly higher salt content makes the membranes of the fat cells more permeable, the fat cells lose their structure and are then easier to suction. In addition, the tissue fluid (the edema) reacts to the increased salt concentration (osmosis), which also makes it easier to suction.

Lipedema begins slowly at first, often on the outside of the thighs (saddlebags), later on the upper and lower legs, and then on the upper body, neck, face, neck or arms. The skin is soft and often appears glassy and transparent. It then takes on a wavy structure and becomes tender. In its later stage, tissue hardening becomes palpable (fibrosis). Symptoms often intensify with heat, prolonged standing and later in the day. Saunas are therefore not recommended.

Depending on the volume of the fatty tissue to be suctioned, treatment takes approximately 30 to 90 minutes, plus preparation time (solution injection and exposure time). If liposuction is performed on several regions of the body in one session, surgery times of 2 to 3 hours or longer may be required. Therefore, costs are highly variable and range between 1500 and 8000 euros depending on the time required.

Added to this are costs for the anesthesia and, if applicable, an inpatient stay.

We would be happy to work out an optional financing plan for you with our partner MEDIPAY in Munich.

Because liposuction for lipedema is a medically indicated procedure, your health insurance company should cover the costs. However, you should clarify this in advance. If you request one, we will provide you with a cost estimate during your consultation at our practice, which you can forward to your insurance company. We settle accounts directly with you rather than with health insurance companies. Therefore, you should have advance confirmation that your insurance company will assume the costs. The fee for treatment must be paid before the operation.

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Professor for Plastic Surgery

Professor and lecturer
in Plastic Surgery

Experience makes the difference

  • More than 6700 procedures in the female genital area
  • Over 20 years of experience
  • Inventor and developer of the “Composite Reduction Labiaplasty”
  • Internationally recognized top specialist
  • Author of the international textbook “Aesthetic and Functional Labiaplasty” (Springer Publishers)
  • Professor and Lecturer in Plastic Surgery

In the most important national and international specialist societies

American Society of Plastic Surgeons
German Society of Plastic, Reconstructive and Aesthetic Surgeons
International Confederation for Plastic, Reconstructive and Aesthetic Surgery
International Society of Aesthetic Plastic Surgery

The Aston Baker
Cutting Edge
Aesthetic Surgery

2018, New York

Faculty Member
The greatest honor for
a Plastic Surgeon