Lymphoedema and lipoedema can present similarly however have different aetiologies and should be considered as distinct clinical entities. Pain is a distinguishing feature of lipoedema. Liposuction can be used in both conditions to reduce bulk and enhance quality of life. Analgesia requirements for cohorts of lipoedema and lymphoedema patients undergoing lower limb liposuction were compared. Requirements for lipoedema cases far exceeded those of lymphoedema cases, in variety, frequency and dosage, suggesting a susceptibility of these patients to perioperative microvascular and sensory damage, thereby propagating their original painful symptoms. Adequate counselling of postoperative expectations, and close consultation with anaesthetic colleagues will improve patient experience and outcome from this procedure.
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