What are the surgical and non-surgical treatments for Lipoedema?

Mr Vasu Karri, one of the UK's Leading Consultant Plastic Surgeons, with extensive experience of treating Lipoedema explains..



To read more about Mr Vasu Karri, who offers both water assisted liposuction and tumescent liposuction for Lipoedema following specialist assessment, then please click here 

To read more about Lipoedema from The Karri Clinic based in East Yorkshire - please click here



What are the symptoms of Lipoedema? With thanks to Lipoedema UK


 Lipoedema UK

"In Lipoedema, the hips, buttocks and legs of women who have it are out of proportion with the rest of their body. The amount of Lipoedema a woman has and the way it is distributed on her legs and hips, varies between women, some may just have small pockets of fat above the ankles for example, while in others there’s an obvious discrepancy in size between their upper and lower body. Lipoedema can also develop in the upper arms. Lipoedema is most likely to appear at puberty, before which time a young person will most likely have had a ‘normal’ body shape. However Lipoedema can also appear during other hormonal changes. Lipoedema can be very distressing when a young woman finds certain areas of her body do not reduce in the same way as her friends and family despite following the same healthy diet and exercise routines". read more...


PhysioPod® are delighted that Mr Karri mentions DEEP OSCILLATION® in non-surgical approaches for Lipoedema and would like to take this opportunity to explain why sufferers are finding it helpful with a list of FAQ..


DOT is an internationally patented, intermittent, electrostatic massage therapy. It permeates an 8cm depth, throughout the entire depth of tissue layers; the skin, fat tissue, muscle, blood and lymph vessels and connective tissue.  No pressure is required to apply the therapy, making it ideal for painful, Lipoedema affected limbs and gentler on the demands of the therapists body.

DOT provides a powerful lymphatic drainage massage, either as enhancement to manual lymphatic drainage (MLD) via vinyl gloves or as self management via applicators. It is becoming a popular treatment of choice to reduce pain, reducing the need for painkillers.  It promotes a feeling of 'lighter limbs' and promoting easier mobility.  

It can be used for self-management at home and abroad and it is becoming a highly sought after treatment pre liposuction, preparing tissue for the procedure and in the early post liposuction recovery period; enhancing results and speeding up the rehabilitation process (reducing swelling, pain, bruising and inflammation). 

It is hoped that all the questions and answers below will help interested parties make an informed decision about whether the therapy is suitable for them.  For more information, please contact, PhysioPod UK on info@physiopod.co.uk or call them directly on 0115 9167 685 or 0788 692 5715.






For Lipoedema and Lipo-Lymphoedema sufferers

For symptom management and pre and post Liposuction


Who are PhysioPod® UK Limited?

PhysioPod® UK Limited is a small independent company directed and managed by two sisters, Julie Soroczyn and Mary Fickling. They are the points of contact for all members of the public, therapists and the healthcare authorities in the UK and the Republic of Ireland. Julie was the lady responsible for bringing DOT into the UK in 2006 and The Republic of Ireland in 2009. In 2017, approved NHS suppliers PhysioPod® added another arm to their business in the shape of Physio Equipment, established to lead the way in innovative healthcare solutions for Rehabilitation, Sports and Aesthetic Medicine in the UK and ROI. The role of Physio Equipment is to exclusively supplying a high quality range of products from German leading manufacturers PHYSIOMED ELEKTROMEDIZIN AG for therapists and patients.

Why is it important to see a therapist?

By visiting a PhysioPod listed therapist first, the therapist and patient evaluate the results together and make an “informed choice” before deciding to invest, this could take one, two or more treatments. However, if after they have invested, they decide it is not for them and can provide feedback to that effect, they can return the unit for a refund, less a £520.00 including VAT hire fee after one calendar month which includes delivery and collection. Results are achieved when sufferers are compliant with regular self-management as advised by their therapist. In addition to the sports or aesthetic card supplied with the unit, a bespoke therapy card is produced for each person, when the bespoke therapy card is inserted into the unit and intensity selected, it starts working automatically through the frequencies and bleeps to signify the end of treatment. A standard self-treatment lasts 20-30 minutes.

If I buy a machine, can I stop seeing my therapist?

No, ongoing visits to MLD/Lymphoedema practitioners are still vital even when a personal unit is purchased, to check for any signs of a change in condition that may need attention. The unit may lessen the amount of visits required as regular self-management eases symptoms and improves skin quality.

Does it hurt and can I take it on holiday with me?

No, it is very relaxing and yes, PhysioPod™ UK Ltd supply a letter with purchase for customs.

What is the price of the unit?

Prices for units are obtained on request to PhysioPod® UK Limited email info@physiopod.co.uk

What choices of unit are available?

Personal units come in a choice of either Sports or Aesthetics versions (list of conditions on request). You can read about each unit in products on www.physiopod.co.uk. The Bespoke Therapy card for Lymphoedema/Lipoedema/Lipo Lymphoedema is supplied by PhysioPod® UK Limited free of charge (normal RRP is £90.00 including VAT). A hands on kit is provided enabling a supportive other to provide treatment and one set of applicators for self treatment. It is important to remember that the contraindications apply to sufferer and the person applying when the gloved hands on method is used.

What are the standard accessories?

After choosing which card is the most suitable in terms of the individual requirements, e.g. sports or aesthetics therapy cards, it is supplied with the following standard accessories

[1] Applicator handhold
[4] Batteries
[1] Charging device
[2] Connection cables DEEP OSCILLATION®
[1] Connection cable grey for adhesive electrodes
[1] Operating instructions
[1] Oscillator head Ø 5 cm
[1] Oscillator head Ø 9.5 cm
[1] PHYSIOPADS adhesive electrode for DEEP OSCILLATION® (set of 4)
[1] Powder
[1] Special gloves size M (100 pcs.)
[1] Titanium neutral element
[1] Transportation bag

Are there any additional accessories I can purchase?

Yes, Additional Accessories are listed below:

(1) Battery charger - 4 slots
(1) Monouse Adhesive Electrodes - 60 per pack
(1) Oscillator Head 1.5cm replacement for use with pin applicator
(1) Pin Applicator for use in small areas
(1) Gloves in sizes small to extra large, boxed in 100 pairs or cases of 10 boxes
(1) Sweatbands
(1) Additional therapy cards, Aesthetics and/or Postpartum

Do I need a medical assessment before treatment commences?

In the UK/Ireland, your healthcare professional will go through a consultation form with you, assessing your suitability for treatment, including any possible contraindications and will ask you to sign a consent form before treatment commences.

What are the contraindications for DOT?

All normal massage contraindications: acute infections, TB, Untreated malignant diseases, Cellulitis, infectious skin diseases, pacemakers or other electronic implants, untreated heart diseases, pregnancy.

I have implanted pins/plates; can I still have the treatment?

Yes you can, the therapy does not heat tissue, making it perfectly safe to work over implanted pins and plates.

Am I going to be ‘electrically charged up’ during treatment?

No, the patented circuitry means a circuit is never completed. Imagine drawing 95% of a circle and then stopping, then re-starting, during the break in the drawing, the charge is safely dislodged via a patented internal active discharge device within the machine.

What’s the bar I am holding made of and why do I need to hold it?

The bar is made of high quality titanium and is held in one hand, or popped between the toes, whilst circulating the applicator with the other hand in the correct direction of flow, this set up is required for the therapy to work. Alternatively, two applicators (additional cost) can be connected into the unit to work either side of an effected lower limb or an applicator on each leg.

I felt a little tingle in my hand when holding the bar, is that normal?

Sometimes you can feel a tingle but it’s really not harmful, however, turning down the intensity does reduce the tingle but doesn’t reduce the effectiveness of the treatment, alternatively, the bar can be placed between toes where there is less sensation.

Why do I use talcum powder with therapy?

DEEP OSCILLATION® requires an absolute dry surface in the area to be treated. A light dusting of talc ensures the area is dry and helps the applicator glide over the area, you should see a pattern in the talc showing the effect of the surface of what DOT is doing in the deeper tissue layers.

Is it special powder?

It is a baby powder and is registered on the FDA database without ever having had any safety recalls. It is exclusively produced from elected ingredients, which are subject to strict purity controls comparable with the medical and pharmaceutical control system. Talc free alternatives can be used if the use of normal talc causes concern.

Does the therapy stop if I have a hot flush?

Yes because your core body temperature has raised and the body needs to be at a normal temperature, but please don’t worry, after a few minutes, when it has passed, just try again.

What happens during a treatment?

Electrostatic pulses create pleasant, deeply effective oscillations in the skin, connective tissue, subcutaneous fatty tissue, muscles, and blood and lymph vessels down to a depth of 8 cm.

Do I feel anything during treatment?

You will feel a pleasant, relaxing, vibration (oscillation) deep down inside the muscle tissues.

Does it matter if my mobile phone is in my pocket when I have treatment?

No, it will not effect the treatment or your phone. But it may be an opportunity to put your phone to one side and relax.

Does it matter if I am wearing jewellery?

No, it is perfectly fine. The therapy does not heat tissue. It has an a-thermal effect.

How can I protect the membrane head from wear and tear and prolong the life of membranes?

Cover the head with cling film and wrap/twist around hand base, this keeps the head sterile between treatments, the exterior rubber in place and protects the membrane, it also slightly increases the therapy effect.

What is the intensity button (dosage) on the DEEP OSCILLATION PERSONAL? Does more intensity mean better treatment?

No, effective therapy can be performed at minimal intensity. The therapist will start with the intensity turned up to 80/90 % and will adjust as necessary. It is adjusted to find the appropriate pressure of massage.

What if I stopped moving the applicator?

The therapy will stop, the therapy must be performed with movement, if the movement stops the therapy stops, it starts again as movement recommences.

What is DEEP OSCILLATION® doing to me during treatment?

In higher frequencies - Pain is significantly reduced. The bodies’ lymphatic drainage pathways are opened and activated. The therapy is breaking down the trapped cellular metabolic waste, including protein solids and abnormal fluid build up. This encourages the dispersal of hardened, fibrotic tissue.

In medium frequencies - Microcirculation in the interstitial spaces of the connective tissue is boosted, causing a relaxation of the tissues. The now collected, biological waste products start to move out to the lymph system for removal.

In lower frequencies -Vasodilation (expansion of blood vessels) causes a slight lowering of blood pressure. A powerful, yet gentle, pumping action in these lower frequencies causes strong movement in the tissue. The re-instigation of freely flowing fluids encourages essential nutrients back to the tissue.

What are the clinically proven effects?

• Improvement of the body's natural ability to replenish its depleted supplies of nutrients

• Muscle relaxation

• Pain reduction

• Haematoma (Blood filled swelling/bruising) and microtrauma prophylaxis

• Oedema reduction (fluid/protein filled swelling)

• Improvement in tone (through muscle stimulation and relaxation)

• Inflammation inhibition

• Stimulates wound healing

• Movement facilitation

• Anti-inflammatory effect

• Anti-fibrotic effect

• Reduction of skin irritation

• Detoxification

• Improvement in the tissue quality


Why would I benefit from DOT pre liposuction for Lipoedema?

Since DEEP OSCILLATION possesses anti-oedema, lymph drainage, anti-fibrosis and detoxifying properties, it prepares the tissue for liposuction, makes liposuction more effective and durable and protects against adverse effects of the body sculpting procedure.

Why would I benefit fro using DOT post liposuction for Lipoedema?

Because it can be used at a very early post-operative stage, the healing process is accelerated, scar quality is improved, and local inflammation is inhibited and stopped over a sustained period.

Why is this different to other electrotherapy products?

The therapy is intermittent, that is part of its patent. It is not a traditional electrical stimulation device (i.e. Tens), as a circuit is not completed. Neither does it produce heat (like in the thermal setting of Ultrasound).

Does DEEP OSCILLATION® have any known side effects?

The therapy has no known side effects and does not conflict with any medication. It is perfectly suited as supporting therapy during treatment with medication as well as physical treatment and physiotherapy. Patients may notice an increase in urinary output.

Can I read any feedback from Lipoedema/Lymphoedema sufferers having therapy with an MLD therapist or using the personal unit?

Yes, please visit Testimonials

Where can I read more about the science behind the mechanisms of DEEP OSCILLATION?

An article appeared in MLDuk The Journal in Spring 2017, exclusively written by Dr Jens Reinhold and it can be read here