Arm lipoedema is the abnormal, symmetrical accumulation of fibro-fatty tissue in the upper arms, typically sparing the forearms and hands and creating a disproportionate, column-like appearance from shoulder to elbow. It may be most noticeable on the back and outer aspects of the arm or distributed around the full circumference. The tissue often feels nodular and is tender or painful to touch, with frequent spontaneous bruising from minor contact and a persistent feeling of fullness or heaviness. In later stages the tissue becomes firmer and more fibrotic.

Water-assisted liposuction targets this buildup by first infusing a tumescent solution to numb and firm the area, then using a specialised cannula that emits a low-pressure, fan-shaped water jet to separate fat from connective tissue and vessels. This preserves lymphatic channels and reduces bleeding and swelling compared with traditional suction or heat-based methods. Mr Vasu Karri performs these procedures with emphasis on even fat extraction, whether treating the posterior zone alone or all surfaces of the arm, to achieve a balanced reduction.

Patients can expect a noticeable decrease in arm girth, often several centimetres, with skin generally retracting well in early to moderate stages. Conservative therapies such as compression and manual lymphatic drainage are continued before and after surgery to support recovery and reduce complication risks.

The benefits of this procedure include:

• Removal of lipoedema fat from the upper arms, including posterior and circumferential patterns
• Significant decrease in arm pain, tenderness and easy bruising
• Enhanced arm mobility and reduced fatigue during daily use
• Better clothing and sleeve fit with increased confidence in short sleeves
• Long-term contour stability when combined with a healthy, stable weight