Cankles in lipoedema result from abnormal fat buildup encircling the ankle and extending into the lower calf, eliminating the natural taper and producing a columnar lower leg with symptoms like pain on pressure, spontaneous bruising and restricted ankle mobility. This fat is fibrotic in nature and does not respond to conventional measures.

Water-assisted liposuction is ideal for this sensitive area: tumescent fluid is infiltrated first to numb and protect vessels, followed by a fine cannula using a low-pressure water jet to gently detach fat cells without aggressive suction that could compromise lymphatics or cause irregularities near the ankle joint. Mr Vasu Karri emphasises precise, conservative removal to restore subtle tapering while preserving ankle function and avoiding over-thinning.

Reduction here often complements other leg procedures, leading to better overall leg symmetry and decreased shoe-related discomfort. Compression and manual lymphatic drainage are essential pre- and post-operatively to support healing and refine contours.

The benefits of this procedure include:

• Precise removal of cankle fat for defined ankle tapering
• Reduced ankle and lower calf pain, tenderness and bruising
• Improved lower leg proportions and natural contours
• Greater comfort in footwear and reduced shoe pressure
• Enhanced mobility and confidence in leg appearance