Serrapeptase After Liposuction for Lipedema: Limited Evidence for Antifibrotic Efficacy.
- 2026-02-05
- Aesthetic plastic surgery 50(9)
- Agostino Bruno
- Valerio Saccoccio
- PubMed: 41642311
- DOI: 10.1007/s00266-026-05638-0
Study Design
- Type
- Observational
- Sample size
- n = 25
- Population
- 50 female patients with a confirmed diagnosis of lipedema undergoing tumescent liposuction
- Methods
- retrospective, observational cohort study; patients allocated to either a serrapeptase group (n = 25), receiving 60,000 IU daily for 4 weeks, or a control group (n = 25) receiving standard care alone
- Duration
- 4 weeks
- Funding
- Unclear
Background
Postoperative fibrosis is a frequent complication following liposuction for lipedema. Serrapeptase, a proteolytic enzyme with purported anti-inflammatory and antifibrotic effects, is used empirically, but robust evidence supporting its efficacy is lacking. This study aimed to assess the clinical effectiveness of postoperative serrapeptase supplementation in reducing fibrosis following lower limb liposuction for lipedema.Methods
This retrospective, observational cohort study included 50 female patients with a confirmed diagnosis of lipedema undergoing tumescent liposuction. Patients were allocated to either a serrapeptase group (n = 25), receiving 60,000 IU daily for 4 weeks, or a control group (n = 25) receiving standard care alone. The primary outcome was tissue stiffness measured by quantitative ultrasound elastography (QUS). Secondary outcomes included B-mode ultrasonography, patient-reported pain (VAS), and clinical assessment of induration. Evaluations were performed at baseline, 4 weeks, and 3 months.Results
Baseline characteristics were comparable between groups. No statistically significant differences were observed in the primary outcome of tissue stiffness at 4 weeks (14.8 ± 3.1 kPa vs. 15.2 ± 3.0 kPa; p = 0.62) or 3 months (13.7 ± 2.9 kPa vs. 14.0 ± 3.2 kPa; p = 0.78). Similarly, no significant benefits were seen in secondary outcomes, including fibrotic changes on ultrasound, VAS pain scores, or clinical induration (p > 0.05 for all). Serrapeptase was well-tolerated with no adverse events reported.Conclusions
Oral serrapeptase supplementation did not demonstrate measurable efficacy in preventing postoperative fibrosis or improving patient-reported outcomes following liposuction for lipedema. These findings do not support its routine use in this clinical setting.Level of evidence iii
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .Research Insights
no significant benefits were seen in secondary outcomes, including clinical induration
- Effect
- Neutral
- Effect size
- Small
- Dose
- 60,000 IU daily for 4 weeks
no significant benefits were seen in secondary outcomes, including fibrotic changes on ultrasound
- Effect
- Neutral
- Effect size
- Small
- Dose
- 60,000 IU daily for 4 weeks
no significant benefits were seen in secondary outcomes, including VAS pain scores
- Effect
- Neutral
- Effect size
- Small
- Dose
- 60,000 IU daily for 4 weeks
No statistically significant differences were observed in the primary outcome of tissue stiffness at 4 weeks (14.8 ± 3.1 kPa vs. 15.2 ± 3.0 kPa; p = 0.62) or 3 months (13.7 ± 2.9 kPa vs. 14.0 ± 3.2 kPa; p = 0.78).
- Effect
- Neutral
- Effect size
- Small
- Dose
- 60,000 IU daily for 4 weeks
Adverse Events Reported
Serrapeptase was well-tolerated with no adverse events reported.
- Finding
- Reported