Specially performed Water Assisted Liposuction (WAL) has been successful in ameliorating many of the symptoms associated with lipedema, especially tender and painful fat. In addition, reduction of the medial fat pads of the thighs can improve gate by decreasing strain on the knees, thus improving mobility. Techniques developed in Germany are now being offered at the Friedman Center as part of its comprehensive care of patients at risk for lymphedema.