Dr. Rosa Kindling was born in Northern Iraq and studied human medicine at the University of Cologne, complemented by international training stations in Lucerne, London, and Sri Lanka. After completing her doctorate in 2019, she underwent her basic surgical training and successfully completed her specialist training as a specialist in plastic and aesthetic surgery in July 2024. Already in June 2021, she founded the private practice dr.rosi alongside her clinical work, specializing in aesthetic and minimally invasive treatments and lipedema surgery.

The diagnosis of lipedema is the endpoint of a long journey of suffering for many women—and at the same time, the beginning of many new questions. When is the right time for surgery? Which method promises the greatest success? And what does optimal preparation look like? In the interview, Dr. Rosa Kindling discusses the importance of an informed decision, realistic expectations, a holistic treatment concept, and why the surgeon's experience is more important than the most modern equipment.

Venen Engel: Medical technology is constantly evolving. What methods do you prefer for liposuction in cases of lipedema?

Dr. Rosa Kindling: I learned with water-jet assisted liposuction (WAL) and still operate using this method today. It allows for very tissue-friendly work.

According to current scientific data, no liposuction method has been shown to be clearly superior to others. Both water-jet assisted (WAL) and power-assisted liposuction (PAL) can achieve excellent results when applied correctly.

In my opinion, the experience of the surgeon is more crucial than the device itself. Even with the most modern technology, poor results can occur if experience or a good aesthetic understanding is lacking. Conversely, precise technique and extensive experience can lead to excellent outcomes.

Venen Engel: Liposuction is not a minor procedure. What does optimal preparation for the surgery look like?

Dr. Rosa Kindling: The best preparation begins several weeks before the operation. A balanced diet, regular exercise, and stable body weight create good conditions for optimal healing.

It's very important to me: Please do not start a radical diet immediately before the operation. For good wound healing, the body needs sufficient energy and especially enough proteins. Therefore, weight should be kept as stable as possible.

Patients with pronounced edema or a strong feeling of tension often additionally benefit from consistent compression therapy and, if individually appropriate, also from manual lymphatic drainage.

Venen Engel: What expectations do patients have when they come to you, and what advice do you give them?

Dr. Rosa Kindling: Most patients come with very realistic expectations. Rarely are purely aesthetic desires at the forefront. More often, it's the pain, the constant feeling of heaviness, and the limitations in daily life that burden them. Many simply want to move more easily again and regain their quality of life.

Of course, there are also patients with unrealistic aesthetic expectations. Then it is our responsibility as surgeons to openly discuss the limits of an operation. If a common realistic expectation cannot be developed or a desired result is not medically achievable, it is better to advise against surgery.

Venen Engel: Speaking of aftercare: Is there a golden rule for the time after surgery?

Dr. Rosa Kindling: Yes – take active responsibility for your health. Liposuction treats the pathologically increased fat tissue but does not replace a healthy lifestyle. Exercise remains a central part of therapy even after the operation.

As soon as circulation and symptoms allow, I recommend my patients take regular walks. Gradually, they can return to sports.

I am always pleased when patients ask, even at the stitch removal, when they can swim or train again. This shows motivation and self-responsibility. The goal should always be sustainable improvement – not the expectation that every future change must be solved surgically again. A successful treatment always considers the person as a whole.

Venen Engel: Is there a patient story from your practice that has particularly stayed with you?

Dr. Rosa Kindling: Yes, especially from my time in the clinic before my parental leave.

We treated patients with very advanced stage III lipedema, who were already significantly limited in their mobility. One patient could hardly manage her daily life independently.

After several liposuctions and subsequent skin tightening procedures, her progress was remarkable. Not only functionally, but also aesthetically, her legs were hardly recognizable. Even more important was how she regained her joy in life. She was able to go for walks again, maintain social contacts, and actively participate in life. Such developments show the enormous impact our work can have on quality of life.

Venen Engel: What advice do you give to women who have just received their diagnosis?

Dr. Rosa Kindling: My most important advice is: Take the time to truly understand the condition.

Inform yourself thoroughly about lipedema, try out conservative treatment options, and observe what personally benefits you. Liposuction can often significantly improve symptoms and enhance quality of life, but it is not an emergency.

Make this decision consciously and without pressure. More importantly, ensure you feel completely supported and understood by your healthcare provider. Only when you have accepted the condition and all your questions are answered should you jointly decide on a surgical procedure.