Background: Long-term results following liposuction in patients with lipedema were available only for an average period of 8 years. Objective: To find out whether the improvements persist for a further 4 years. Methods: In 60 patients with lipedema a single-centre study with a mail questionnaire – often in combination with clinical controls – was performed after an average period of 12 years following liposuction(s). All patients in this group had already been surveyed 4 and 8 years after surgery. Results: Compared with the earlier results improvement persisted with regard to spontaneous pain, sensitivity to pressure, edema, bruising and restriction of movement; similar outcomes were observed for self-assessment of cosmetic impairment, reduction in quality of life and overall impairment. While in the period from 4 to 8 years postoperatively complaints slightly increased, this was not the case for the period 8 to 12 years postoperatively. In addition a similar reduction of conservative treatment (decongestive therapy, compression garments) was observed as after 4 and 8 years postoperatively. Compared with the body weight before liposuction, 55% of the patients showed a reduction of 6.2 kg on average and 43.3% had a weight increase with an average of 7.9 kg. Conclusion: The results show, that the positive effects of liposuction last 12 years postoperatively without relevant worsening. They imply that liposuction for lipedema leads to a permanent reduction of symptom severity and need for conservative therapy.