In 1997, a new chapter in therapy in lymphology began. Sufficient dermatosurgical resecting procedures were added to the known conservative measures of complex physical decongestive therapy (CPT). The focus was on the following: “Lymphological Liposculpture” is a supra-fascial-subcutaneous-subtotal-aspiration-vibration- exhairese with the MicroAire®-PAL-System. It is used for Lipohyperplasia dolorosa (LiDo), “Lipoedema” in tumescent local anaesthesia (TLA) and lymphoedema in TLA + H (Hyaluronidase). The “Lymphological Liposculpture” method includes two steps: (1) Resection of the subcutaneous tissue. (2) Accentuated manual lymph drainage (AMLD) as lymph vessel training. In Lipohyperplasia dolorosa, this procedure in TLA leads to painlessness, normalises lymph flow, is permanent and allows dispensing with further conservative therapy with manual lymph drainage and compression. The primary goal of this lymph surgical measure is not aesthetic improvement of the patient’s silhouette. The medical treatment aims to restore a balanced lymph production and transport ratio, thus equalising the high-volume transport insufficiency. A success rate of 97% was achieved for the procedure goal—eliminating the need for CPT or MLD. In lymphoedema, “Lymphological Liposculpture” in TLA + H resulted in a complete waiver in 58.46% of the patients in the 15-year study and a significant reduction of CPT in 33.82%. What was once reserved for selected cases is increasingly becoming the standard: As a lymphologist, please also check whether the surgical treatment options of the speciality can be applied to your patient!