Why is Morbidity the Defining Factor for Plastic Surgery?

Why is morbidity the defining factor for plastic surgery safely rather than disfiguration, and chronic pain that is so common?  Why wait until people die to set more sane regulations? It's common for liposuction patients to be disfigured and left in chronic pain. I suggest that doctors take time to read the comments/reviews from all the women who have been overly and improperly resected. 5 liters is a huge amount of fat/fluid to remove from a healthy person. If liposuction is truly for contouring only, why would you ever suction out so much healthy adipose tissue? This doesn't make any good medical or ethical sense. 

Doctor Answers (3)

Why is Morbidity the Defining Factor for Plastic Surgery?

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      5 liters has been determined to be a safe upper limit of lipoaspirate volume.   In general, the amount of fat volume at the high end will be about 3 liters or so for this lipoaspirate volume.   On a very thin patient, only a liter or so may be suctioned from the abdomen, flanks, and back.  However, most patients have much more than 3 liters of fat on the abdomen, flanks, and back.   Contour irregularities tend to vary by surgeon and technique and judgement employed and utilized.  Kenneth Hughes, MD Los Angeles, CA


Los Angeles Plastic Surgeon
5.0 out of 5 stars 218 reviews

Morbidity in Plastic Surgery

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Board  Certified Plastic Surgeons would generally agree with you. Unfortunately, you are lumping everyone doing cosmetic surgical procedures together, when, in fact, there are multiple groups of physicians performing these procedures, each with different compitencies. Both the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, two organizations of board certified plastic surgeons, have for years worked diligently to improve patient safety and to prevent the things you mention. Unfortunately, state regulations generally allow any physician to perform any procedure they wish with frequently very little oversight. Some states do have regulations regarding safety requirements of operating rooms, but, unfortunately, many non plastic surgeons have found ways around many of these. It really boils down to the fact that you have to protect yourself. First, you need to check the credentials of the physician you plan to see. If you are planning on fillers or injectables, they should be a plastic surgeon, dermatologist or other physician who has had extensive training in these procedures. ExpertInjector.org recognizes these. If you are contemplating surgery, the person doing it should be a real surgeon who completed a full surgical residency. They should also be privileged in a fully licensed hospital to perform the procedure you are contemplating. The procedure should be done in a fully certified facility. If this facility is not a hospital, it should have passed the same review as a hospital. If the person and facility do not meet these criteria, find someone else. Membership in the above mentioned organizations guarantees that these requirements are met, as they require full training, competence that has been examined and certified and that the procedures are done in a certified facility where privileges for the procedures have been granted by an oversight committee.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 4 reviews

Why is Morbidity the Defining Factor for Plastic Surgery?

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I think we have some disagreements about the meaning of morbidity, as I would certainly include pain and disfigurement within my definition.

A consent form that many ASPS (American Society of Plastic Surgeons) use lists a large number of potential complications for liposuction. The primary ones include bleeding, infection, scarring, altered sensation, skin discoloration or swelling, skin contour irregularities, asymmetry, seroma, anesthetic risks, pain, hypersensitivity, damage to deeper structures, delayed healing, allergic reactions, fat necrosis, lymphedema, shock, blood clots, tumescent injection risks, unsatisfactory outcome. 

Next is the definition of common. I know there are patients who have pain and feel that their outcomes were unsatisfactory. But those are rather uncommon in my experience. I see a fair number of unsatisfied patients who were seeking my second opinion. Few would I actually call disfigured. Almost all who brought preop photos looked better, if not up to their expectations. Almost all of the truly unsatisfactory results came from practitioners who were not, in my opinion, properly trained. It has been rare to see such a patient after surgery performed by a plastic surgeon or dermatologist. 

Thanks for your question. All the best

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 31 reviews

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