What are the risks of liposuction? Are certain types of liposuction more likely to cause complications than others?
Doctor Answers 23
Liposuction is real surgery
Liposuction has been trivialized by patients, non-plastic surgeon practitioners and the media into just a "procedure" - it is not that, it is real surgery with real risks. Have you heard ads for "lunchtime lipo"? This is ridiculous!
Liposuction should be done by properly trained surgeons in accreditied facilities with anesthesia providers present. But the law allows anybody wielding a cannula to try to tempt you to go them. They will sell you on having it done under totally local anesthesia with no anesthesia doctor present, yet just yesterday in Seattle, the news carried a story about a liposuction patient from Sonno Bello clinic (a national body sculpting chain) dying 12 hours after her "procedure" in her hotel room of local anesthetic toxicity.
Contour irregularities are common as patients have overly aggressive liposuction done, or liposuction done with laser units that encourage the naive non-plastic surgeon to go close to the skin in order to encourage the skin to shrink better. These deformities are almost impossible to repair.
Infection can be a disaster as it rampages through the liposuction tunnels where the tissue barriers to the spread of infection have benn broken down and the tunnels are filled with serum in a warm dark environment - perfct culture medium. I have known of patients who have lost limbs to this.
Besides these dangers is the fact that liposuction is the single most revised cosmetic procedure (ie. the patients aren't that happy often).
So, consider it as real surgery, be careful who you go to as there are many poorly qualified practitioners out there who want your business, make sure to have anesthesia providers present, and do it in an accreditied facility. Make sure your expectations are realistic, as it is not for weight loss but rather for spot reduction of problem areas that resist exercise and diet.
I hope this helps!
Types of liposuction and likelihood of complications
If you want to be safe start by asking for the best liposuction surgeon and insist that your operation be done in a AAAASF / Medicare approved facility.
While there is no denying that a single knife stab wound is quite invasive.
Yet, it still amazes me how commercial interests have convinced THOUSANDS of American that if this proverbial knife is replaced with a sterile, shiny, fat-vacuuming steel tube (IE cannula), and instead of being stabbed once or twice, you will be stabbed hundreds of times, liposuction is somehow magically transformed into a "non or mini-invasive procedure" which ANYONE, regardless of their training and board certification can easily and safely do.
- You could be hurt by an overdose of Lidocaine in the Tumescent solution
- You can be hurt by an allergic reaction of an overdose of the intravenous medications given to sedate you (especially without a MD or CRNA anesthesiologist / anesthetist there to watch over you)
- you could bleed
- you could develop a rip roaring infection (especially if the facility you have your surgery in does not have specific protocols for sterility)
- your liposuction doctor could stab through an unrecognized hernia and puncture your bowels
- you could have areas of large asymmetry
- with laser lipo you could have areas of burns to the skin and permanent discoloration
Start by picking a surgeon who is a member of The American Society of Plastic Surgeons (www.plasticSurgery.org). Visit a few and ask them all your questions. Pick the one you feel the most comfortable with and you will guarantee yourself the least amount of potential complications.
I was the first surgeon to teach liposuction to other doctors in the United States and have taught safe liposuction techniques in more than 20 countries around the world.
When liposuction is performed in an accredited (AAAHC, JCAHCO) facility by a trained physician, who follows published clinical safety guidelines, it is a remarkably safe procedure.
There are risks in any surgery; liposuction is surgery! There is no such thing as non surgical or minimally invasive Liposuction. Complications are rare, but do occur. They include scars, infections, blood loss, abdominal perforation, ripples, asymmetry, poor cosmetic result, DVT.
In 1989, I chaired the first committee to publish safety guidelines for Liposuction. The American Society of Liposuction Surgery and the American Academy of Cosmetic Surgeons updates the safety guidelines every two years.
Ask these questions before scheduling liposuction: Is the surgeon trained and experienced? Do not be fooled by extensive advertising. Is the facility accredited or state licensed? Does it look like a hospital operating room and have all the safety, monitoring, and resuscitation equipment found in a hospital OR? Will an anesthesiologist or a CRNA be present? A surgeon should never do both the surgery and the anesthesia/monitoring. Will the surgeon use Tumescent infiltration? Even if general, epidural , or sedation is used, tumescent infiltration must be used for safe liposuction.
Every surgery has risks; properly performed liposuction has a 30 year record for safety.
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What are the Risks of Liposuction Surgery?
Liposuction risks have been greatly reduced by having undergone the procedure under local anesthesia instead of general anesthesia. The advent of tumescent technique local with the micro canulas have revolutionized the procedure and resulted in amazing results and almost no blood loss at all but there are some risks still present. Dimpling and burning holes in the skin with permanent discolorations are more common with the laser liposuctions and should be avoided since it was more gimmicky and not worth the increased risks and problems and that is why it is cheaper now. Shock and death from pulmonary emboli was seen more commonly with gen. anesth but still can occur. Infections are possible but if done by a qualified surgeon such as a derm surgeon in an accredited facility you greatly reduce those risks. Contour irregularities can occur but since we are able to stand patients up and put them in all sorts of positions during the procedure since they are totally awake, this allows for much more fine tuning and assure the patient of the smoothest results possible. Numbness or unusual sensations occur for the 1st 3 months but may be permanent but is rare. Overall it is a great procedure with amazing results. Enjoy the new you! Sincerely,
Risks of Liposuction
Dr. Richard Dolsky wrote a wonderful reply. In addition, some people notice focal areas of increased sensitivity while others might have areas of numbness. Indentations and raised nodules, either from localized inflammation or underresectiton, can occur. Hyperpigmentation, hypopigmentation (darker and lighter skin color) and hypertrophic / raised or keloid scars can develop from the insertion sites where the cannulae are introduced.Rapid heart beat, toxic levels of local anesthetic related to administration of a larger volume than indicated, or a medication that is taken daily interfering with the metabolism of the local anesthetic, perforation of an organ (rare during awake tumescent anesthetic), allergic reactions to the disinfectant, or local anesthetic, bleeding, hematoma (collection of blood under the skin), seroma (collection of serum, not blood, under the skin), bruising, blistering and other side effects and complications can occur.
The older type of ultrasonic liposuction caused some problems with ulceration and burns when the cannula were not moved enough and the heat damaged the skin through which the instrument was inserted. Experience has improved technique and the prevalence of this complication had decreased, but the technique itself is used less these days as more doctors have switched to laser-assisted liposuction if they do not perform straight tumescent liposuction.
The safest technique is the tumescent technique of liposuction. Associated with minimal bruising and quicker recovery, patients usually return to a desk job in 3 days. The tumescent technique is typically performed in an office facility. There is published scientific data from across the US regarding the safety of this technique. TUMESCENT LIPOSUCTION IS CONSIDERED THE GOLD STANDARD against which all other techniques are compared. There is a limit to how much local anesthesia can be safely administered, depending on your body weight, the medications you take and your general health. Usually, this is not an issue because the ideal candidate for liposuction is close to ideal body weight and needs limited stubborn areas removed. If you have multiple areas or large to be liposuctioned, it is possible that the best plan is to treat the areas in two sessions to prevent exceeding the safe limit of local anesthetic for you.
Your dermatologic surgeon will advise you about how all of these risks can be minimized by paying careful attention to preparation for the procedure and recovery. To keep your procedure simple, my recommendation is to find a board-certified dermatologic surgeon ( the ASDS website a useful resource) experienced in liposuction to get the best results the first time.
as with any surgical procedure, there are risks. There are small risks of bleeding and infection that are quite rare. There are risks of temporary waviness or dimpling of the skin due to swelling. There are temporary risks of sensation changes in your skin. There is the risk of the skin not tightening up and remaining loose after the procedure. The more rare problems of a perforation into the abdomen where internal organs lie, is luckily very very rare. In experienced and well trained hands, such as those of a board certified plastic surgeon, the risk profile is minimized as we are trained to take measures to limit those risks.
Liposuction Risks, Real But Rare
Liposuction is statistically one of the safest procedures in all of elective plastic surgery.
Having said that, remember that it is real surgery and should be performed by Board Certified Plastic Surgeons who understand the surgical changes and risks better than non-plastic surgeons.
The first risk parameter is that of volume. The more tissue that is removed, the more changes in fluids and electrolytes than can happen, and blood loss as well. So, volumes are generally limited to five liters (quarts) of aspirate as an out patient, and approximately seven liters of aspirate with an overnight stay, where monitoring of fluids, electrolytes, and volume status can be done. This is very important and keeps patients safe because after large volumes of liposuction the body replaces the aspirated fat with body fluids, which come out of the blood stream, so there is only a limited capacity for this. Good fluid replacement in the O.R. and good postoperative surgical management will almost always mitigate these risks. This is why Board Certified Plastic Surgeons are so much better qualified than anyone else to perform these procedures.
Other risks, such as infection and bleeding, are extremely rare, as are fluid collections called seroma. Overall, the procedure is safest in the hands of Board Certified Plastic Surgeons.
The subject of risks and potential complications of surgery is best discussed on a personal basis with you when you visit us during your consultation and your preoperative appointment. The risks in most surgeries are similar. Some of the potential complications that may be discussed with you include hematoma (an accumulation of blood under the skin that may require removal), infection, changes in sensation, scarring, allergic reactions, damage to underlying structures, need for revisions, unsatisfactory results possibly necessitating additional procedures and medical risks. Other risks more specific to liposuction may include indentations and irregularities.
You can help minimize certain risks by following the advice and instructions we provide, both before and after your liposuction surgery. Best of luck!
Dhaval M. Patel
Double board certified
Shim Ching, MD
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.