Seeing a report that a woman died in Australia from liposuction. News story says "Dr Dieu said the incidence of death from liposuction was about one in 5000 and the risks were discussed with Ms James." Is this true, 1 in 5000 people die from liposuction???
Risk of Death from Liposuction?
Doctor Answers 11
Some perspective on liposuction risks
A lttle history: when lipo was first introduced about 30 years ago, it was done without any tumescent type of infusion and so only small volumes could be done without too much blood loss. By adding infusion (whether wide awake, with sedation, or under general) the blood loss is much less and so larger volumes of fat could be removed. In the 1990's there was a report citing the figure you mentioned. As a result of what appeared to be an escalating incidence of serious complications, a task force was put together and they determined that the cause was often doing too much at one time. They then recommended that no more than 5000 cc's be removed as an outpatient, and the operation has become much safer now. My concern however, is that some are starting to push the limits again and we may see more problems. So the procedure should be done in an accredited facility, by an experienced surgeon, and know the limits.
Tumescent liposuction has an excellent safety track record
As all liposuction procedures performed are not reported, the true mortality rate from this procedure is possibly much lower than the early reports.
Pure tumescent liposuction, (large amounts of dilute local anesthetic injected into the fat) with an awake patient (no general anesthesia) and avoidance of doing other surgical procedures at the same time, limiting the amount of fat removed to less than 5 liters, limiting the dose of lidocaine (anesthetic) to 35 - 45 mg/kg of body weight, and ensuring that daily medication consumed by the patient doesn't interact with the local anesthetic are the conditions that provide the greatest safety to our patients.
1 in 5000 lipo death rate is not accurate
Many procedures that require anesthesia have some risk of death. The risk may be very rare or less rare. The particular figure you are quoting probably never existed even at the height of the rash of deaths associated with liposuction in the 90's.
These coincided with a trend to do liposuction with ultrasonic suction aspirators that required significant infiltration of wetting solution into the fat to avoid a tissue burn and higher volumes of liposuction. The wetting solution contained local anesthetic and when combined with the drugs for general anesthesia, the combination proved to be lethal.
With the Medical Boards of Florida and California leading the way, and recognition on the part of plastic surgeons that this was bad business, limits were placed on the volume of liposuction done at one time. This has helped reduced the incidence of liposuction related deaths.
The one in 5000 case incidence which is extremely high came from a survey study of general plastic surgeons and probably grossly overestimates the death rate. However other studies suggest that the rate is about 1 in 30,000 to 1 in 50,000 cases.
To put this in perspective the risk of dying on a commuter aircraft is about 1:500,000. So these numbers should no be dismissed lightly. If a surgeon tells you that "it has never happened to me in X years of practice," take this with a grain of salt. The incidence even at 1:5000 cases that many surgeon will practice an entire career without experiencing this complication.
Now there is an alternative to having liposuction under general anesthesia. When liposuction is performed under local anesthesia there are virtually no operative deaths. The incidence of death from this type of liposuction is about 1:500,000. Who performs liposuction under local anesthesia? Dermatologic surgeons. Using this method called tumescent liposuction, you can have liposuction safely performed with almost no risk of death.
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Safety of Liposuction
Liposuction, indeed, in one study had a mortality of 1 in 5000. This caused a moratorium on liposuction in Florida several years ago. After significant studies confirming the safety of Liposuction when done properly, it was again allowed with certain restrictions. These restrictions included careful patient monitoring during the procedure and limitation of how much fat is suctioned and what other procedures are done at the same time as an outpatient. With these precautions, Liposuction has the same risk of mortality as a hernia repair, very low. Unfortunately, we are now seeing many untrained physicians doing Liposuction with little realization of the potential problems that can occur. My advice is to pick a surgeon who has significant experience and operates only in a certified facility. The easiest way to start this search is with a member of the American Society of Plastic Surgeons ( www.PlasticSurgery.org ) or the American Society for Aesthetic Plastic Surgery ( www.surgery.org ). Both organizations require their members to operate in a certified facility for this type of surgery.
Liposuction death risks
Liposuction is a very safe procedure. A study from the early 90's reported this number but it was based on all volumes of liposuction and multiple procedures as well. If liposuction is done in a controlled setting with less than 5 liters in the appropriate patient, then it is very safe.
Liposuction is very safe.
Nothing is 100% safe. One can get killed crossing the street. But, if 3 requirements are met, liposuction is probably the safest cosmetic surgery operation. The 3 requirements are:
1) experienced plastic surgeon.
2) healthy patient.
3) Not removing more than 5000 cc's (that's about 10 pounds). In our typical patient, we remove 2000 cc's to 3000 cc's. So, very safe.
Risk of death from liposuctioning
That number is from a review article in plastic surgery from liposuctioning in the 1990's. I have to assume that the number is even smaller now. Liposuctioning is one of the most common procedures performed by plastic surgeons and they are not the only ones performing liposuctiong. You can even find family doctors, dentists and eye doctors doing liposuctioning. You should understand the main risk factors associated with liposuctioning. The higher the volume the greater the risk.
Death from liposuction
We have no hard and fixed numbers on this because all cases of liposuction are not recorded. Liposuction is performed by many specialties including family practitioners, general surgeons, otolaryngologists, gynecologists, dermatologists, and plastic surgeons. It is very difficult to gather data from this diverse set of practitioners.
Typcially, the most common cause of death from liposuction is attributed to deep venous thrombosis with pulmonary embolus. Other causes include fat embolism, necrotizing faciitis, electrolyte imbalance
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.