I want to get liposuction on every part of my body, but scared of dying on the operation table. How can I overcome my worry?

its hard for me to tone up through diet and exercise. Despite a safe surgery, I have read about people who died from it. I had my physical done in October, and overall I am healthy. The doctor I am going to has stellar reviews and is a board certified cosmetic surgeon. I have mutliple areas that needs to be done, so I dont know what he is planning since I am flying in. What if I have underlying medical conditions that I am unaware of? Please help me ease my worries. Thanks

Doctor Answers 10

Considering a game change

I suggest you put on the brakes.

You should have no trouble finding an experienced, board-certified plastic surgeon in the Seattle area who can help you get through this safely and successfully.

Before that, though, you first have to be assessed to make sure you're an appropriate candidate.

Has this cosmetic surgeon met you? It is not possible to make an accurate assessment if someone is a good candidate for liposuction without a physical examination.

I would highly advise against full-body liposuction by someone not trained and board-certified in plastic surgery.

I think your concerns are legitimate only because of the context of your situation.

I suggest you find a local, experienced, board-certified plastic surgeon and have a proper in-person evaluation.

Next, start by having treatments on the areas that will give the most satisfaction.

See how you like the results and if you like that person's work.

You can then move forward and have additional areas treated over time.

Finding someone who is not properly trained, who gives the best price and is willing to do all of the surgery at one time sounds like a potentially very dangerous and bad decision.

As you know, there have been fatalities from liposuction. There have been fatalities in Seattle from liposuction by non-plastic surgeons performing this procedure.

That pretty much summarizes my answer for you.

The following is just a long ramble about board certification and its importance.

Board certification:

My answers tend to be lengthy at times. This may be one of those longer answers.

No single physician or medical specialty has a monopoly on any one procedure or treatment. Legally, a radiologist can do heart transplants. In reality, though, that is usually not the case.

Most major surgeries are done in operating rooms. To get access to an operating room in a hospital or surgery center, the physician has to have privileges. Privileges are only granted to physicians with appropriate qualifications. Unless a physician owns their own hospital or surgery center, they are required to have appropriate training and background. There are many physicians who do own their own surgery center or do substantial surgeries in their offices.

Since the scope of practice cannot legally be limited, there needs to be mechanisms to protect the public. These include state medical boards and other regulatory agencies as well as board certifications.

The great majority of medical board certifications are overseen by the American Board of Medical Specialties. Their website is certificationmatters.org.

That's an excellent place to start if you want to get some further background on board certification.

All the different medical specialty boards overseen by the American Board of Medical Specialties require some type of residency or fellowship training or proof of competencies. The great majority of practicing physicians in the United States belong to one of the many boards overseen by this agency.

Just as physicians cannot be legally limited to their scope of practice, neither does the American Board of Medical Specialties have a monopoly on creating medical boards.

As such, there are medical boards that are not recognized by the American Board of Medical Specialties.

One such board is the American Board of Cosmetic Surgery. There is technically no residency in cosmetic surgery (there are fellowships in cosmetic surgery done after a residency). The great majority of training in cosmetic surgery is done in plastic surgery residency. Other specialties that also include some forms of cosmetic surgery during their training are ear, nose and throat, or otorhinolaryngology, and dermatology.

You would think the majority of the members of the American Board of Cosmetic Surgery would be plastic surgeons. They are not. Very few plastic surgeons are members of the American Board of Cosmetic Surgery. The majority of their members come from different backgrounds like general surgery, OB/GYN, dermatology, internal medicine, emergency medicine, etc.

I am not going to go on and on about which board is a real board and which board is a fake board. I will let the consumer figure that one out. I will say that both the American Society of Plastic Surgeons and the American Board of Plastic Surgery, which are the main political organizations that oversee plastic surgery, have spent much time and effort trying to educate the public as to what certification means and why it is important. Some would argue more could and should be done in terms of educating the public regarding board certification.

So why does it matter if a doctor is certified? Being board-certified is no guarantee that a physician is going to be of the highest caliber, but it is a very rigorous process that is very difficult to achieve. For starters, it requires that you complete residency or fellowship training. Anyone can practice medicine as long as they have finished medical school and completed one year of internship. That's generally five years of training. To put things in perspective, most plastic surgeons have had 10-13 years of training.

One note on facial plastic surgery: there is a recognized board called the American Board of Facial Plastic Surgery. Most of their members are trained in ear, nose and throat, or otorhinolaryngology, and have completed a fellowship in facial plastic surgery.

The great majority of surgeries done on the face and in the head and neck were developed by plastic surgeons. Over the years, otorhinolaryngologists and other specialists have evolved and incorporated many of those procedures into their own specialty.

The first Nobel Prize given to a surgeon was to Joseph Murray, a plastic surgeon who performed the first kidney transplant. Today, a plastic surgeon would most likely not be given privileges to perform kidney transplants in any major hospital in the United States.

Who is best qualified to do what procedure? I've tried to explain why board certification is important, but that still leaves choices of which type of doctor.

Here are my criteria:

If a physician can offer all of the alternative procedures, can take care of the any and all complications, did not learn the procedure by experimenting on people after weekend courses and has privileges to do the procedure in a hospital, they are qualified to do the procedure.

There are many competent dermatologists, otorhinolaryngologists, etc., who do liposuction. Few, if any of them, are trained to do tummy tucks, mini tummy tucks, brachioplasties (arm lifts), etc.

You may have heard the expression, "If you're a hammer, the world looks like a nail."

Unfortunately, if someone only performs liposuction and not the other procedures, they are probably less likely to recommend a tummy tuck or arm lift even if those may be the better procedures.

Hand surgery is a specialty on its own that has developed from backgrounds from both orthopedic surgery and plastic surgery. Most hand surgery in the United States is done by doctors who are either orthopedic surgeons or plastic surgeons. Many of those have done an additional fellowship training in hand surgery. There are also general surgeons who have done fellowship training in hand surgery and can be certified in hand surgery as well.

As one of my favorite teachers used to say, "If you want to be a plastic surgeon, you should go to plastic surgery school."

Cosmetic surgery in general pays significantly more than any insurance-based procedure. Call it greed or just a desire to earn a good living, many physicians from different specialties want in on the action.

As such, cosmetic surgery, which at one point was synonymous with plastic surgery, has been picked apart and gobbled up by many talented and sometimes not-so-talented physicians from different backgrounds.

So do your research. Look for board certification and understand the scope of practice and limitations of different specialties.

My last recommendation is to choose a surgeon who has a lot of experience, good reviews, excellent before-and-after pictures and who is a patient advocate looking out for your best interest. That may be easier said than done, but that's what we should all be shooting for.

Another one of my professors used to say, "Don't look for bargains when buying parachutes or cosmetic surgery."

In the end, this is a situation of "caveat emptor (buyer beware)".

I hope I was of some help.

Best of luck,

Mats Hagstrom, M.D.

I'm worried for you

I'd love to ease your worries, but I can't.  Just reading your questions makes me worried for you.  But general anesthesia is not what I'm worried about.  Here are the red flags:

1.  To where are you flying and what is the timetable for your flight home relative to surgery?  Air travel too close to surgery can greatly increase the risk of blood clots.  Blood clots are much more likely to kill you than general anesthesia.  They can break off, travel to the lungs and cause sudden death.

2.  Liposuction on every part of your body cannot be done safely all at once.  Too many freshly operated sites at once could cause too much bleeding and/or fluid imbalances which could be fatal.

3.  Double check your doctor's credentials.  Is he/she a board certified PLASTIC surgeon or board certified COSMETIC surgeon?  They are not the same.  Most ABCS certified doctors have their training in specialties other than plastic surgery.

4.  Where did you read those stellar reviews?  There are many untrustworthy web sites out there.  HIPAA privacy laws make it impossible for any website to verify whether someone posting a rating is a real patient.  (Kudos to RealSelf for their role in getting LifeStyle Lift busted for posting fake reviews!)  To get better recommendations, try asking your primary doctor, nurse, friends, or anybody you trust who is in a position to know.

5.  Have you met this doctor yet?  You wrote that you do not yet know the surgical plan.  What will you do if get there and find you don't like the plan or are uncomfortable with the surgeon?  Would you go through with it anyway because you've already invested in airline tickets and possibly the surgery itself?  You live in a city chock-full of competent, board certified plastic surgeons who will meet with and examine you (often for free).  You can decide whether you like them and their plan before you have committed to the expenses of travel and/or surgery.  

6.  Have you thought about what you would do if you had a complication after returning home?  Your far-away doctor won't be able to take care of you.  It won't be cheap finding a local plastic surgeon willing to clean up someone else's mess.

Moderation is key to your overall wellbeing.

It’s understandable to have some anxiety about an unfamiliar medical procedure, especially if you're traveling to meet a new surgeon and aren't yet aware of your treatment plan. However, all of these things are red flags when taken together. You certainly should have a consultation with your surgeon before the procedure, so that he or she can answer any questions and address any concerns you may have. It is also crucial that you only seek treatment from a board certified plastic surgeon who has proven experience in liposuction. Finally, getting extensive liposuction throughout the body is not safe, and goes against the intended goal of the procedure, which is to treat isolated problem spots. Proceed with caution, do plenty of research, and put your health and safety first.

Clay Forsberg, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 15 reviews

I want to get liposuction on every part of my body, but scared of dying on the operation table. How can I overcome my worry?

WOW.  How many red flags are you waving?

Why are you flying somewhere to have surgery?  There are a bajillion well qualified, board certified plastic surgeons in Seattle.  If you are flying somewhere because you cannot find a surgeon in Seattle willing to do a total body liposuction, you should be worried!  If you are travelling to get a "cheap deal", you should be worried.  What part of the operation is being discounted?  Anesthesia?  Sterile technique?  Pre and post op care?   If you are using liposuction as a substitute for weight loss, you should be worried. 

The vast majority of liposuction deaths have been in cases that sound similar to you - large volume and multiple areas on overweight patients.

My advise is to see a local surgeon certified by the American Board of Plastic Surgery.  He or she will give you honest advice.   Sometimes the best advice is to not have surgery.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 67 reviews

Liposuction and Full Body Contouring -- Please Get A Tumescent Approach, Local No Asleep

You can have liposuction done without being put to sleep.  It is very safe and has much less downtime.  I suggest seeing an expert.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 167 reviews

#Liposuction - "on every part of my body"

This is already an unrealistic expectation and I think you should sit back, take a deep breath, and start the process over again.

Liposuction is an outstanding procedure and hundreds of thousands of people have it, with great success, every year in the United States alone, with many more world wide.   That being said, there are certain standards, and there are "red flags" - things that cause one to worry.  Red flags include underlying medical problems, unrealistic expectations for the surgery (ie expecting it to provide weight loss rather than contouring, etc).

You should start with a board-certified plastic surgeon ("cosmetic" may or may not be that) or, if you're willing to have smaller amounts done (on multiple occasions), a board-certified doctor who does tumescent lipo (that can be a dermatologist, ENT or, actually, many other types of surgeons).  Despite the preference among some to designate only one specialty as "qualified," the reality is that the board-certification alone may not be adequate for choosing a qualified and competent surgeon.

But it is unrealistic to have lipo on every part of your body.  That alone would, in my opinion, produce too many raw surgical sites, into which you could bleed, and would increase the risks of the surgery.  There is a limit to what can be done safely at one time, both in terms of the total volume and, arguably, the percent of the body being operated upon.  A more cautious approach is to limit the amount and/or the regions.

You should discuss this again with your surgeon and seek additional opinions from surgeons who can examine you in person.  There is no shortage of them in and around the Seattle area, so you should start with that and make a decision on what to do, and where, after you're explored this anew.

I hope that this helps and good luck,

Dr. Alan Engler
Member of #RealSelf100
@RealSelf

I want to get liposuction on every part of my body, but scared of dying on the operation table. How can I overcome my worry?

First of all it is unrealistic to get liposuction from head to toe in one operation, no matter how "stellar" your chosen surgeon is. Second, as Dr. Rand pointed out, there's no board certification for cosmetic surgery under the ABMS (American Board of Medical Specialties) umbrella organization. The ABMS oversees ALL the legitimate medical and surgical boards in the USA. You also state that you are flying in and do not know what your cosmetic surgeon plans for you. I assume that you will have a face to face consultation a few days prior to your proposed surgery (since you are flying in, need to wait with surgery at least 48 to minimize your risk of blood clots, pulmonary embolus or even death) and not a 5 minute visit before you hop on the operating room table.

Not to scare you, but liposuction is surgery, and in the hands of an untrained surgeon or non-surgeon (yes family practitioners, ER physicians, gynecologists and the list goes on) do liposuction. Yes, there are reported deaths not only in this country, but also in other countries which offer the surgery at greatly discounted prices. Many Americans travel to cash in on the "deal" and trade in their health and sometimes their lives.

It is imperative that you see a board certified PLASTIC surgeon for an in person consultation/evaluation to allay your fears and discuss the best options for a good outcome. Good luck.

Liposuction does not have to be performed under general anesthesia.

Although your fears about general anesthesia are totally misplaced almost all patients can have liposuction done with oral sedation augmented by tumescent preparation of the fat.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

What do you mean by a board certified "cosmetic" surgeon??

There is NO true board certification in "cosmetic" surgery recognized by the American Board of Medical Specialties. The thing you want is certification by "The American Board of Plastic Surgery", nothing less. That means you have found a real plastic surgeon. Medical tourism is also not a great idea as has been discussed frequently on RS and neither is lipo all over your body. Best to re-research the doctor and rethink all of this! It IS possible to die from getting the wrong surgery, doing too much surgery, or going to the wrong doctor.

Scared

2 suggestions:
Start by doing only one area at first. This can be done under local anesthesia.  An oral relaxant medication will help your concern and anxiety.  You will get a sense of the process and be part of it and feel in control.  Better yet, you will get a sense of the results your surgeon can deliver before getting everything else done.
I understand you are flying in to get it done.  This may be adding to your concerns.   Most of all-do not feel rushed! 

Michael A. Giuffrida, MD
Venice Plastic Surgeon
4.5 out of 5 stars 17 reviews

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.