What's the risk and what are the complications associated with hitting main arteries during liposuction?

Question

I'm considering awake lipo and want to know the risk of provider hitting a main arterie and what would be the complications associated.

Semih Yildiz, MD, FEPOBRAS · Answer

Injury to a major artery during liposuction is uncommon, but it is a serious surgical complication and should not be minimized just because the procedure is done awake. The risk depends on the treatment area, cannula depth, prior scars or surgery, anatomy, the surgeon's training, and whether the procedure is done in an accredited setting with an emergency plan.

Possible consequences include significant bleeding, a hematoma, rapidly increasing swelling, low blood pressure, emergency transfer, blood transfusion, vessel repair, or additional surgery. Smaller vessel bleeding is much more common than a main artery injury and may show up as bruising or a localized hematoma. Before choosing awake liposuction, ask exactly who performs the procedure, what areas and depth will be treated, how bleeding risk is reduced, and what emergency protocol is in place. After liposuction, urgent evaluation is needed for rapid swelling, severe pain, dizziness or fainting, chest pain, shortness of breath, or heavy bleeding.

Chad Deal, MD · Answer

Arteries really are not the concern during liposuction. All of the arteries and veins that are encountered during liposuction are small enough that they can be compressed and stop bleeding with simple combination of the epinephrine and the garments that you wear after the case. The most common complications liposuction are contour irregularities, and fluid buildup called a seroma. Certainly we could go over a long list of potential complications, but those are the most common. When using heat based skin tighten devices, skin burns are also a concern. Of course, the most dramatic complication would be if they punctured into deeper structures like the abdomen and caused organ damage. This should be a very rare complication.

Gary M. Horndeski, MD · Answer

Liposuction is performed in the fat layer and there are not major arteries running through the fat layer. The major arteries run much deeper so it is unlikely that a skilled plastic surgeon would hit a major artery during liposuction. The cannulas used are blunt and would go around the major arteries.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

There are no large superficial blood vessels, arteries or veins, in the areas where liposuction is most frequently performed. Your surgeon should be aware of anatomy and with careful liposuction technique should avoid injury of larger vessels which are located beneath the fascia or within abdominal and chest cavity. This is something that you should discuss in more detail with your surgeon ahead of surgery. Good luck.

David Hansen, MD · Answer

Liposuction is so safe and easy to under go now a days.  Really there are no main arteries to worry about in the typical lipo  areas since lipo is above the muscle and under the skin where main arteries just don't really exist.  It's great that you are getting lipo under local with or without a little iv sedation.  That is the only way to get lipo done. (never under general if you want safety and best results).

Roger Smith, MD, FACS · Answer

Hello Considerate630036,
In the subcutaneous space between the fascia covering the muscle and the Scarpa's fascia on the skin, where most liposuction is performed, there are no 'main arteries.' Certainly there are arteries and veins in this space, but they are relatively small and will not cause massive hemorrhage if injured during surgery. Liposuction cannulas are blunt tipped and all larger that the blood vessels that are in the subcutaneous tissue, making it more likely that the cannula will allow the artery to 'roll around' the side of the cannula during the procedure rather than poking right through it. 
Certainly, bleeding can occur during liposuction or any other surgical procedure, however, it is not likely to be severe. If a blood vessel that we described above were to be injured during the procedure, you would notice bruising of the skin (which is likely to happen after liposuction anyway) or a collection of blood under the skin called a hematoma. The smaller blood vessels in the areas where we perform liposuction will stop bleeding on their own or with just mild pressure such as you get with your post-operative compression garments. 
I would recommend consulting with a qualified surgeon who can further address your specific concerns regarding bleeding.
Best of luck!-Dr. Smith

Connie Hiers, MD, FACS · Answer

If you go to a board-certified plastic surgeon who has been trained in liposuction, the risks should be very low. There are no main large arteries in fat. We use Epinephrine in the numbing solution to minimize bleeding from the small arteries in fat. this makes liposuction very safe. The "cosmetic" surgeons are not plastic surgeons, and many are not well trained.

Camille Cash, MD · Answer

Liposuction removes subcutaneous fat which is the top fatty layer under the skin surface.  Arteries and major vessels are deeper than this layer.  There would be a low risk of damaging these vessels during liposuction.  That being said it is always important to choose an experienced board certified plastic surgeon for your procedure.

Mats Hagstrom, MD (license on probation) · Answer

Overall liposuction is considered a fairly safe procedure. That said major organ structure including major arteries have been reported damaged causing severe morbidity and death. 
Serious complications are not common. By far the most common complication is ending up with disfigurement or poor outcomes. Perhaps not a medical complication but this is what patients should be most concerned with because it happens far more often than medical complications. 
Results are based on patient candidacy and provider selection. 
Delivering consistent quality liposuction results is more difficult than most people realized.
The number of glass surgeons who approach mass three of this procedure is in reality quite small.
I recommend patients to be more selective than they think necessary and scheduled multiple in person consultations to help find the right provider.
And the hands of the right provider the chance of medical complications is decreased as well.
Best,
Mats Hagström MD

What's the risk and what are the complications associated with hitting main arteries during liposuction?

Answers (9)

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