Complications and Risks
What Factors Increase the Risks of Liposuction Complications?
The most dangerous aspect of liposuction is an attitude that ignores the risk of doing too much liposuction on a single day, or disregards the risks of doing multiple unrelated surgical procedures on the same day that liposuction surgery is performed.
- It is dangerous to attempt too much liposuction on the same day. There is a limit to the amount of surgical trauma that the human body can safely withstand. If the patient desires a large amount of liposuction, is it far safer to divide the procedure into two or more separate surgeries spaced 3 to 4 weeks apart, rather than to do one excessively large surgery on a single day.
- It is dangerous to combine liposuction with other unrelated surgeries, such as facelift, breast surgery, or laser surgery, on the same day as liposuction. It is especially dangerous to do abdominal liposuction on the same day as a gynecologic surgical procedure.
- The use of general anesthesia or IV sedation for liposuction may tempt a patient or a surgeon to do too much liposuction. Both the patient and the surgeon must be aware that too much surgery in a single day can be dangerous.
What are the Risks in a Liposuction Surgery?
What Complications can be expected after a liposuction?
Yet, liposuction does have some risks.
Though rare some of the risks are:
- Pulmonary thromboembolism (a blood clot in the lung)
This complication is a risk cause of using general anesthesia, excessive surgical trauma, and obesity.
In Liposuction infections are very rare. Inadequate sterilization of the surgical instruments, the application of Reston foam to reduce bruising, and ultrasonic assisted liposuction may increase the risk of infections.
- Intra-Abdominal Perforation with Visceral Injury
If done under Local Anesthesia, any intestinal injury will immediately lead to severe pain, which can be diagnosed promptly. However, if a liposuction cannula punctures the intestine, and the diagnosis is delayed until an infection has spread throughout the abdominal cavity, the consequences can be fatal, since, if the liposuction is done under general anesthesia, then both the patient and the surgeon may be unaware of the injury until it is too late.
- Hematoma or Seroma
Bleeding into a closed space under the skin (hematoma), or the leakage of serum into closed space under the skin (seroma) can occur after liposuction. There is an increased risk of these types of complications associated with obesity, excessive liposuction with a large cannula, and with ultrasonic assisted liposuction (UAL).
- Nerve Damage
Permanent nerve damage is very rare with tumescent liposuction. It is far more common with the use of ultrasonic assisted liposuction (UAL). Nevertheless, nerve injury is a known risk of any surgery.
- Swelling or Edema
Temporary swelling of areas treated by liposuction is part of the natural healing process, and usually resolves within 4 to 12 weeks. By allowing incision sites to remain open (not closed with stitches), post-operative drainage of the residual blood-tinged local anesthetic solution can occur. By encouraging this drainage of inflammatory fluid, the degree and intensity of postoperative swelling and edema is minimized. When the surgeon closes incision sites with stitches, a considerable amount of inflammatory material is trapped under the skin, and this augments the swelling process.
- Skin Necrosis
Skin necrosis, or the death of skin cells within a circumscribed area, can result from thermal injury (burn or freezing), infection, or injury to the blood vessels that supply oxygen to the skin. Skin necrosis can occur with liposuction if the surgeon uses the liposuction cannula to intentionally injure the skin (some surgeons erroneously believe that injuring the skin will encourage contraction of the skin). It is not unusual for ultrasonic assisted liposuction (UAL) to cause skin necrosis as a result of ultrasonic energy burning the skin or burning blood vessels that supply the skin. Finally, a rare type of severe bacterial infection can cause necrotizing fasciitis of the skin. This type of infection is associated with UAL and with the use of Reston foam applied to the skin after liposuction in an effort to reduce bruising.
- Pulmonary Edema
Excessive doses of intravenous fluids during and after liposuction have been known to cause excessive accumulation of fluid in the lungs. Severe cases of pulmonary edema can cause death. Intravenous fluids are not necessary, and in fact are contraindicated, with tumescent liposuction because the large volume of dilute tumescent local anesthetic fluid that is injected under the skin. The tumescent local anesthetic fluid is sufficient to replace any fluid that is lost by liposuction. Any additional fluid given through an IV is unnecessary and could be excessive.
- Adverse Drug Reactions (Toxicity or Allergic Reactions)
This can occur with any medication. Both local anesthesia and general anesthesia can cause complications during or after liposuction.
In the year 2000, a survey of liposuction surgeons who traditionally do liposuction under general anesthesia found that these surgeons encountered one death in every 5000 cases of liposuction. In a more recent survey of surgeons who only do liposuction by local anesthesia, there were no deaths in 65,000 cases of tumescent liposuction.
Does anesthesia affect the safety of liposuction surgery?
Is blood loss expected with liposuction? If Yes, how much?