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Liposuction Risks & Complications

Clinic 360

All About Liposuction Risks & Complications

Liposuction, broken down to its most basic elements, is a surgical procedure involving the insertion of a hollow stainless steel metal tube (known as a cannula) through an incision in the skin to remove undesired fat using vacuum-suction. Though modern liposuction is considered to be a safe, routine procedure, it is still surgery, and as such does carry certain risks of complications.

The main risks, complications, and unpleasant side-effects associated with liposuction include infection, embolism, inflammation, organ and nerve damage, skin death, burns, excessive bruising, toxicity from anaesthesia, and, in rare cases, fatality. The statistics on the risk of death from liposuction range from 3 in 100,000 surgeries performed on the low end to upwards of 20 to 100 out of every 100,000 surgeries performed. This is akin to the danger of dying in a car accident (16 per 100,000).

Inform Your Surgeon of Any Pre-Existing Medical Conditions

Given these stakes, it is best to thoroughly educate yourself and to consult with a registered plastic surgeon so that you can make an informed decision as to whether the benefits outweigh the risks. Remember, liposuction is a cosmetic procedure (and typically not medically necessary), so you can take your time gathering information to make the most thoughtful decision possible. Also be sure to inform your surgeon of any pre-existing medical conditions you may have along with any medications you regularly take to minimize the chance of complications.

The Most Common Liposuction Side Effects

  • Bruising, Swelling and Numbness:
    The most common unpleasant side effects following liposuction include heavy bruising, swelling, and numbness around the treated area. Most of these effects will go away within 6 months after the surgery, although continued numbness may be indicative of nerve damage (that can be permanent). While most people can expect severe bruising for the first 7 to 10 days, patients with a tendency to bleed (i.e. hemophiliacs) and those who took anti-inflammatory medications prior to the procedure may experience more severe, longer-lasting bruising. It should also be noted that fluids might continue to ooze from swollen incisions.
  • Skin Damage:
    Major, non-life-threatening risks associated with liposuction include skin necrosis (the death of the layer of skin directly above the treated area). This dead skin will at first change colour and, if it spreads over a large area, can become infected by bacteria. Another risk, particularly of Ultrasound-Assisted Liposuction and Laser-Assisted Liposuction (otherwise known as SmartLipo), are burns. During these procedures, the probes can get extremely hot because of the ultrasonic and laser energy that pass through the cannula, which may burn surrounding areas. This, in turn, may cause permanent scarring, skin discolouration, and nerve damage.

    Besides scarring and skin discolouration, another purely cosmetic risk of liposuction is contour irregularities in the skin. This occurs when the skin appears wavy, bumpy, or withered because of unusual healing, poor skin elasticity (especially in older patients), and uneven fat removal.

  • The Risks of Anaesthesia:
    More seriously, the use of anaesthesia in liposuction can cause certain complications to arise during and immediately following surgery. Tumescent Liposuction, the most common liposuction technique, uses a high dosage of the local anaesthetic lidocaine. An excess of lidocaine in the body can lead to lidocaine toxicity with patients experiencing numbness, drowsiness, ringing in the ears, slurred speech, seizures, unconsciousness, and potentially respiratory and cardiac arrest. Respiratory and cardiac arrest can be fatal. Before undergoing liposuction, be sure to undergo a complete physical exam in order to assess whether you are suitable for the procedure. A patient can minimize risks by selecting a registered, experienced plastic surgeon. It is important to be totally honest about your past medical history. The use of anaesthetic in any surgery may cause complications and should always be understood as a risk.
  • Infection:
    Along with the use of anaesthesia, another inherent risk of any surgery is infection. While the incisions made in liposuction are relatively small, and the risk of infection is low, it should still always be considered a possibility. The most serious infectious threats post-surgery include necrotizing fasciitis (flesh-eating bacteria) and toxic shock syndrome, both of which can be fatal. Further operation may be required to treat infected tissue, increasing the overall risk of permanent scarring. As a preventative measure, some surgeons prescribe an antibiotic to all patients undergoing liposuction though this is not always the case. To minimize the risk of infection, be sure to diligently clean all wounds regularly following surgery and consult your surgeon immediately if symptoms arise.
  • Embolism:
    Another potentially fatal risk of liposuction is embolism. A fat embolism can occur when loosened fat becomes trapped in blood vessels that are broken during surgery. This loosened fat then either gathers in the lungs or travels to the brain. Either of these scenarios should be considered a medical emergency, as fat trapped in the lungs can cause shortness of breath, difficulty breathing, and respiratory arrest. Even worse, a fat embolism that reaches the brain can cause permanent disability and potentially death.

    Internal punctures or visceral perforations should also be considered a medical emergency; they occur when a surgeon inadvertently pierces or damages an internal organ with the cannula. If there are signs of internal damage, immediate surgical action is required, as visceral perforations can also be fatal if left unchecked.

  • Fluid Imbalance:
    If a large amount of liquid is injected during the procedure, as is the case in Tumescent Liposuction, a fluid imbalance can occur. An excess of fluid can lead to potentially life-threatening heart, lung, and kidney problems as your body attempts to reestablish balance. A fluid imbalance should not be confused with seroma, or the pooling of straw coloured liquid from your blood in a place where tissue has been removed. While usually temporary, these seromas may need to be drained away with a needle by your doctor or nurse.

    All risks associated with liposuction can be exacerbated if a large area is being operated on, a high volume of fat is being removed, or more than one procedure is being performed on the same day. This includes doing “complementary” cosmetic procedures such as tummy tucks, face-lifts, and breast reductions. That said, most patients are happy with the results of their liposuction and do not experience major complications. Informing yourself as much as possible, understanding the limitations of the procedure, and extensive consultations beforehand with your surgeon are the best ways to ensure that you achieve your desired results in the healthiest manner.

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Liposuction Risks & Complications FAQ

Is liposuction considered a safe surgery?
Generally, yes. However, liposuction carries certain risks inherent with any surgery such as complications related to  anaesthesia, the possibility of infection, and excess swelling and bruising.
What are the major risks associated with liposuction?
The main risks, complications, and unpleasant side-effects associated with liposuction include infection, embolism, inflammation, organ and nerve damage, skin death, burns, excessive bruising, toxicity from anesthesia, and, in rare cases, fatality. The statistics on the risk of death from liposuction range from 3 in 100,000 surgeries performed on the low end to upwards of 20 to 100 out of every 100,000 surgeries performed. This is akin to the danger of dying in a car accident (16 per 100,000).
Are certain liposuction techniques less risky than others?
Most surgeons would consider Tumescent Liposuction the safest liposuction technique. Because tumescent liposuction uses a large amount of lidocaine, a local anaesthetic, this means you can typically avoid being put to sleep with general anaesthetic (which carries substantially more risks and complications). Additionally, the use of epinephrine in tumescent liposuction constricts blood vessels and reduces blood loss, thereby minimizing the risk of bleeding out and the need for intravenous fluid replacement following surgery.
Are there ways to minimize the risks of liposuction before surgery?
The best way you can protect yourself and your health is to learn as much as you can about liposuction. Consulting your registered plastic surgeon at Clinic 360 (and being totally honest with them about your medical history) will also ensure that liposuction is in fact the procedure for you. Your surgeon will help you find the safest procedure that best suits your needs.
What’s more dangerous: local or general anaesthesia?
Both local and general (or systemic) anesthesia carry certain risks. Lidocaine (the local anaesthetic used in Tumescent Liposuction) is the safest of all local anaesthetics; however, going over the maximum-dosage can lead to lidocaine toxicity. General anesthesia is considered more dangerous than local as it can suppress the respiratory system if used improperly, leading rapidly to a medical emergency and potentially death.
What kind of bruising can I expect from liposuction?
The first 7 to 10 days will be the worst for bruising; however, this should go down in the subsequent week or two. Patients with a tendency to bleed (i.e., hemophiliacs) and those who had been taking anti-inflammatory medications prior to the procedure may experience more severe, longer-lasting bruising.
Can I get an infection from liposuction?
Yes. While some surgeons prescribe antibiotics after all liposuctions, this is not always the case. The best policy is to regularly clean the wounds post-surgery (per your surgeon’s recommendations) and to seek medical attention immediately if you feel or see that something is amiss. The most serious infectious threats post-surgery include necrotizing fasciitis (flesh-eating bacteria) and toxic shock syndrome, both of which can be fatal. Further operation may be required to treat infected tissue, increasing the overall risk of permanent scarring. Infection can also arise from skin necrosis, or the death of the layer of skin directly above the treated area. This dead skin will first change colour and, if it spreads over a large area, can become infected by bacteria.
Will the part of my body I get liposuction go numb?
This does occasionally happen for some people post-surgery. Usually this numbness should subside within 6 months following surgery, though continued numbness may be indicative of permanent nerve damage.
Am I going to have permanent scarring?
As with any invasive procedure, scarring is possible (particularly if there are complications such as burns or infection). There may be some marks or skin discolouration where the incisions were made following surgery; however, these should be gone within the first 6 months. In the case of darker skinned patients, this may last up to 1 or 2 years.
Will my skin look bumpy or uneven where I got liposuction?
Occasionally, contour irregularities in the skin do appear following surgery. This occurs when the skin appears wavy, bumpy, or withered because of unusual healing, poor skin elasticity (especially in older patients), and uneven fat removal.
Will my skin ooze after liposuction?
Probably, but don’t worry—oozing along with some swelling is normal. If there’s a risk of infection your doctor may prescribe an antibiotic as a precaution.
Certain forms of liposuction use ultrasonic and laser energy. Is that dangerous?
Ultrasound-Assisted Liposuction and Laser-Assisted Liposuction (SmartLipo) respectively use ultrasonic and laser energies that can run the risk of burns. As the energy passes through the cannula in these liposuction techniques, the probes can get extremely hot causing skin burns. Most of these burns, however, can often be treated with topical emollients or antibacterial ointments. As with most cosmetic procedures, touch-ups may also be necessary. In some cases, permanent scarring, skin discolouration, and nerve damage make occur. Rest assured that at Clinic 360 you are in the hands of qualified specialists who are highly trained to avoid such complications.
Can loosened fat be harmful?
A fat embolism can occur when loosened fat becomes trapped in blood vessels broken during surgery. This loosened fat then either gathers in the lungs or travels to the brain. This should be considered a medical emergency as fat trapped in the lungs can cause shortness of breath, difficulty breathing, and respiratory arrest. Even worse, a fat embolism that reaches the brain can cause permanent disability and potentially death.
Lidocaine toxicity was mentioned earlier. Can you elaborate on that more?
Tumescent Liposuction, the most common liposuction technique, uses a high dosage of the local anaesthetic lidocaine. An excess of lidocaine in the body can lead to lidocaine toxicity with patients experiencing numbness, drowsiness, a ringing in the ears, slurred speech, seizures, unconsciousness, and potentially respiratory and cardiac arrest. Respiratory and cardiac arrest can be fatal, although these risks are minimized by going with a registered, experienced plastic surgeon and being totally honest with them about your past medical history.
Can the cannula do damage while it’s inside me?
This does happen, albeit rarely. Internal punctures should be considered a medical emergency and occur when a surgeon inadvertently pierces or damages an internal organ with the cannula. Otherwise known as a visceral perforation, immediate surgical action is required as this can also be fatal if left unchecked.
Tumescent Liposuction requires injecting a lot of fluid. Is that safe?
If a large amount of liquid is injected during the procedure, as is the case in Tumescent Liposuction, a fluid imbalance can occur. An excess of fluid can lead to potentially life-threatening heart, lung, and kidney problems as your body attempts to reestablish balance. Rest assured that at Clinic 360 you are in the hands of qualified specialists who are highly trained to avoid such complications.
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