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.
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.
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.
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.
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.