General Liposuction Risks and Complications
As with all surgeries, there are risks, so naturally there is an inherent liposuction surgery risk to consider. There is no such thing as a surgery that is perfectly safe each and every time. Please read this section thoroughly so you are well informed.
General Liposuction Risks and Complications
There are risks that accompany any type of surgery. You could develop a hematoma (a pocket of blood or clotted blood), a seroma (a collection of clear fluid), or an infection. You could bleed excessively.
There is a risk you could have a allergic reaction or other negative reaction to the anesthesia and other medications used during liposuction.Even if you have had anesthesia with no problems in the past, you could still have a problem this time.
You could also have a reaction to either lidocaine or epinephrine, two drugs in the solutions used in wet, super-wet, and tumescent liposuction. Too much lidocaine can result in lidocaine toxicity, which is an overdose. Please see our Anesthesia Section for more information.
Emboli and Pulmonary Thromboemboli
A serious liposuction risk is pulmonary thromboemboli. An embolus is anything in the bloodstream can cause a blockage in a vein or artery. A thromboembolus is a blood clot in a blood vessel that has broken free. It is a pulmonary thromboembolus if it travels to the lungs. This can cause serious breathing difficulty and possibly cardiac arrest or coma. Pulmonary thromboemboli can happen within 3 weeks of surgery, but are most likely to occur within the first 72 hours. The symptoms are shortness of breath and fatigue.Pulmonary thromboemboli can occur suddenly and without warning.
An embolus that travels to the brain can cause a stroke. One that lodges in the coronary arteries of the heart can cause a heart attack.
A fat embolus is a globule of fat that has entered the bloodstream. It can cause the same types of symptoms and damage if it lodges in the lungs and can cause a stroke if it lodges in the brain. Symptoms of a fat embolism are generally the same as with pulmonary thromboemboli if the fat is carried to the lungs, however the fat can be carried to the brain and heart as well.
Fat and Tissue Necrosis
Fat and its surrounding tissues can become necrotic, which is the medical term for dead tissue. This can happen if blood vessels are severed and the tissue does not get enough of a blood supply.When fat becomes necrotic, it tends to turn an orangy color and drain from the incision. If other tissue becomes necrotic, it is a more serous problem. Necrotic tissue must be removed before a major infection, possibly even gangrene, develops.
Necrotic skin looks very black and the discolored skin, which looks different from a normal bruise, spreads and does not clear up.Necrosis could require the excision of all affected tissue.One treatment for necrotic tissue is hyperbaric oxygen therapy.
Another liposuction risk is pulmonary edema or fluid in the lungs. This can occur when too much fluid is delivered intravenously, but excess fluid delivered subcutaneously can cause pulmonary edema as well. Pulmonary edema is more likely with tumescent and super-wet techniques.
Liposuction Risks Associated With UAL
With the ultrasonic liposuction technique, the risk of burns from the ultrasound waves is present.Although ultrasound is not a form of heat, the high frequency waves can heat up fat molecules and fluids.If the ultrasonic cannula or external ultrasonic pads/paddles are not kept in constant motion, burns and tissue damage can result. Blisters can also form if the tip of the ultrasonic cannula gets too close to the underside of the skin.
Fluid Shifts and Blood Loss
Longer liposuction operations or operations without enough fluid replenishment can lead to dehydration and fluid shifts.This is especially true for high-volume liposuction, involving more than 5 liters of fat and fluid. Fluid shift is when fluids in your body start to pool within your body but outside of your blood vessels. This can cause your blood pressure to drop precipitously.
Traditional liposuction or aggressive liposuction without ample amounts of epinephrine (or by an unskilled surgeon) can results in excessive blood loss.If you lose a lot of blood, you may need a transfusion.High-volume liposuction is more likely to put you at risk for significant blood loss than are smaller liposuction procedures.Actually, high-volume liposuction increases all the risks found in this section.
Your surgeon must carefully monitor the amount of fluid being infused into you and how much fat, fluid, and blood comes out. For high-volume liposuction, it is imperative for the surgeon to carefully monitor the patient's fluid status and perhaps even keep patients overnight in the hospital.It is safer yet to break the procedure into several smaller liposuctions and avoid this risk entirely.
Visceral Fat Removal Risks
Also as we discussed in the Anatomy Section, the use of liposuction to remove visceral fat, the fat within the abdominal cavity, is not recommended by many surgeons. Many people feel the risk of nerve damage, blood loss, hematoma, burns to internal organs (with UAL), and or punctures to internal organs. The fat in the abdominal cavity is hard to get to and is too close to vital organs like your intestines, liver, kidneys, and (if your are a woman) uterus and ovaries. Although there may be surgeons who perform liposuction in this area, I don't think it is a good idea.
Irregular Contour Deformities
Although you will see before-and-after photos of people with perfectly smooth hips and thighs after their liposuction, not every one ends up with that kind of smoothness. There are aesthetic liposuction risks. You may have asymmetry, lumpiness, hyperpigmentation (permanent dark spots or areas), loose skin that must be tightened in a second surgery, or scar tissue formation. Skin thinning can also happen if there is too much undermining.Permanent irregularities can develop from excessive undermining of the skin.
Dents, bumps and waves may appear after your procedure and you may need additional liposuction, deep tissue massage, or fat grafting.These poor outcomes can be due to lack of skill of your surgeon or your failure to comply with postoperative instruction. However, fibrous scar tissue can form in the treated area even when your surgeon is the best and your followed your doctor's orders. We will discuss this subject more in the Revision Liposuction section.
General Dissatisfaction with Liposuction Results
You also risk just being unsatisfied with the outcome of your liposuction. Please be sure to describe your desires and expectations to your surgeon and listen to what he or she has to say about whether your desires are reasonable.Lack of communication can easily ruin your chances of a good result with liposuction. If you want to have more taken off your hips, tell him or her.If you want abdominal and flank liposuction as well, say so.
But unreasonable expectations can be an issue. Some people who go to a cosmetic surgeon's office looking for liposuction actually have an image disorder. No matter how thin they are or how smooth their thighs look, they will not be happy with their body.However most dissatisfaction is either from too little or too much fat removed or dents and lumps. Please see our Revision Liposuction section for more information on this subject.
Mary Lee Peters, MD
901 Boren Avenue
Seattle, WA 98104
Wandra Miles, MD
Miles Plastic Surgery
1221 Madison St.
Seattle, WA 98104
Sepehr Egrari, MD, FACS, PC
Egrari Plastic Surgery
2950 Northrup Way
Bellevue, WA 98004