Is Liposuction Safe?
This depends upon many factors. I mean, yes - it is safe if the below factors are in your favor and the guidelines followed. But it CAN be disastrous if they are not. Don't go into this procedure blind - this isn't getting your hair cut.
Success and safety depend upon:
if you disclose your complete medical history, conditions, medications, and anything else which is pertinent to helping a surgeon to determine if you are a good candidate.
the ability of a surgeon to determine if you are a true candidate for the procedure.
the surgical skill and training of the surgeon
the skill and training of the anesthesiologist (if applicable)
the skill and training of the surgical staff
incidence of inherent risks which may occur intraoperatively
the skill and training of the recovery staff
your willingness to follow post-operative protocol to a "T"
incidence of inherent risks which may occur postoperatively
Want statistics? Okay we'll go over them but think of the fact that a really controlled study is hard to conduct. If everyone does as they are told, the surgeon performs surgery *perfectly*, the post-operative care is followed closely, risks drop significantly. Plus, not all surgeons will agree. The the general risk of death is reported at 1 in 5,000. That is 20 in every 100,000 patients. Some surgeons believe this to be too high and not a true representation due to unmonitored patients and lack of skill of the surgeon or his/her staff. These surgeons maintain that it is not subsequent of the liposuction procedure but a tragedy stemming from other factors outlined above.
Two of the most dangerous complications are Pulmonary Thromboemboli (a blood clot to the lungs) and Fat Emboli (free fat in the blood stream carried to major organs) are often seen within 72 hours of the procedure - although usually within 24 hours. This is why it is important to properly monitor a patient post-operatively and to have the patient move about and not lie down or sit immobile for long periods. Large volume liposuction patients should be kept overnight in the hospital for continued monitoring. Pneumatic compression "sleeves" may significantly lessen clotting problems.
Complications and dissatisfaction percentages are of course higher yet no controlled study has been performed nationwide to account for all, or even the majority, of these cases. This study would take massive amounts of time, money and cooperation from all physicians performing liposuction and a guarantee that all cases will be divulged regardless of outcome. So all we really have to go by are the reports of societies and boards conducted by several types of physicians.
Does This Percentage Relate to the Type of Physician?
This depends upon who you ask. Dermatologists say they are the safest bet because of the verified statistics of zero deaths reported within 300,000 procedures from 1995 to 2000. And that they had less than 1% of the malpractice claims asassociated with liposuction as compared to plastic surgeons, general surgeons, gynecologists and others.
Does This Percentage Relate to the Location?
Many surgeons who believe that hospitals are safer than ambulatory settings don't have their own surgical suite. I have seen some great hospitals and some detestable ones as well. I have seen some meager surgical suites that, aesthetically, turned me off - but were "clean" and obviously passed inspection to be accredited at one point and time. I have also seen some surgical theaters that look as though a medical version of Bill Gates created it with the help of a world renown architect. It depends upon the amount of money, effort and knowledge a surgeon is willing and able to put into building a surgical suite. But remember still, facts maintain that amazingly ambulatory facilities had fewer deaths and malpractice suits than patients treated in hospital settings.Many times this may be to infection. Infections seem to be higher in hospital settings and when reviewed these cases were from lack of sterility in the operating rooms. Then again a string of cases may erupt in on-site ambulatory suites due to improper sterilization or cleaning by privately-owned companies or improperly trained staff. There are so many factors, all we can go on are studies. However studies may be affected by bias or lack of funding.
What This Really Means to You
You of course want the lowest percentage of risks and complications and the highest chance of satisfaction with your liposuction procedure. Who doesn't? Think you have no control over over this percentage or your results? Think again. Below are the key factors in increasing your chances of a safe and satisfying surgery. You must realize things DO happen but you can do your best to prevent them.
Research, research, research!!! This means about the procedure, the risks, the recovery and what to expect, YOUR SURGEON - anything having to do with liposuction.
Search far and wide for a properly trained and extremely experienced surgeon to perform your liposuction. Worried about the stigma of not choosing a "board certified plastic surgeon" (American Board of Plastic Surgery)? There are enough wonderful board certified plastic surgeons out there to give you the results you desire - safely.
Although, don't decrease your options by ruling out non-ABPS board certified surgeons. There are numerous dermatologists and cosmetic surgeons who are able to safely give you the results you want and less expensive. Go on consistent results and word of mouth. But it is YOUR decision.
Inquire regarding the skill and training of the surgical and recovery staff.
Be sure to convey your exact expectations, and make sure they are realistic. You can't turn in to someone else with a little liposuction.
Prepare your mind, body and recovery area thoroughly before your procedure - this is important!!!
Follow post-operative protocol as instructed.
Attend your post-operative appointments.
Continue and post-operative instructions such as massage, diet or additional procedures like Endermologie until you are released from your surgeon's care at your final post-operative appointment.
Erwin J. Bulan, MD
Bulan Plastic Surgery
75 Main Street
Millburn, NJ 07041
Joshua A. Greenwald, MD, FACS
Cosmetic Surgery Associates of New York
166 5th Avenue
New York, NY 10010
Nikesh K. Patel, MD
New Reflections Plastic Surgery
1001 West Main Street
Freehold, NJ 07728