Liposuction - Procedure & Complications

Procedure & Complications

Tumescent liposuction is the commonly followed technique. Complications include the dreaded although rare fat embolism.

The actual steps of the operation are as follows:

1. Injecting the fluid mixture containing local anesthetic and saline under the skin- this type of anesthesia is called 'tumescent anesthesia'
2. Inserting the canula by means of small openings made in the skin and applying a vacuum to it in order to suck out the fat
3. Assessing the volume of fat sucked out and the resultant change in the body contour that ensues. The surgeon then decides how much fat can be sucked out.
4. Some surgeons do not practice removing more than five liters of fat at a single sitting, though the upper limit is very variable.

Complications

These include those common to almost every operation namely, infection, hematoma or clot formation, wound separation.

Other complications include:

• Nerve injuries,
• Skin pigment changes,
• Circulation problems in the case of arm or thigh suctioning.
• Seroma-refers to collection of watery fluid after suctioning - this is a common but innocuous complication.
• Lymphedema. - At times, during thigh liposuction -the lymph may get blocked leading to lymphedema.
• Anemia is possible if large volumes of fat have been sucked out.

Serious complications include-:

Fat embolism is fortunately very rare, but it could be life-threatening.

Small particles or droplets of fat can get dislodged and enter the blood stream during suction and give rise to a condition known as fat embolism. It can affect the lungs, brain, cardiovascular system, and skin, by blocking the blood vessels in the above organs. It is difficult to diagnose this condition; vigilance is required to pick up the early signs. There may be a rash over the skin or breathing difficulties which often leads the doctor to suspect fat embolism.²

Shock due to excess blood loss does not happen in experienced hands.

Lung problems- like pneumonia, embolism and so on is also uncommon

References:

1. Indian J Dermatol Venereol Leprol. 2008 Jan;74 Suppl:S54-60. LinksTumescent liposuction: standard guidelines of care.Mysore V; IADVL Dermatosurgery Task Force
2. Aesthetic Plast Surg. 2008 May 29. Fat Embolism Syndromes Following Liposuction. Wang HD, Zheng JH, Deng CL, Liu QY, Yang SL.
3. Semin Cutan Med Surg. 2008 Mar;27(1):72-82. New advances in liposuction technology. Mann MW, Palm MD, Sengelmann RD. China.