Liposuction – Risks & Potential Complications
March 9th, 2010
What Are the Major Risks and Potential Complications of Liposuction?
Like any non-cosmetic major surgery, liposuction has potential risks and complications. Therefore, you should consider it as seriously as you would any major surgery.
What Are the Common Minor Complications, or Consequences?
Changes in Skin Sensation. This is a normal consequence of liposuction that occurs in everyone to a different extent. You may experience “paresthesias,” which is an altered sensation at the site of the liposuction. This may either be in the form of an increased sensitivity (pain) in the area, or the loss of any feeling (numbness) in the area. This sensation is permanent in very rare cases. However, in almost all patients it goes away within the first two to four months after surgery. Massaging the area helps increase circulation, and facilitate return of normal skin sensation.
Swelling. This is also a normal occurrence that occurs in every patient. Compression garments and post-operative massage help to minimize this, as well as reducing its duration to less than two months.
Bruising: There will be bruising in many areas that are liposuctioned, as well as in adjacent or dependent areas. For example, people who have abdominal liposuction experience swelling and bruising in their genitalia. This is not because these areas are actually liposuctioned. However, bruises usually move downward due to gravity, and can thus temporarily accumulate in the genitalia. Some bruising can last a long time or even lead to permanent skin pigmentation. Sun tanning immediately after surgery can cause these bruises to become permanent skin stains.
Skin Irregularities or Wrinkles: The extent of this depends on the elasticity of the suctioned skin areas. People who have many stretch marks, cellulite, or skin dimples have poor elasticity and therefore will have more skin irregularities or wrinkles. Usually, post-operative massage helps to smooth these areas.
Asymmetry: No two halves of the body are identical. Therefore, following surgery, there may appear to be very slight differences between the contour and size of the two sides. Scoliosis or other spine derangements can magnify body asymmetry.
Muscle Spasm: It is very common to get temporary muscle spasm or cramps in the areas that were worked on. This usually resolves quickly by itself or can be helped by gentle heat and massage.
Pain and Discomfort: You should expect to have pain or discomfort similar to a feeling of having worked out too hard. Some of this may feel like a stabbing pain in the liposuctioned areas, and in adjacent areas. This can usually be managed by pain medications, and it generally lasts for a few weeks. Rarely, and in people with Fibromyalgia, or other forms of chronic pain syndrome, there can be a worsening of the patient’s baseline pain.
Depression, emotional, or sexual changes: There have been reported incidents of post-liposuction depression similar to postpartum depression. While this is usually temporary, patients need to address it with their physician.
Seroma or fluid collection: After surgery, there may be a pooling of serum, the straw colored liquid from your blood, in areas where tissue has been removed. While this can be a common problem with Ultrasound Assisted Liposuction (UAL), it rarely occurs with standard Tumescent Liposuction. Your surgeon can alleviate these by draining them with a small needle in an office procedure.
Rare and Severe Complications:
Infections. Infections may happen after any surgery and may rarely occur after surgery. Because we routinely prescribe an antibiotic to all patients we have never yet seen a patient who has developed post-operative infection after liposuction. Extremely rarely, infections may be serious or life threatening such as in cases of necrotizing fasciitis (bacteria that eat away at the tissue) or with toxic shock syndrome, a serious, sometimes fatal infection caused by a bacteria, that is associated with surgery (such as is sometime caused by the use of tampons).
Embolism. This is also extremely rare and is lessened by early postoperative mobility so that blood does not have time to become stagnant in calf muscles. Fat embolism may occur when fat is loosened and enters the blood through blood vessels ruptured (broken) during liposuction. Pieces of fat get trapped in the blood vessels, gather in the lungs, or travel to the brain. The signs of pulmonary emboli (fat clots in the lungs) may be shortness of breath or difficulty breathing. If you have the signs or symptoms of fat emboli after liposuction, it is important for you to seek emergency medical care at once. Fat emboli may cause permanent disability or, in some cases, be fatal.
Visceral Perforations (puncture wounds in the organs). During liposuction, the physician is unable to see where the cannula, or probe, is. It is possible to puncture or damage internal organs during liposuction. This may happen, for instance, if the intestines are punctured during abdominal liposuction. When organs are damaged, surgery may be required to repair them. Visceral perforations may also be fatal.
Skin Necrosis (skin death). The skin above the liposuction area or at the site of stab wound incisions may become necrotic or “die.” This is more prevalent with Ultasound Assistant Liposuction. When this happens, skin may change color and be sloughed (fall) off. Large areas of skin necrosis may become infected with bacteria or microorganisms.
Burns. During Ultrasound Assisted Liposuction, the ultrasound probe may become very hot and can cause burns.
Fluid Imbalance. Fat tissue, which contains a lot of liquid, is removed during surgery. Also, physicians may inject large amounts of fluids during liposuction. This may result in a fluid imbalance. While you are in the physician’s office, surgical center or hospital, the staff will be monitoring you for signs of fluid imbalance. However, this may happen after you go home and can result in serious conditions such as heart problems, excess fluid collecting in the lungs, or kidney problems as your kidneys try to maintain fluid balance.
Toxicity from Anesthesia. Lidocaine, a drug that numbs the skin, is frequently used as a local anesthetic. You may have had a similar drug, Novocaine, to numb your mouth at the dentist. Large volumes of liquid with lidocaine may be injected during liposuction. This may result in very high doses of lidocaine. We try to minimize the potential for Lidocaine toxicity by greatly limiting the extent of Lidocaine used during general anesthesia. The symptoms of this toxicity are lightheadedness, restlessness, drowsiness, tinnitis (a ringing in the ears), slurred speech, metallic taste in the mouth, numbness of the lips and tongue, shivering, muscle twitching and convulsions. Lidocaine toxicity may cause the heart to stop, resulting in death. In general, any type of anesthesia may cause complications and is always considered a risk during any surgery.
By: Dave Stringham
Like any non-cosmetic major surgery, liposuction has potential risks and complications. Therefore, you should consider it as seriously as you would any major surgery.
What Are the Common Minor Complications, or Consequences?
Changes in Skin Sensation. This is a normal consequence of liposuction that occurs in everyone to a different extent. You may experience “paresthesias,” which is an altered sensation at the site of the liposuction. This may either be in the form of an increased sensitivity (pain) in the area, or the loss of any feeling (numbness) in the area. This sensation is permanent in very rare cases. However, in almost all patients it goes away within the first two to four months after surgery. Massaging the area helps increase circulation, and facilitate return of normal skin sensation.
Swelling. This is also a normal occurrence that occurs in every patient. Compression garments and post-operative massage help to minimize this, as well as reducing its duration to less than two months.
Bruising: There will be bruising in many areas that are liposuctioned, as well as in adjacent or dependent areas. For example, people who have abdominal liposuction experience swelling and bruising in their genitalia. This is not because these areas are actually liposuctioned. However, bruises usually move downward due to gravity, and can thus temporarily accumulate in the genitalia. Some bruising can last a long time or even lead to permanent skin pigmentation. Sun tanning immediately after surgery can cause these bruises to become permanent skin stains.
Skin Irregularities or Wrinkles: The extent of this depends on the elasticity of the suctioned skin areas. People who have many stretch marks, cellulite, or skin dimples have poor elasticity and therefore will have more skin irregularities or wrinkles. Usually, post-operative massage helps to smooth these areas.
Asymmetry: No two halves of the body are identical. Therefore, following surgery, there may appear to be very slight differences between the contour and size of the two sides. Scoliosis or other spine derangements can magnify body asymmetry.
Muscle Spasm: It is very common to get temporary muscle spasm or cramps in the areas that were worked on. This usually resolves quickly by itself or can be helped by gentle heat and massage.
Pain and Discomfort: You should expect to have pain or discomfort similar to a feeling of having worked out too hard. Some of this may feel like a stabbing pain in the liposuctioned areas, and in adjacent areas. This can usually be managed by pain medications, and it generally lasts for a few weeks. Rarely, and in people with Fibromyalgia, or other forms of chronic pain syndrome, there can be a worsening of the patient’s baseline pain.
Depression, emotional, or sexual changes: There have been reported incidents of post-liposuction depression similar to postpartum depression. While this is usually temporary, patients need to address it with their physician.
Seroma or fluid collection: After surgery, there may be a pooling of serum, the straw colored liquid from your blood, in areas where tissue has been removed. While this can be a common problem with Ultrasound Assisted Liposuction (UAL), it rarely occurs with standard Tumescent Liposuction. Your surgeon can alleviate these by draining them with a small needle in an office procedure.
Rare and Severe Complications:
Infections. Infections may happen after any surgery and may rarely occur after surgery. Because we routinely prescribe an antibiotic to all patients we have never yet seen a patient who has developed post-operative infection after liposuction. Extremely rarely, infections may be serious or life threatening such as in cases of necrotizing fasciitis (bacteria that eat away at the tissue) or with toxic shock syndrome, a serious, sometimes fatal infection caused by a bacteria, that is associated with surgery (such as is sometime caused by the use of tampons).
Embolism. This is also extremely rare and is lessened by early postoperative mobility so that blood does not have time to become stagnant in calf muscles. Fat embolism may occur when fat is loosened and enters the blood through blood vessels ruptured (broken) during liposuction. Pieces of fat get trapped in the blood vessels, gather in the lungs, or travel to the brain. The signs of pulmonary emboli (fat clots in the lungs) may be shortness of breath or difficulty breathing. If you have the signs or symptoms of fat emboli after liposuction, it is important for you to seek emergency medical care at once. Fat emboli may cause permanent disability or, in some cases, be fatal.
Visceral Perforations (puncture wounds in the organs). During liposuction, the physician is unable to see where the cannula, or probe, is. It is possible to puncture or damage internal organs during liposuction. This may happen, for instance, if the intestines are punctured during abdominal liposuction. When organs are damaged, surgery may be required to repair them. Visceral perforations may also be fatal.
Skin Necrosis (skin death). The skin above the liposuction area or at the site of stab wound incisions may become necrotic or “die.” This is more prevalent with Ultasound Assistant Liposuction. When this happens, skin may change color and be sloughed (fall) off. Large areas of skin necrosis may become infected with bacteria or microorganisms.
Burns. During Ultrasound Assisted Liposuction, the ultrasound probe may become very hot and can cause burns.
Fluid Imbalance. Fat tissue, which contains a lot of liquid, is removed during surgery. Also, physicians may inject large amounts of fluids during liposuction. This may result in a fluid imbalance. While you are in the physician’s office, surgical center or hospital, the staff will be monitoring you for signs of fluid imbalance. However, this may happen after you go home and can result in serious conditions such as heart problems, excess fluid collecting in the lungs, or kidney problems as your kidneys try to maintain fluid balance.
Toxicity from Anesthesia. Lidocaine, a drug that numbs the skin, is frequently used as a local anesthetic. You may have had a similar drug, Novocaine, to numb your mouth at the dentist. Large volumes of liquid with lidocaine may be injected during liposuction. This may result in very high doses of lidocaine. We try to minimize the potential for Lidocaine toxicity by greatly limiting the extent of Lidocaine used during general anesthesia. The symptoms of this toxicity are lightheadedness, restlessness, drowsiness, tinnitis (a ringing in the ears), slurred speech, metallic taste in the mouth, numbness of the lips and tongue, shivering, muscle twitching and convulsions. Lidocaine toxicity may cause the heart to stop, resulting in death. In general, any type of anesthesia may cause complications and is always considered a risk during any surgery.
By: Dave Stringham
