Liposuction Risks

As with any plastic surgery procedure, liposuction is not without risk. Below is a list of risk factors and the accompanying medical studies on complications and deaths related to this procedure in the US

List of possible complications:

  • Abnormal body contour
  • Anesthesia reaction
  • Bleeding
  • Burning
  • Death
  • Depression (mild depression is normally following elective surgery)
  • Dimples
  • Discoloration
  • DVT (Blood Clot)
  • Fat Embolus (less than 0.1%)
  • Heart Failure
  • Hematoma
  • Hypothermia
  • Infection
  • Keloid (heavy scar)
  • Nerve damage
  • Perforation of bowel or abdominal wall
  • Permanent numbness (risk is less than 1%)
  • Puckers
  • Reactions to medications
  • Seroma (fluid collection under skin)
  • Shock
  • Skin irregularities
  • Skin death (necrosis)
  • Slow healing
  • Swelling
  • Tingling
  • Visible scar

Deaths related to liposuction surgery can happen for a number of reasons: blood clot, perforation of the abdominal wall or bowels, shock and hemodilution (blood dilution), and excess amounts of lidocaine.

FDA liposuction statistics

According to the FDA, a survey conducted by the American Society of Plastic Surgeons (ASPS) of more than 1,500 plastic and reconstructive surgeons in January 1999 showed that there was an unexpected high death rate of one in every 5,000 (or 20 out of 100,000) liposuction patients between 1994 and 1998.

These high numbers may be due to an increase in unqualified surgeons performing liposuction during that period. Since 1995, the number of deaths related to liposuction have decreased dramatically, to around 1 in 100,000, or approximately 25 deaths out of 250,000 liposuction procedures per year.

Dermatologic Surgery Statistics

A study published in the scientific journal, Dermatologic Surgery, shows that office-based liposuction may be significantly safer than hospital-based liposuction. No deaths were reported by dermatologists performing approximately 300,000 procedures from 1995 – 2000.

Physicians Insurance Association of America Study

A review of malpractice claims from the Physicians Insurance Association of America (PIAA) showed that of the 257 claims filed from January 1, 1995 through December 31,1997, less than 1 percent were against dermatologists even though dermatologic surgeons perform more than one-third of the liposuction procedures in the United States.

According to statistics from their respective professional organizations, dermatologic surgeons currently perform about 100,000 liposuctions annually, with plastic surgeons accounting for more than 170,000 fat removal procedures per year.

“Our study found that liposuction is safest when it is performed as a solo procedure under local (tumescent) anesthesia in an outpatient setting by a board-certified dermatologic surgeon. In fact, our data shows that there have been no deaths from liposuction by dermatologic surgeons.” -William P. Coleman, III, MD, president of the American Society for Dermatologic Surgery.

According to Dr. Coleman, more risks are associated with:

  1. Extracting large amounts of fat
  2. Using general anesthesia in a hospital setting
  3. Performing multiple procedures during the same surgery

The PIAA study confirmed that patients who had liposuction performed under local anesthesia using the tumescent technique had no fatalities and fewer complications.

Source: http://www.asds-net.org/lipo_safety.html

ASPS Liposuction Task Force Study

According to a study by the ASPS Liposuction Task Force, released in October 1998, the rate of significant complications from liposuction is low. The Task Force reviewed 24,295 liposuction surgeries performed by board-certified plastic surgeons for the study and found that only .03 percent reported significant complications.

Factors that increase the risk of complications include: large volume liposuction, because of the use of greater amounts of fluid and anesthesia, as well as removal of more fat; extended length of surgery; multiple procedures; or a patient whose preoperative health is compromised.

Source: http://www.plasticsurgery.org/mediactr/homework.htm

ASAPS Study

In 1997 board certified plastic surgeons formed a task force to investigate liposuction safety. Their research led to increased efforts by ASAPS and other plastic surgery organizations to re-educate plastic surgeons about risk reduction in lipoplasty procedures. Several measures were identified as ways to increase patient safety:

  1. Using stricter patient selection criteria
  2. Limiting the length of surgery
  3. Avoiding pre-injection of excessive amounts of fluid and local anesthetic
  4. Removing a smaller volume of fat
  5. Avoiding the combination of liposuction and certain other procedures
  6. Careful postoperative monitoring

Beginning in mid-1998, the safety record of lipoplasty performed by board-certified plastic surgeons appears to have improved dramatically. In May 2001, a major survey on lipoplasty safety was published in Aesthetic Surgery Journal, the peer-reviewed journal of the American Society for Aesthetic Plastic Surgery. The survey, covering many thousands of lipoplasty procedures performed by ASAPS members from September 1998 through August 2000, showed that the risk of death from lipoplasty performed as an isolated procedure (not in combination with any other surgeries) was 1 per 47,415 procedures, a nearly 10-fold decrease from rates suggested by earlier published surveys.

Source: http://www.surgery.org

The following tables record the data from that survey.

Nonfatal complications from lipoplasty and lipoplasty combination procedures
for 94,159 lipoplasty procedures performed by ASAPS members: Sept 1, 1998, through Aug 31, 2000

Complication Percent Rate (1 complication in every __ procedures)
Skin slough .0903% 1 per 1107
Ultrasound-assisted lipoplasty skin burns 0.0712% 1 per 1404
Deep vein thrombophlebitis 0.329% 1 per 3040
Pulmonary embolus 0.0266% 1 per 3759
Excessive blood loss 0.0149% 1 per 6711
Fluid overload 0.0138% 1 per 7246
Fat emboli 0.0053% 1 per 18.868
Cannula penetration of abdominal cavity 0.0021% 1 per 47,619
Lidocaine toxicity 0.0021% 1 per 47,619
Surgical shock 0.0011% 1 per 90,909

In the same study, the mortality rate was 0.0021%, or 1 death per 47,415 procedures. “Stated positively, the estimated non-mortality probability is 99.98%.”
Source: CE Hughes, Reduction of lipoplasty risks and mortality: An ASAPS survey. Aesth Plast Surg 2001;21:120-127

Liposuction satisfaction rates study

Questionnaires were sent to 332 patients who had liposuction performed at Alia Clinic (in New South Wales, Australia) in 1999 and 2000. 123 patients responded.

“87.8% of respondents were female. The mean body mass index (BMI) was 26.16. A large proportion of patients experienced positive lifestyle outcomes from the procedure: 80.5% were more confident, 74.8% noted an increase in self-esteem, and 87% were more comfortable in clothes. The time since surgery did not influence results.”

Source: Goyen MR, Lifestyle outcomes of tumescent liposuction surgery. Dermatol Surg 2002 Jun;28(6):459-62


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