Liposuction

 

What is liposuction?

Liposuction is a minimally invasive procedure to remove unwanted fat from under the skin.

 

Does Liposuction require General Anaesthesia or Local Anaesthesia (numbing)?

In some instances liposuction can be done by giving sedatives to keep the patient drowsy and numbing the area (local anesthesia). However, most often it is quicker to do the procedure under general anesthesia. Procedures done under local anaesthesia (numbing) have a lower complication rate.

 

What is the  'tumescent technique'?

The tumescent technique is used to minimize blood loss. A specially prepared solution of adrenaline and local anesthetics is injected under the skin to make it turgid. This makes the area numb, stops bleeding and makes fat removal easier. Most practitioners now use this technique even if they are doing the procedure in general anaesthesia.

 

Will I require admission for liposuction?

Small volume liposuctions not requiring general anesthesia are usually done as outpatients. However if general anaesthesia is used it is safer for the patient to stay in the hospital overnight.

 

Will there be scars after liposuction?

Liposuction is done through very tiny incisions hidden in natural skin creases. They are usually well hidden but in rare cases they may hypertrophy and become very prominent.

 

What is the down time after liposuction?

Patient are sometimes admitted for 1 days. A special pressure garment is worn under the clothes for 4 weeks. Patients generally return to active work after a week or 10 days. Very low volume procedure such as on the face have minimal down time of 2 to 3 days.

 

How long will the effects of liposuction last?

If the patient continues to have a healthy lifestyle, the effects are generally life long.

 

What can go wrong during liposuction?

 

Most patients are pleased with the outcome of their liposuction surgery. However, like any other medical procedure, there are risks involved. That's why it is important for you to understand the limitations and possible complications of liposuction surgery. Before you have liposuction, you should be aware of these risks and should weigh the risks and benefits based on your own personal value system. It is important for you to understand what the risks are and decide if you are willing to accept the possibility that it might happen to you.


Complications

 

Infections. Infections may happen after any surgery and may occur after liposuction. Some physicians prescribe an antibiotic to all patients undergoing liposuction. Sometimes, infections may be serious or life threatening such as in cases of necrotizing fasciitis (bacteria eat away at the tissue) or with toxic shock syndrome, a serious, sometimes fatal infection caused by a bacteria, that is associated with surgery.


Embolism. 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. 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 canula 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.


Seroma. After liposuction, there may be a pooling of serum, the straw colored liquid from your blood, in areas where tissue has been removed.


Nerve Compression and Changes in Sensation. 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. If these changes in sensation persist for a long period of time (weeks or months) you should inform your physician. In some cases, these changes in sensation may be permanent.


Swelling. Swelling or  edema may occur after liposuction. In some cases, swelling may persist for weeks or months after liposuction.


Skin Necrosis (skin death). The skin above the liposuction site may become necrotic or "die." When this happens, skin may change color and be sloughed (fall) off. 


Burns. During ultrasound assisted liposuction (SmartLipo), the ultrasound probe may become very hot and can cause burns.


Fluid Imbalance. Fat tissue, which contains a lot of liquid, is removed during liposuction. 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 watching 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. Lignocain, a drug that numbs the skin, is frequently used as a local anesthetic during liposuction. Large volumes of liquid with lidocaine may be injected during liposuction. This may result in very high doses of lidocaine. The signs of this 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. Of course, this can be fatal. In general, any type of anesthesia may cause complications and is always considered a risk during any surgery.


Fatalities Related to Liposuction. There are reports of deaths related to the liposuction procedure. Some of the studies indicate that the risk of death due to liposuction is as low as 3 deaths for every 100,000 liposuction operations performed. However, other studies indicate that the risk of death is between 20 and 100 deaths per 100,000 liposuction procedures. One study suggests that the death rate is higher in liposuction surgeries in which other surgical procedures are also performed at the same time. It is important to remember that liposuction is a surgical procedure and that there may be serious complications, including death.