Abstract:During the past 2 years, media attention has focused on catastrophic outcomes associated with liposuction. A critical review of the lipoplasty literature was undertaken to determine the incidence of severe and mortal complications. Reported lipoplasty complications and patient outcome studies published in the English literature through January 1, 1999, were reviewed. From these and from ASPRS questionnaire surveys of experienced, board-certified plastic surgeons, it is apparent that (1) plastic surgeons do not… Show more
This treatment appears to be associated with minimal risks when used by specifically trained and experienced doctors. The possible risks associated with this treatment should be balanced against the risks of other treatment options.
This treatment appears to be associated with minimal risks when used by specifically trained and experienced doctors. The possible risks associated with this treatment should be balanced against the risks of other treatment options.
“…Complications of liposuction for lipoma removal have not been specifically reported in human beings, however dry liposuction can lead to life‐threatening conditions such as deep vein thrombosis, necrosis of overlying skin, fat embolism and anaesthetic complications in approximately 0·1% of patients. Non‐lethal complications are more common (3·6 to 9·3%) and include ecchymoses, haematoma or seroma formation and infection (Courtiss 1984, Pitman and Teimourian 1985, Teimourian and Rogers 1989, Daane and Rockwell 1999). The complication rate is inversely proportional to the surgeon’s experience (Courtiss 1984, 1985).…”
Section: Discussionmentioning
confidence: 99%
“…The reported incidence of serious complications following dry liposuction is approximately 0·01%. Milder complications that resolve with time are more common (up to 9·3%) and include ecchymoses, haematoma, infection, seroma and paraesthesia of the surgical site (Courtiss 1984, Pitman and Teimourian 1985, Courtiss and Donelan 1988, Teimourian and Rogers 1989, Daane and Rockwell 1999).…”
Liposuction may be less invasive and more attractive to owners than conventional surgery for lipomas up to 15 cm in diameter. Liposuction is not recommended for infiltrative or giant inguinal lipomas. Regrowth can be expected in a high proportion of lipomas, which should be considered when choosing liposuction over conventional excision.
“…15 The second most common cause of death is abdominal viscus perforation (14.6%), with up to 50% mortality following the perforation. 10 Rao et al analysed three deaths between 1993 and 1998 in the New York area.…”
SummaryA 35-year-old woman collapsed 18 hours after undergoing abdominal wall liposuction. Abdominal CT scan revealed a punctured spleen. She underwent an emergency splenectomy and made an uneventful recovery.
Case reportA 35-year-old woman presented to plastic surgeons with increased adiposity in the lower trunk and upper thigh. She did not have any significant past medical or surgical history and was not taking any regular medications. Her preoperative haemoglobin level was 11.2 g/dL. She underwent abdominal wall and upper thigh tumescent liposuction through suprapubic and lateral abdominal wall stab incisions under general anaesthetic. She made an uneventful initial recovery from the anaesthetic and slept pain-free throughout the first night. Sixteen hours hours after surgery she complained of acute onset of severe generalized abdominal pain and abdominal distension and collapsed. On examination she had marked pallor and class II hypovolaemic shock. She responded to initial fluid resuscitation.She was transferred to an acute general surgery hospital. On admission she was noted to have marked pallor, severe hypovolaemic shock (class III) and a tense distended abdomen. The general surgery and anaesthetic team were paged as an emergency within five minutes of the patient arriving. She had superficial abdominal bruising at the site of liposuction and mild diffuse abdominal tenderness. There was no abdominal guarding or signs of peritonism present. The bowel sounds were reduced and digital rectal examination was normal. Her blood results revealed haemoglobin level of 3.6 g/dL. She made a moderate recovery to aggressive fluid resuscitation. She was urgently transfused six units of whole blood, type specific blood was given within 15 minutes, followed by cross-matched blood within one hour. After initial resuscitation her blood pressure was stable at 110/60. Her repeat haemoglobin level was 10.6 g/dL. She continued to have persistent tachycardia, with a pulse rate of 110 bpm.A rapid Focused Abdominal Sonography for Trauma (FAST) abdominal ultrasound scan was performed within 30 minutes, first by the emergency department consultant, then by the radiology specialist registrar. The FAST scan was positive for intra-abdominal fluid; the source of bleeding could not be identified, however, as the scan was difficult to interpret due to the recent liposuction. A computed tomography (CT) scan was done within a hour of the ultrasound scan. It showed a large volume of free intraperitoneal fluid in perihepatic space, paracolic gutters and pelvis. The spleen was displaced medially with heterogeneous haematoma seen laterally with active contrast extravasation indicating persistent bleeding. The haemorrhage was extraperitoneal but deep to the abdominal wall musculature (Figure 1).As the patient had continuing abdominal distension and pain she underwent an emergency laparotomy within 4 hours of arriving in the resuscitation room. Perioperatively, she received six units of packed red cells, three units of fresh frozen plasma, one un...
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