When performed by an experienced plastic surgeon, liposuction is considered to be a rather safe surgical procedure. However, any time one undergoes surgery, it comes with risks.
Liposuction is the process of removing unwanted fat from the body with a small vacuum, but the reality is that liposuction is actually used more to sculpt the body than remove fat from it. Yes, the procedure does remove fat, but the sculpting done makes it look like much more weight was actually lost.
One Patient’s Experience with Liposuction
There is a limited amount of fat that can be removed during one session. This is because removing too much fat can lead to lumpiness under the skin and runs much higher surgical risks as well. Someone looking to drop 100 pounds should not be looking to liposuction as an answer.
Before determining if this procedure is right for you it is important to look at all of the risk factors and potential complications. And, of course, it is important to go over all of these things with a medical professional.
The Liposuction Procedure
The liposuction procedure can be done on virtually any area of the body, but typically only on areas where there are fat deposits that are not responding to diet or exercise. These types of fat deposits are something inherited from family and there is little that can be done to lessen them without surgical intervention.
The first step to discovering if this procedure is right for you is to understand the process of the procedure itself. Here are the basic steps in a liposuction surgery:
- Marking the Body – Through this process your doctor will literally draw on your skin, marking the areas where they will not only insert their instruments, but also suck out the fat cells and shape your new body. This is done while you are completely awake and aware.
- Anesthesia – Typically liposuction is done under a local anesthesia, meaning just the local area is numbed up, leaving you fully awake and alert. Occasionally, however, doctors will prefer to use an epidural or even an IV for sedation purposes. This will depend on your surgeon’s preferences and your health needs.
- Wetting Solution Infusion – In order to help minimize blood loss, a wetting solution is injected into the area where the liposuction procedure is going to take place. This solution is a combination of saline, epinephrine, and anesthetic. There are different degrees of the “wet” technique which all have their benefits and draw backs. Two of these wet techniques are called super-wet or tumescent; both have been connected to complications with lidocaine overdose and are not the most common process.
- Fat Removal – There are actually several different ways that this process can happen, but the bottom line of all the available procedures is the same, removing or destroying the fat cells from the area. Here are the most common liposuction techniques.
- “Traditional” – In this method a cannula, which is a long, thin, surgical tube, is inserted into the area via a small incision. The cannula is moved back and forth in the fat breaking up the fat cells and then sucking them out with a small surgical vacuum that is connected to the tubing. This method can also be performed with a motorized cannula, which causes the fat to be broken up more quickly and is often referred to as the power assisted liposuction.
- Ultrasound – A special cannula that emits sound waves is used in this type of liposuction. Instead of breaking up the fat cells by hand, the sound waves do all of the work. This makes the procedure easier, but it is still unclear the effects on the rest of the body’s cells. This can be done either invasively or non-invasively.
- Laser – No cannula is used in this procedure, rather a laser probe is inserted into the specific area of the body and liquefies the fat before it is removed via vacuum. It is also believed that this method can also tighten skin, but this has yet to be proven.
- Water Jet – In this method the fat cells are loosened by a fan shaped jet of water. In this method the fat cells are not destroyed or broken, just loosened from the connective tissue, which is why it is considered to be less traumatic on the body than most of the other methods.
Risks, Complications, and Other Things to Know
After deciding that liposuction is something you want to do, your next step will be going through your medical history with a board certified plastic surgeon. It’s important that you share what your expectations are and that your doctor is clear whether those expectations are realistic or not. From there, you need to have a candid discussion about the risks, the complications, and what you need to do, before and after, the procedure to prevent complications.
Right after the liposuction procedure, the area is going to be swollen. Occasionally the surgeon will leave the incisions open to allow for more draining after the process is completed. The area will be wrapped in bandages and you may be required to wear support hose to help prevent swelling and bruising.
Blood clots are a serious post-opt complication and one way to help avoid this issue is to get up and move around as soon as you can after the surgery. Most often, regular activity will be allowed after just a few days of rest, but strenuous activities, or hard exercise, will need to be avoided for up to a month.
Many people are frustrated after their procedure, because they could actually look larger than they did before the surgery, but it is important to keep in mind that the swelling will go down and it could take up to six months to see what the actual and final results are going to look like.
Just like with any medical procedure there will be some side effects that you have to deal with afterwards. These can be things like:
- Bruising and Swelling – although most often short term the bruising and swelling can be extremely painful. Swelling can take several months to completely diminish and can be uncomfortable until completely gone.
- Hematoma – This is when blood and clotting collects in the incision or punctured area. Typically this goes away on its own, but it can be painful and unattractive. The skin will swell and a collect blood, leading to a large lump under the surface of the incision.
- Scarring – The amount of scarring will be dependent on the specific type of procedure that is performed. There are typically only small incisions from a liposuction procedure and they will most often fade after the first few weeks of healing. For some people healing scars can take up to a year’s time. Very few people will have visible liposuction scars a year after surgery, assuming you take proper care of them, which includes avoiding tanning, smoking, and applying some kind of cream fading cream.
- Pain – There will be some amount of pain, but this experience is different for everyone. Most often the pain levels can easily be controlled by an over the counter pain reliever. For some a stronger prescription pain reliever is needed.
- Numbness or Discoloration – A loss of sensation in the area, or having odd coloration, is a normal side effect and is most often temporary.
A study done in 2000 revealed that between 1994 and 1998, there were approximately 20 deaths for every 100,000 liposuction procedures, the medically acceptable number of deaths from any medical procedure is 1 in 100,000. Of course, since the time of that study, medical procedures have drastically improved. One of the most common factors in this figure is the overdose of lidocaine.
Yes, death is always a possibly, although it is extremely rare. The following are also extremely rare, but they can happen:
- Bodily Damage – Occasionally the skin or tissue beneath the skin can be permanently damaged. This will look like spots or discoloration. To avoid this possibility, most surgeons will work with deeper layers of fat. There is also a possibility of internal organs being punctured by the cannula. Although unlikely, and most often correctable with surgical intervention, it can lead to death.
- Reactions – You can have a negative, or allergic, reaction to virtually any part of the process. This could be caused by an allergic reaction from medications or materials that were used during the procedure, from infection from bacteria, or shock from the removal of you fatty tissues.
- Burns – Friction from medical equipment can occasionally cause burns to the skin, or even the nerves. When using the ultrasound or laser methods of liposuction the heat from this piece of equipment can cause burns or damage to deeper tissues in the body.
The above are troubling complications, but there are even more serious issues that need to be considered:
- Skin Necrosis – This is a rare issue and requires extended recovery time and treatments to recover from it. Basically, the skin around the puncture doesn’t heal properly. The skin ends up dying and falling off, what is referred to as, the necrotic area.
- Embolisation – This is unlikely to happen from a liposuction treatment, but it is a serious and potentially life threatening issue. During the procedure, or after, patients can develop blood clots which can lead to thromboembolism, pulmonary embolism, and fat embolisation. If blood clots develop and make it into the lungs or the heart, this can lead to death.
- Lidocaine Toxicity – Overdosing on lidocaine is the number one reason for death when it comes to liposuction. During the wetting process large amounts of fluid are pumped into the body. If done incorrectly, these amounts of fluid could contain a higher concentration of the drug than the body can handle. Poisoning from lidocaine starts with tingling or numbness and then leads to seizures, unconsciousness, and cardiac arrest. This can happen during the procedure or afterwards if too much liquid is left in the body. This can cause complications with the kidneys, the lungs, and the heart.
Just like with any other medical procedure or surgery the risks are going to be greater for people who are not already in good health or have medical conditions or complications before the procedure. This is especially true for people with heart or lung disease, people who have diabetes, or even people dealing with issues related to poor circulation.
You can never know for certain what may or may not happen during your own procedure, but there are several things that you can do to prepare for liposuction that can help to prevent serious issues or long term recovery.
Of course, your doctor is going to know best what you need to do for your own health and well-being, so it is important to have a conversation with them before moving forward, but there are also things that you can do to help your recovery and possibly improve your overall health and wellness.
There may be specific guidelines that recommendations for food and drink leading up to your surgery and depending on your level of anesthetic you might not be allowed to eat or drink the day of your procedure at all. These are all things that your doctor will go over with you at a pre-operation appointment.
If you smoke, quit now. Smokers have higher rates of complications for any medical procedure across the board. It is good if you have stopped smoking for at least 30 days before your surgery takes place.
There are also several medications that can increase bleeding during surgery. Over the counter drugs like aspirin and anti-inflammatory medicines are just two examples. Be clear with your surgeon about any drugs that you are taking to confirm they won’t cause complications. Don’t stop taking prescriptions without medical consent either. This can end up being just as much of a problem.