The risk of death during liposuction is quoted between one in 5000 and one in 50,000 cases, but statistics don’t easily predict the safety of your procedure which may feature details that dramatically affect its risk.
What then are the details that determine the safety of liposuction for you?
Your Health: Your surgeon should carefully assess your past medical history. Smoking, a history of lung disease, or blood clotting disorders (too much or too little), may increase your risks. Any medical illnesses must be optimized before surgery. Your weight should be stable, and preferably within 30% of your ideal body weight. Significant medical problems should prompt consultation with an anaesthetist and possibly a medical consultant before surgery, and in-hospital surgery must be considered. If you have previously had successful surgery, this “test” helps to predict that you will safely handle the stresses of a surgical procedure.
Surgeon: Choosing a Royal College certified Plastic Surgeon is your safest decision. To assess a surgeon’s experience/reputation, internet message boards can be valuable, and your family doctor can be a great source of information. At consultation with your surgeon, ask to see lots of before and after pictures. Never accept a meeting with a nurse or other surrogate in place of a full consultation with your surgeon.
Facility: Your surgery should either be in a hospital or an accredited (CAAASF) facility. A CAAASF facility will provide the safety measures available in hospital, and decrease the risks inherent in hospital care (e.g. distracted staff, medication errors, exposure to infectious diseases). Nevertheless, if there are details of your surgery that make you more likely to require intensive care post-op (e.g. medical illness, planned liposuction over 5 litres), then your procedure should be in hospital.
Technique: Liposuction is a superb and time-tested technique, and power tools (laser, ultrasound, etc) are not necessary to remove fat! Claims that power tools provide better results are not supported in the medical literature. Liposuction of small volume or limited areas is ideal for the ‘Tumescent technique’. Prior to liposuction, the tissues are injected with an anaesthetic solution until swollen (tumescent). For larger procedures, intravenous medications and fluids allow for a more comfortable procedure with less fluid injection into the surgical field (‘Superwet’ technique) and potentially better cosmetic outcomes. Large volume liposuction has been defined as over 5 litres of fat removal, but if you are 5’1” and 110 lbs, even 2 litres of liposuction could put you at increased risk. Large volume liposuction should be done in a hospital, with an overnight stay and close monitoring post-operative. Liposuction of body areas in which deep structures are vulnerable (e.g. upper abdomen, front of thighs, neck) should only be performed by an experienced plastic surgeon.
Alternatives to Liposuction: Weight loss is a great alternative to liposuction if the weight comes off the ‘right’ areas.Injection lipolysis (e.g. mesotherapy, lipodissolve, etc) is experimental, unregulated, but most importantly, inferior to liposuction. Similarly, external energy techniques (e.g. radiofrequency, ultrasound) remain experimental, and are at present no match for liposuction. These techniques are an exciting development for clinicians who can’t perform liposuction, but not a good option for you!
Liposuction has proven to be among the safest and most rewarding operations in all of surgery. Be a smart consumer, follow the guidelines above, and your opportunity for a successful outcome is excellent.