Liposuction is a widely sought-after cosmetic procedure worldwide, offering individuals a way to reshape their bodies by removing extra/ unwanted stubborn fat deposits. It involves the removal of fat from specific body areas using a suction technique. It’s not a weight-loss method but rather a body-contouring procedure targeting areas resistant to diet and exercise. Common areas treated include the abdomen, thighs, hips, buttocks, back, arms, and neck. The procedure gives a smoother body shape with improved body contours. While it can yield transformative results, it is imperative to understand that liposuction is a surgical intervention, so it can’t be without inherent risks.
Safety Profile
“Contours & Caution: Navigating the Landscape of Liposuction”
Liposuction is regarded as a fairly safe procedure with a relatively low complication rate- between 0.7% and 0.9%. Liposuction is generally considered safe when performed by a qualified professional, board-certified plastic surgeon in an accredited medical facility. An accredited medical facility refers to centres or hospitals that adhere to strict safety standards and are equipped with the necessary medical equipment to handle any potential complications. However, like any surgical procedure, it carries certain risks and potential complications, and it is essential to be aware of these potential risks. All risks should be fully discussed with the patient/ client before taking consent for the procedure. Furthermore, risks increase when too much fat is removed at once or multiple areas are treated in a single session. Special considerations are needed when large amounts – usually more than five litres of fat – are suctioned. The risks that can arise during recovery may include:
- Contour Irregularities or asymmetries: Problems with the shape or contours of the body may occur. Rippling or loose skin, or worsening of cellulite, can take place. Uneven fat removal can lead to bumpy, dimpled or wavy skin that may be permanent sometimes. Others may develop depressions or indentations in the areas that were suctioned.
- Fluid Accumulation: Temporary pockets of fluid accumulation (medically termed as ‘seroma’) can form under the skin, which may require drainage.
- Numbness: Some people experience nerve damage and changes to skin sensation that may persist, leading to temporary or permanent numbness in the treated areas.
- Infection: As with any surgery, there’s a risk of infection at the incision sites.
- Fat Embolism: Rarely, loosened fat may enter the bloodstream and block blood vessels, which is a serious condition.
- Organ Damage: Though again rare, the liposuction cannula can puncture internal organs. Damage to deeper structures such as nerves, blood vessels, muscles, lungs and abdominal organs can happen as a rare complication.
- Anaesthesia Risks: Reactions to anaesthesia can occur, ranging from mild to severe anaesthetic complications, along with fluid and electrolyte imbalances.
- Skin Necrosis: There can be bruising, pain/ soreness, swelling, poor wound healing, scars, skin colour changes or pigmentation. The skin above the treated area may necrose (discolour, become dead), leading to further complications.
- Deep Vein Thrombosis (DVT): Blood clots can form in major vessels, potentially leading to pulmonary embolism with cardiac and pulmonary complications.
- Technical Difficulties: Cannula breakage, thermal burn or heat injury from ultrasound with the ultrasound-assisted technique can take place.
- Need for revision surgery. Secondary procedures may sometimes be recommended to reduce excess skin.
Who are the Good or Bad Candidates for Liposuction?
“Cutting Fat, Not Corners”
Good candidates for liposuction include people who have good skin elasticity without much excess skin, have good muscle tone, have fat deposits that won’t go away with diet or exercise, are in good physical shape and overall health, aren’t overweight or obese, and don’t smoke. And hence liposuction should be avoided in the opposite group like those who do not want to quit smoking, have chronic health problems, have a weak immune system, are overweight, have saggy skin, have a history of diabetes, cardiovascular disease, deep vein thrombosis (DVT), or seizures, take medications that can increase the risk of bleeding, such as blood thinners.
Safe Sculpting: Beyond the Mirror
To ensure the procedure is safe and minimise risks, it’s essential to keep a few key points in mind beforehand. These can be summed up as:
- Patient Education: Patient education about the procedure, its potential risks, and the expected outcomes is to be explained to the patient. Informed patients are better prepared for the process and recovery. Liposuction is safe within medical guidelines and under expert care, but pushing limits, like excessive fat removal, can lead to serious complications.
- Choose a Board-Certified Plastic Surgeon: Always consider choosing a board-certified plastic surgeon with specific training and experience in liposuction. Board-certified surgeons have undergone rigorous education and training, making them well-equipped to perform the procedure safely.
- Preoperative Medical Evaluation: Patients should undergo a thorough medical assessment to identify any underlying conditions that may increase surgical risks. Certain medical conditions and contraindications, like heart disease, diabetes, immune disorders, renal diseases, and breathing (lung) problems, can increase the risks, and these individuals may not be considered suitable candidates. Pre-operative tests can also ensure the patient is healthy enough for surgery.
- Discuss Medications: All the medications and supplements, and other health conditions must be disclosed, and these should be thoroughly discussed.
- Smoking Cessation: Smoking needs to be stopped at least four weeks before surgery to promote better healing.
- Realistic Expectations: It’s essential to understand the limitations and capabilities of liposuction and set realistic expectations. It is important to understand that it’s not a weight-loss solution; it doesn’t address issues like loose skin, cellulite, or significantly alter overall weight. Understand the safe limits; safe fat removal is typically under 5 litres per session. Also, avoid combining too many procedures at once.
- Accredited Facility: Ensure that the procedure is performed in an accredited surgical facility equipped to handle complications and emergencies. Also, ensure that the accredited centre adheres to strict safety and hygiene standards, providing an added layer of protection.
- Monitoring During Surgery: The patient’s vital signs are to be monitored continuously during the procedure, ensuring that any potential complications are detected and addressed promptly.
- Follow Postoperative Care Instructions: Adhere to your surgeon’s postoperative advice meticulously to promote healing and reduce risks.
- Compression Garments: Wear recommended compression garments to reduce swelling and support healing.
- Monitor for Complications: Watch for warning signs. Be vigilant for signs of infection, excessive swelling, or unusual discharge or breathing issues require immediate attention.
- Limit Physical Activity: Avoid strenuous activities until the surgeon advises it’s safe to resume back to daily routine, as well as workout protocol.
- Attend Follow-Up Appointments: Regular check-ups will help to monitor recovery progress.
Takeaway
Sculpt Smart: Trim the Risk
Liposuction is generally a safe and effective procedure with a low complication rate when performed by qualified professionals in appropriate/ accredited facilities. However, it is essential to be aware of the associated risks and take proactive steps to ensure safety. Remember that not everyone is a good candidate for it; always prioritise health and well-being over aesthetic desires.
Dr P Umar Farooq Baba
SKIMS, Srinagar
Disclaimer : The opinions here are personal views of the authors. IAAPS is not responsible. All members may not have the same scientific view point
