08 January 2009

Side Effects
LiposuctionA side effect, as opposed to a complication, is medically minor, although it can be uncomfortable, annoying, and even painful.
  • Bruising can be painful in the short term, and should fade after a few weeks.
  • Swelling should subside gradually over a month or two.
  • Scars will vary in size depending on the particular procedure, and should fade over the weeks. Scarring is an individual thing, partly dependent on heredity. For some, scar healing may take as long as a year.
  • Pain should be temporary and controlled by either over-the-counter medication, or by a prescription.
  • Numbness sometimes persists for a few weeks.
  • Limited mobility will depend on the exact procedure.
There could be various factors limiting movement for a short while, such as :
  • Wearing a compression garment
  • Keeping the head elevated
  • Temporary swelling or pain
The surgeon should advise on how soon the patient can resume normal activity.

Possible Risks of Liposuction
  • Uneven contours
  • Rippling or loose skin
  • Skin or nerve damage
  • Irregular pigmentation
  • Infection
  • Fat clots
  • Blood clots
  • Excessive fluid loss or fluid accumulation
  • Unfavorable scarring
  • Thermal burn or heat injury from ultrasound with the ultrasound-assisted lipoplasty technique
  • Anesthesia risks
  • Bleeding (hematoma)
  • Change in skin sensation
  • kin discoloration or swelling
  • Asymmetry
  • Pain, which may persist
  • Damage to deeper structures such as nerves, blood vessels, muscles, lungs, and abdominal organs
  • Poor wound healing
  • Persistent swelling in the legs
  • Deep vein thrombosis, cardiac and pulmonary complications
  • Possibility of revisional surgery
In order to minimize the risk of liposuction, the patient must be aware of the following facts :
  • Too much liposuction is an excessive volume of aspirated fat, or an excessive number of areas treated. Excessive liposuction is dangerous and is an important cause for serious liposuction complications.
  • Unrelated surgical procedures on the same day as liposuction are unnecessary. Prolonged exposure to anesthesia is dangerous and is an important cause for serious liposuction complications.
  • he three types of excessive surgery include 1) removal of an excessive volume of fat by liposuction on a single day, 2) liposuction of an excessive number of body areas on the same day, 3) combinations of liposuction and other unrelated surgical procedures which involves excessive surgical trauma and prolonged exposure to general anesthesia.
  • Disfiguring skin irregularities and depressions are frequently the result of the surgeon's inattention to detail. For example, if a liposuction surgeon attempts to do too much on a single day, and becomes fatigued, the result may be an inattention to detail, and undesirable cosmetic results. A liposuction cannula is a stainless steel tube inserted through an incision in the skin that is employed to suction the fat. The size of the liposuction cannula can influence the smoothness of the skin after liposuction. The use of large cannulas tend to create irregularities more commonly than microcannulas (outside diameter less than 3 millimeters). Surgeons who do total-body liposuction tend to use larger cannulas.
The more serious possible complications include :
  • Allergic reaction to medications or material used during surgery.
  • Infection. Any time the body is incised or punctured, bacteria can get in and cause an infection.
  • Damaging the skin. Most surgeons work on the deeper levels of fat, so as to avoid wounding the skin any more than they must for the insertion of the cannula. Sometimes the cannula can damage tissue beneath the skin, which may show up as a spotted appearance on the skin surface.
  • Skin necrosis (dead skin) is a rare complication, in which the skin falls off in the necrotic area.
  • Internal organ puncture. Since the surgeon can't see the cannula, sometimes it damages an internal organ, such as the intestines during abdominal liposuction. Such damage can be corrected surgically.
  • Contour irregularities. Sometimes the skin may look bumpy and/or withered, because of uneven fat removal, or poor skin elasticity.
  • Thromboembolism and fat embolisation.
  • Burns. Sometimes the cannula movement can cause friction burns to skin or nerves. Also, in UAL, the heat from the ultrasound device can cause injury to the skin or deeper tissue.
  • Lidocaine toxicity. When the super-wet or tumescent methods are used, too much saline fluid may be injected, or the fluid may contain too high a concentration of lidocaine. Then the lidocaine may become too much for that particular person’s system. Lidocaine poisoning at first causes tingling and numbness and eventually seizures, followed by unconsciousness and respiratory or cardiac arrest.
  • Fluid imbalance. Since fat contains a lot of fluid and is removed in liposuction, and since the surgeon injects fluid for the procedure, even a very large amount of it for tumescent liposuction, there is a danger of the body’s fluid balance being disturbed. This could happen afterwards, after the patient is at home. If too much fluid remains in the body, the heart, lungs and kidneys could be badly affected.
Risks of Local Anesthesia
Lidocaine is the safest of local anesthetics available for liposuction. At lidocaine concentrations in the blood exceeding 6 milligrams/liter, patients might experience some toxicity. Blood concentrations of lidocaine in excess of 12 milligrams/liter can produce serious cardiac toxicity. The maximum recommended dosage of lidocaine for tumescent liposuction is 50 mg/kg (50 milligrams/kilogram of patient weight). The most extraordinary aspect of the tumescent technique is its unprecedented safety record when used as directed. Most liposuction surgeons know that it can be dangerous to give a patient a dosage of tumescent lidocaine that exceeds 50 mg/kg. All liposuction-related deaths have been associated with either the use of general anesthesia, or IV sedation, or lidocaine doses in far in excess of 75 mg/kg. The tumescent technique is dangerous in the hands of surgeons or anesthesiologists who have not had specific training in the technique. There has never been a reported death associated with tumescent liposuction totally by local anesthesia.

Risks of General Anesthesia
General anesthesia for liposuction can be considered safe when 1) the general anesthesia is administered by a board certified anesthesiologist, 2) liposuction is not performed with other unrelated surgical procedures, and 3) there is no excessive liposuction. The most dangerous aspects of general anesthesia are respiratory depression and impairment of protective airway reflexes. The risks of general anesthesia include human error, unsuspected inherited hypersensitivity to anesthetic drugs, accidental overdose of anesthesia, any undetected airway disconnection or airway blockage. General anesthesia, which increases the risk of vomiting and impairs protective airway reflexes, can cause aspiration of stomach contents. Because general anesthesia impairs the ability to breathe, when a complication does occur it can lead to disaster.

Drugs That Increase Bleeding
Drugs that increase bleeding, if taken by a patient soon before having liposuction, can cause liposuction complications such a hematoma (a large collection of blood trapped beneath the skin), or excessive bleeding that might require hospitalization. Among the more common drugs that can interfere with normal clotting of blood are aspirin, ibuprofen (Motrin, Advil), and warfarin (Coumadin). Even vitamin E, red wine, and some herbal remedies can cause prolonged bleeding. You are provided with a long list of prescription drugs and non-prescription drugs that interfere with bleeding.

Dangers of Ultrasonic Liposuction
Ultrasonic Assisted Liposuction (UAL) requires the use of tumescent fluid and uses either a metal probe or metal paddle to deliver ultrasonic energy and heat into subcutaneous fat. Internal UAL has largely been abandoned because of the risk of full-thickness skin burns and severe scaring. The initial reports of internal UAL were unrealistically enthusiastic. Some authors did not report their complications, and others have learned of major UAL complications after publishing their articles. Because of insufficient proof of safety, UAL devices have not been approved by the FDA for use in doing liposuction.

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