Liposuction is one of the most popular plastic surgery procedures, with over 200,000 being performed annually. Liposuction is best when performed on people who are at a reasonable weight for their height, and is a great way to spot-reduce fat in certain areas of the body. These areas of spot reduction are those that are resistant to reasonable diet and exercise.
Liposuction has gone from being a major procedure, which often required blood transfusions and an overnight stay in the hospital afterwards, to a procedure that can safely be done while a patient is awake on an outpatient basis. In fact, it's uncommon nowadays if a patient requires anything more than pain medication (often only Tylenol) and good oral rehydration after surgery. Some of my patients even feel good enough to drive themselves to their postoperative appointment the day following liposuction!
Despite the fact that undergoing liposuction has become less of an ordeal, it's still an operation. And like it or not, all surgery comes with risks. When a plastic surgeon discusses the risks of any procedure with a patient, those risks entail events that may not necessarily occur, but have the possibility of happening. If you're a person who doesn't think you can tolerate any of the possible consequences reviewed by the surgeon, you shouldn't have the procedure.
Liposuction complications range from minor, such as a localized skin infection at an incision site, to death — the ultimate complication. We’ll review some possible liposuction complications and sequelae below. Complications are unforeseen events that ideally shouldn’t occur, while sequelae are events that will occur, and are routine or normal in connection with the associated procedure.
- Lumps and Bumps
During liposuction, fat is removed with a cannula: the surgeon holds the cannula in her hand and uses a back and forth motion to remove fat from the area. These strokes are done from different directions to obtain a smooth contour. If a surgeon has not been trained properly, areas of fat can be liposuctioned for too long, creating divots or waviness. A plastic surgeon who has completed a plastic surgery residency or plastic surgery fellowship is best qualified to perform this procedure.
Infection after liposuction is uncommon. If it does occur, it's usually limited to some redness and discomfort at one of the incision sites. More rarely, an entire area can become infected. Some surgeons may start antibiotics prior to surgery, to be continued for a week to ten days afterwards, to help prevent infection.
- Blood Clots
A blood clot is the complication most dreaded by plastic surgeons, as it can lead to death. Blood clots can form in the veins of your legs after any surgery, and if a piece of the clot breaks off and heads to your heart and lungs, sudden death can occur. The best cure for blood clots is prevention. Avoiding general anesthesia if possible, minimizing the length of the surgery, and walking around after surgery instead of lying in bed will decrease the chances of this deadly complication.
- Damage to Deep Body Parts
Poking holes in bodily organs (the liver, kidneys and intestines, for example) or in deep structures such as blood vessels with the liposuction cannula is quite rare, but it has happened. As with the complication of lumps and bumps, this type of complication usually occurs in the hands of those who have not been properly trained in the skill of liposuction.
- Skin Loss
Smokers and people with poorly managed diabetes are more prone to skin loss. Smoking and diabetes narrow blood vessels, and thus reduce the amount of blood and oxygen to the skin, which may result in skin death. Smokers should avoid smoking two to four weeks before and after liposuction. Diabetics should have normal blood sugars for three months prior to liposuction, and they should also closely manage their blood sugar levels after liposuction.
- Skin Burns
Depending on the liposuction machine used, burns may be a factor. Techniques involving ultrasound energy or laser energy can cause major skin burns and eventual skin loss and bad scars if not done with a properly-trained surgeon.
Scarring is not a complication. You will have scars at the incision sites after liposuction, but this is not a complication — it's normal. Anytime a surgical cut is made in the skin, there will be an indicator that an incision has occurred. Depending on how you heal, the scar may become barely perceptible with time. It can take up to 12-18 months for a scar to fully mature, and even at that, it will still be present. Although such a scar may not be so noticeable to others, you will likely always be able to detect it.
- Loss of Sensation
There will be some numbness of your skin after liposuction, which is normal. As with scarring, this is better termed a “sequelae,” as opposed to a complication. Normal skin sensation should return over the course of approximately six months.
Depending on your tendency to bruise, as well as the type of liposuction performed, you will likely have bruising — a normal occurrence after liposuction that typically dissipates after approximately three weeks.
- Waviness and Wrinkling of the Skin
If you have poor skin tone before liposuction, you will have poor skin tone after liposuction. Poor skin tone includes all skin that is not firm, and people with poor skin tone are more prone to waviness and wrinkling of the skin. Loose skin is more difficult to stabilize during liposuction and has a higher chance of having these types of irregularities. The solution to loose skin is removal, not liposuction. If you have loose skin but choose to have liposuction, you need to accept that your skin may become even more loose after liposuction, and may have waviness and/or wrinkling, depending on the thickness of your skin.
Major complications from liposuction are rare. If they weren’t, it wouldn’t be the most popular plastic surgery procedure. While a particular complication may occur only five percent of the time, it's important to remember that if it happens to you, it's 100 percent. That said, liposuction enjoys a good safety profile if performed by a properly trained surgeon.