Severe complications can be minimized by making
sure you disclose your entire medical history to your doctor and discussing all
prescription and other medication that you take on a regular basis. In
most cases the side effects associated with liposuction surgery are minimal. Do
your home work so that you understand all the risks, problems, and complications
associated with the liposuction procedure.
Although, not very common
sometimes a bleeding episode can occur after liposuction
or lipotrophy procedures. If post operative
liposuction bleeding occurs, it may require an emergency
treatment to either have blood drained which might have
accumulated (such as a
hematoma) or possibly a blood
transfusion. It is of utmost concern that you
follow your plastic surgeon's post operative
instructions with making sure you stay away from certain
types of medication that might contribute to thinning
the blood.
Sometimes the cannula
movement can cause friction burns to skin or nerves. Ultrasound-Assisted
Liposuction can produce a large amount of heat - which
can increase the risk of burning the skin, causing
blisters or possible scarring.
DVT is a blood clot that forms in a vein deep in
the body. Blood clots occur when blood thickens and clumps together. These
blood clots form after prolonged immobility (such as bed rest after surgery).
During recovery, it is important to stand often and flex the feeet more often to
keep the blood flowing in the legs. Most deep vein blood clots occur
in the lower leg or thigh however, they can occur in other parts of the body as
well.
A Pulmonary Fat
Embolism is a very rare event after liposuction. The
liposuction procedure involves suction of fat cells from specific parts of
the body after loosening the fatty areas up first with a solution
(tumescent). A Fat Embolism can occur when fat is loosened and a fat
particle enters the blood through a blood vessel that was either torn or
ruptured during liposuction. Fat particles can sometimes get trapped
in the blood vessels, go to the lungs or to the brain.
Symptoms of a
Pulmonary Fat Emboli (fat clots in the lung)
shortness of
breath
difficulty in
breathing
Any patient that
has these symptoms after surgery needs to contact medical help immediately.
Fat emboli can cause permanent disability or in some cases - cause death.
An
instrument called a
cannula is used to suck out fat accumulations during
the surgical procedure called liposuction. The surgeon is unable
to see where the cannula goes during the procedure, so the chance of
puncture or damage to internal organs is a risk. Visceral
Perforations basically causes "puncture wounds" in the organs. When this happens, surgery may be required to repair them. This
complication can be fatal.
A hematoma is a collection of whole blood that
has leaked out of injured blood vessels and become trapped inside the body. The
vasoconstriction produced by the tumescent technique for liposuction has
virtually eliminated the occurrence of hematomas.
Seromas
after liposuction are the result of
surgical trauma which injures or destroys the lymphatic vessels
within the targeted fatty tissue. Lymphatic vessels are tiny,
thin-walled tubular structures located throughout the body, and have
the specific function of draining tissues of fluids that leak out of
capillary blood vessels. Large
liposuctioncannulas can
sometimes create large empty pockets within targeted fatty tissues
as well as removing lymphatic vessels.
Both of
these conditions encourage the formation of seromas after
liposuction. Unfortunately, seromas
are a common problem after ultrasonic assisted
liposuction (UAL). Ultrasonic
liposuction
cannulas create a considerable amount of heat which injures
blood vessels as well as the delicate lymphatic vessels. Without
lymphatic vessels to drain away excessive lymph fluid, the fluid
collects within the excavated spaces in the fatty created by the
liposuction process.
Preventing Seromas:
The use of micro-cannulas have been proven to
reduce the risk of seromas. Micro-cannulas are very small liposuction
cannulas which has an outside diameter of less than 3 mm. The purpose of
using the micro-cannulas is that it creates smaller tunnels which will not leave
the larger cavities that a larger cannula can cause. It is these larger
cavities of space that tend to be perfect place for seromas to form. Also,
larger cannulas because they remove fat faster can damage the lymphatic vessels
and create larger cavities within the fat.
Incisions that are not closed with sutures helps
with the drainage of the tumescent anesthetic solution and also the lymphatic
system. This is known as the "open drainage technique. Also wearing
a compression garment helps with squeezing the walls of the empty tunnels
together so that they adhere faster and close up the empty cavities - making it
less likely for a seroma to form.
Malignant hyperthermia is a
very rare complication from
general anesthesia,
which can sometimes be
fatal. The inhaled
agents used in the
anesthesia can sometimes
cause a biochemical reaction
which is marked by intense
muscle contractions that
will eventually lead to
rigidity in muscle tissue.
Hyperthermia is another word
for an abnormal high fever
and muscle breakdown.
How Malignant Hyperthermia
Happens:
This condition only
happens to patients who
are genetically
susceptible to malignant
hyperthermia
Patients produce
abnormal proteins inside
their muscle cells.
These proteins will
trigger the response or
release of excess
calcium when the person
inhales certain common
anesthetics
Increased calcium
activates the sustained
muscle contractions -
which will increase the
amount of energy the
body will use
The end result is an
increase in heat
production
(hyperthermia)
The overactive muscle
cells eventually run out
of energy and die off.
With the cells dying,
high levels of potassium
and a protein are
released into the
bloodstream causing
muscle damage, cardiac
arrest, brain damage,
massive internal
bleeding, kidney
failure, other organ
failure and death
These events can be
prevented if the
anesthesiologist
administers the proper
treatment immediately
This complication is not
always fatal, in fact
death rates have been
dropping significantly.
Death rate in the
1960-1970 - 80 percent -
Death rate today is
close to 10 percent
Lymphedema is
an injury
that damages your lymph
nodes or lymph vessels.
Lymphedema has been reported
with ultrasonic liposuction
because of the potential of
it to burn the vascular
system.
Ultrasonic
liposuction cannulas
create a considerable amount
of heat which injures blood
vessels as well as the
delicate lymphatic vessels.
Phlebitis means inflammation of a vein. Thrombophlebitis refers to a blood clot which causes inflammation. Phlebitis can be superficial, in the skin, or deep in the tissues. Symptoms of phlebitis include constant pain, swelling and redness.
Cellulitis is a skin
infection which is caused by
bacteria. Our skin
normally helps protect our
body from infection. If we have a cut, sore,
insect bite or recovering
from surgery - sometimes
bacteria can get into the
skin and spread to the
deeper tissues. This
complication requires
antibiotics immediately, as
the infection has the
capability of spreading to
the blood or the lymph
nodes.
Most surgeons prescribe
antibiotics as precaution
after every surgical
procedure so an infection or
cellulitis cannot occur. Without treatment, this
could be fatal.
Symptoms of Cellulitis:
Infected area is warm to
the touch
Inflammation can cause
the area to be red,
swollen and tender
One of the longer term effects of liposuction can
be nerve damage. This can occur due to the stripping of the outer sheath
of nerve cells containing a fatty layer which is called myelin. Six
percent of all patients can experience some sort of problem with damage to the
sensory nerves. Damage to the sensory nerves will create the feeling of
pins and needles.
Liposuction to the lower face area also can
sometimes cause damage to the facial nerves due to suctioning out the fat along
the jaw line. These nerves in the facial area tend to recover on their own
requiring no treatment.
You many
experience numbness around the area
where your liposuction surgery was
performed. This is also known as "paresthesia"
- and is very normal. A numbing
sensation may occur off and on for 4-8
weeks, but feeling and sensation should
return after that time.
Permanent
numbness is very rare and occurs less
than 1 percent of the time. The
method of liposuction that has the
majority of nerve problems is with the
ultrasound assisted liposuction (UAL)
Toxicity from anesthesia is a risk factor with
surgery. Lidocaine is a drug that numbs the skin and is used frequently as
a local anesthetic during the procedure of liposuction.
Some of the side effects of Lidocaine are:
feeling
light-headed
restless
dowsy
tinnitus (ringing
in the ears)
slurred speech
metallic taste in
the mouth
numbness of the
lips or and tongue
shivering
muscle twitching
convulsions
Toxicity with
lidocaine may cause the heart to stop. Any
type of anesthesia is considered a risk during
surgery. Lidocaine toxicity is a rare
complication with tumescent liposuction. With
the tumescent liposuction procedure too much saline
fluid may be injected or the "tumescent solution"
contains too high of a concentration of lidocaine. Most surgeons are very skilled at knowing exactly
how much to inject according to body size and their
medical history.
Other Medication
Make sure you tell
your surgeon any and all medication you are taking
on a regular basis, including over the counter
remedies. Drugs that increase bleeding can
cause a hematoma or excessive bleeding requiring
possibly hospitalization.
Having an infection with
liposuction is normally a rare
occurrence. Should an
infection start - contact your
surgeon immediately. Treatment for infections include
a prescription of antibiotics or
additional surgery depending on
the severity of the situation.
To
help with any
hypertrophic scarring
or
keloid
prevention, some surgeons will suggest silicone gel sheeting. This silicone
sheeting comes in gel shapes which are commonly used for various different types
of cosmetic surgery.
Keloid scarring resembles a lumpy pink raised scar and normally occur in people
who have this tendency.
Swelling or edema is a very common problem that may occur after
liposuction. In some cases, swelling may persist for weeks or
months after liposuction. This is not uncommon and can be
considered part of the healing process in liposuction.
Shock can happen with large volume liposuction. Shock and blood dilution can occur after a patient has had excessive amounts of fluid injected and then excessive amounts of fat and body fluid removed (over 5,000 ccs or about approximately 11 pounds). Large volume liposuction should be considered carefully. It is generally not recommended. However there are surgeons that specialize in it.
Full Thickness Skin
Necrosis is death of the affected skin. This complication can
result from excess superficial liposuction that injures the vascular
supply of the overlying skin.
Bruising occurs often following the procedure of
liposuction. Bruising will vary from patient to patient due to many
factors. The severity of the bruise is associated with the time period
that a bruise will appear after the surgery along with the color of the bruise.
Bruises are more likely to happen with:
Patients who have a low blood platelet
level
Poor nutrition (which is in direction
correlation of having inadequate nutrients for the body)
Patients who did NOT stop certain
medications before their procedure (make sure you tell your surgeon and
anesthesiologist everything you take in regards to medication and over
the counter products).
Most surgeons will suggest to take Arnica or
Bromelain to prevent and reduce the risk of bruising. Also, the use of
compresses will help reduce bruising. Bruising can last up to six to eight
weeks; however, depending on your body type it might be much less.
Skin irregularities
including depressions or dimpling of the skin might
occur after liposuction. Also including possible
visible and palpable wrinkling of skin. If these
irregularities happen, additional plastic surgery might
be needed to treat these depressions, etc.
