The truth about liposuction...
Original article by Rosemary Leonard in the Daily Mail
A patient of mine came to see me last week and said she was concerned about the shape of her thighs. Then she asked about 'having a spot of liposuction', as if it were as simple as having her teeth polished. Like this woman, an increasing number of people consider cosmetic surgery to be a quick-fix solution. It may sound like a minor procedure, but people should be warned that it can go wrong, and there are enormous risks involved. According to a new report from America, liposuction has a mortality rate of one in just more than every 5,000 procedures. In contrast, the total death rate for all surgical procedures performed in America is just one in 100,000. But is this just another inaccurate, scaremonger survey, or is liposuction genuinely dangerous?
Liposuction often involves far more than just sucking away fat and, as with any operation, it doesn't always go according to plan. Things can, and sometimes do, go wrong. The operation can be performed under a local anaesthetic combined with sedation or, for larger areas, a general anaesthetic may be used. Though nowadays complications from intravenous sedatives or general anaesthetics are rare, patients who are overweight and therefore more likely to be having liposuction - are slightly more at risk.
Liposuction is not a gentle procedure. Initially, a cold salt solution, which also contains adrenaline and a local anaesthetic, is injected into the fat cells. Next, a large, hollow needle, usually about 3mm in diameter, which is attached to a powerful suction machine, is inserted in turn through several small cuts in the skin. It is passed into pockets of fat, where it is moved around with considerable force. Fat is quite solid, and needs some liquidising in order to be sucked into the cannula (draining tube). The saline solution helps to loosen and liquidise the fat, but it can cause problems.
REMOVING a large amount of fat can lead to a dramatic loss of body fluid and a sudden drop in blood pressure, so it is important that it is replaced. But it is vital to get the balance right - giving too much fluid can also be dangerous, and can cause kidney problems. Worse still, the local anaesthetic the fluid contains can cause irregularities in the heartbeat, which can be fatal. Inevitably, the way the operation is performed damages blood vessels, which can lead to a considerable loss of blood. The risk of haemorrhage is greater when large volumes of fat are removed, and most surgeons recommend that no more than three litres of fat be removed at a time. The operation can cause severe bruising so, to minimise this, special garments which compress the skin must be worn for two to three weeks after the operation. Even if the operation goes well, it can cause pain and stiffness afterwards. The results of the operation may not be immediately apparent either, as swelling is quite common and may take up to six months to settle completely.
Infection at the operative site is a well-known risk and, while this can usually be treated with antibiotics, it is painful and can increase the risk of scarring. There have been reports from America of severe and widespread infections, which have caused extreme disfigurement. However, the major risk from the surgery is the formation of a clot, or thrombosis, in a vein in one of the legs. The clot can move up to the lungs, becoming a pulmonary embolus.
Small pieces of fat that pass into the blood stream - fat emboli can also be extremely dangerous, and are the most common cause of death after liposuction. Recently, liposuction has been combined with a form of ultrasound which uses high-frequency sound waves to help liquidise the fat cells. This can generate intense heat, and must be used carefully to avoid burning the skin.
Apart from all the health risks, liposuction's results can vary, too. The procedure works best on younger women - those under 40 - whose skin is more elastic, and springs back into shape relatively easily. Removing large volumes of fat, especially in older women, can cause unsightly sags and folds. And, if too much is removed from one place, or if it is removed unevenly, it can cause ridges and dimples.
Liposuction can't slim you down all over, so it shouldn't be regarded as a means of weight loss. But it can dramatically change your body contours. The operation can be very useful for evening out an unbalanced figure which just won't be corrected by diet or exercise - as many women with, for instance, large thighs and a small waist will testify. It can slim thick ankles and remove unsightly bulges from around the knees, too.
Liposculpture, which is done with a fine cannula, can be used as part of a facelift or to remove a double chin. It can also be used in conjunction with other plastic surgery, such as breast reduction or a tummy tuck, to help give a better cosmetic result. SOME doctors use lipo-suction as a treatment for obesity but, to be really effective, it must be part of a general weight loss programme.
To minimise the risks, patients should make sure their surgeon is properly qualified. He should be a Fellow of the Royal College of Surgeons (FRCS after their name) and, ideally, should also be a member of the British Association of Aesthetic and Plastic Surgeons. A well-qualified anaesthetist (FFA RCS) should be in attendance. Anyone having more than three litres of fat removed, or who is at increased risk for any other reason, should stay in hospital for at least one night after the operation, and there should be easy access to a properly staffed and equipped intensive care unit.
The heavier you are and the more fat that is removed, the greater the risks, so it makes sense to lose as much weight as possible before undergoing liposuction. Anyone with another medical condition, such as diabetes or high blood pressure, should always consult their GP or a specialist beforehand.
Those undergoing liposuction should be given detailed advice about postoperative care, particularly exercise because it is important to get mobile as soon as possible after the operation to reduce the risk of a venous thrombosis.
It is vital for a patient to understand the risks involved in losing an inch or two. If you're very unlucky it could cost you more than just money, it could even cost your life.
About 15,000 people undergo liposuction in Britain every year. Here are some facts about the procedure:
* LIPOSUCTION is a means of removing fat that cannot be broken down by exercise or diet.
* NO more than half a stone of fat should be removed at once. If more is taken, the patient may lose too much blood and require a transfusion.
* A PATIENT will spend the night in hospital following treatment.
* FOR three to four weeks afterwards, a tight garment must be worn to protect the area where the procedure was done.
* IN ULTRASONIC liposuction, sound waves are used to break up fat cells. This is done by contracting and expanding them at high speed, eventually destroying them. This method is popular because it reduces the chance of damage to nerve endings. It is fast, taking as little as half an hour to complete, but expensive - costing at least £3,000.
* FATALITIES resulting from liposuction have been attributed to either mismanaged fluids, perforated organs or blood clots.
* COMMON complaints include stretched skin not shrinking back to its former size, numbness in muscles surrounding the area operated on, and uneven fat removal, which leaves lumps.
Read more: http://www.dailymail.co.uk/femail/article-4483/The-truth-liposuction.html#ixzz43ksihceU
A patient of mine came to see me last week and said she was concerned about the shape of her thighs. Then she asked about 'having a spot of liposuction', as if it were as simple as having her teeth polished. Like this woman, an increasing number of people consider cosmetic surgery to be a quick-fix solution. It may sound like a minor procedure, but people should be warned that it can go wrong, and there are enormous risks involved. According to a new report from America, liposuction has a mortality rate of one in just more than every 5,000 procedures. In contrast, the total death rate for all surgical procedures performed in America is just one in 100,000. But is this just another inaccurate, scaremonger survey, or is liposuction genuinely dangerous?
Liposuction often involves far more than just sucking away fat and, as with any operation, it doesn't always go according to plan. Things can, and sometimes do, go wrong. The operation can be performed under a local anaesthetic combined with sedation or, for larger areas, a general anaesthetic may be used. Though nowadays complications from intravenous sedatives or general anaesthetics are rare, patients who are overweight and therefore more likely to be having liposuction - are slightly more at risk.
Liposuction is not a gentle procedure. Initially, a cold salt solution, which also contains adrenaline and a local anaesthetic, is injected into the fat cells. Next, a large, hollow needle, usually about 3mm in diameter, which is attached to a powerful suction machine, is inserted in turn through several small cuts in the skin. It is passed into pockets of fat, where it is moved around with considerable force. Fat is quite solid, and needs some liquidising in order to be sucked into the cannula (draining tube). The saline solution helps to loosen and liquidise the fat, but it can cause problems.
REMOVING a large amount of fat can lead to a dramatic loss of body fluid and a sudden drop in blood pressure, so it is important that it is replaced. But it is vital to get the balance right - giving too much fluid can also be dangerous, and can cause kidney problems. Worse still, the local anaesthetic the fluid contains can cause irregularities in the heartbeat, which can be fatal. Inevitably, the way the operation is performed damages blood vessels, which can lead to a considerable loss of blood. The risk of haemorrhage is greater when large volumes of fat are removed, and most surgeons recommend that no more than three litres of fat be removed at a time. The operation can cause severe bruising so, to minimise this, special garments which compress the skin must be worn for two to three weeks after the operation. Even if the operation goes well, it can cause pain and stiffness afterwards. The results of the operation may not be immediately apparent either, as swelling is quite common and may take up to six months to settle completely.
Infection at the operative site is a well-known risk and, while this can usually be treated with antibiotics, it is painful and can increase the risk of scarring. There have been reports from America of severe and widespread infections, which have caused extreme disfigurement. However, the major risk from the surgery is the formation of a clot, or thrombosis, in a vein in one of the legs. The clot can move up to the lungs, becoming a pulmonary embolus.
Small pieces of fat that pass into the blood stream - fat emboli can also be extremely dangerous, and are the most common cause of death after liposuction. Recently, liposuction has been combined with a form of ultrasound which uses high-frequency sound waves to help liquidise the fat cells. This can generate intense heat, and must be used carefully to avoid burning the skin.
Apart from all the health risks, liposuction's results can vary, too. The procedure works best on younger women - those under 40 - whose skin is more elastic, and springs back into shape relatively easily. Removing large volumes of fat, especially in older women, can cause unsightly sags and folds. And, if too much is removed from one place, or if it is removed unevenly, it can cause ridges and dimples.
Liposuction can't slim you down all over, so it shouldn't be regarded as a means of weight loss. But it can dramatically change your body contours. The operation can be very useful for evening out an unbalanced figure which just won't be corrected by diet or exercise - as many women with, for instance, large thighs and a small waist will testify. It can slim thick ankles and remove unsightly bulges from around the knees, too.
Liposculpture, which is done with a fine cannula, can be used as part of a facelift or to remove a double chin. It can also be used in conjunction with other plastic surgery, such as breast reduction or a tummy tuck, to help give a better cosmetic result. SOME doctors use lipo-suction as a treatment for obesity but, to be really effective, it must be part of a general weight loss programme.
To minimise the risks, patients should make sure their surgeon is properly qualified. He should be a Fellow of the Royal College of Surgeons (FRCS after their name) and, ideally, should also be a member of the British Association of Aesthetic and Plastic Surgeons. A well-qualified anaesthetist (FFA RCS) should be in attendance. Anyone having more than three litres of fat removed, or who is at increased risk for any other reason, should stay in hospital for at least one night after the operation, and there should be easy access to a properly staffed and equipped intensive care unit.
The heavier you are and the more fat that is removed, the greater the risks, so it makes sense to lose as much weight as possible before undergoing liposuction. Anyone with another medical condition, such as diabetes or high blood pressure, should always consult their GP or a specialist beforehand.
Those undergoing liposuction should be given detailed advice about postoperative care, particularly exercise because it is important to get mobile as soon as possible after the operation to reduce the risk of a venous thrombosis.
It is vital for a patient to understand the risks involved in losing an inch or two. If you're very unlucky it could cost you more than just money, it could even cost your life.
About 15,000 people undergo liposuction in Britain every year. Here are some facts about the procedure:
* LIPOSUCTION is a means of removing fat that cannot be broken down by exercise or diet.
* NO more than half a stone of fat should be removed at once. If more is taken, the patient may lose too much blood and require a transfusion.
* A PATIENT will spend the night in hospital following treatment.
* FOR three to four weeks afterwards, a tight garment must be worn to protect the area where the procedure was done.
* IN ULTRASONIC liposuction, sound waves are used to break up fat cells. This is done by contracting and expanding them at high speed, eventually destroying them. This method is popular because it reduces the chance of damage to nerve endings. It is fast, taking as little as half an hour to complete, but expensive - costing at least £3,000.
* FATALITIES resulting from liposuction have been attributed to either mismanaged fluids, perforated organs or blood clots.
* COMMON complaints include stretched skin not shrinking back to its former size, numbness in muscles surrounding the area operated on, and uneven fat removal, which leaves lumps.
Read more: http://www.dailymail.co.uk/femail/article-4483/The-truth-liposuction.html#ixzz43ksihceU