Vaser Liposuction Risks
Risks, Complications, Prevention and Treatment
| Risks and Complications | Description | Prevention and Treatment |
|---|---|---|
| Alcohol | Alcohol causes swelling, thinning of the blood and bruising. There is also a higher risk of bleeding with haematoma. This will required daring and anaemia due to the blood loss. | If you are a regular drinker, discontinue intake of alcohol one week before surgery and resume no earlier than 7 days post-procedure. If you drink occasionally you can avoid alcohol two days before the procedure and resume 7 days post-op. |
| Allergy | Allergic reactions to the drugs used in liposuction, are extremely rare | The patient should mention all allergies during the consultation. They will be asked. Allergies to penicillin, codeine latex are rather common and are easy to avoid. |
| Aspiration of stomach content | Patients who opt for sedation need to mention a history of reflux and taking of omeprazole | Strict nil per mouth for 6 hours+ before the procedure. No fluids, no foods are allowed, at all |
| Asymmetry | The human body is never perfectly symmetrical. During liposculpting procedures, we try our best to keep everything as symmetrical as possible. | During the procedure where maintaining symmetry is important we look, feel, pinch and measure the extracted fat to ensure symmetry and to make the best of it. Even with all these measures in place we sometimes have a slight asymmetry. It can be corrected in most instances. Typical areas where prevention of asymmetry is important are the thighs and hips. |
| Body Dysmorphia Disorder | Body dysmorphic disorder (BDD), or body dysmorphia, is a mental health condition where a person spends a lot of time worrying about flaws in their appearance. These perceived flaws are unnoticeable to others. | We include a checklist in the consent process to assist us and the patient to identify this condition. Patients with BDD will be advised to find treatment at their Health care centre. Treatment can consist of cognitive behaviour therapy and a medication called SSRI’s e.g. citalopram and fluoxetine (Prozac). |
| Bleeding | Overzealous liposuction can cause damage to a blood vessel with resultant bleeding. Cases have been described where a patient requires a blood transfusion after liposuction. | The experienced surgeon will know when to leave sufficient subnormal support behind by not being over-enthusiastic removing all the fat and collagen and damaging the blood vessels (and nerves) Blood tests and clotting profiles also rule these complications by early detection of prep anaemia and clotting problems with a bleeding tendency. |
| Blood clots | See thromboembolism | Maintain mobility, avoid long haul flying and long travel with legs bent for extended periods of time. Wear compression stockings when exposure to the above is unavoidable. |
| Bruising | Discolouration of the skin due to trauma | This is unavoidable and always settles. The degree of bruising varies significantly amongst individuals. |
| Burns | The vaser probe can cause a friction burn. This would occur at the entry point or at the tip of the probe should it touch the skin approaching from the subnormal layer or if the probe touches naked skin. The Bodytite probe can cause a thermal burn. | The technique of sufficient fluid placement into the subnormal layer will prevent any of these. In all instances The skin is protected by placement of plastic ports as well as wet cloths to protect the naked skin. |
| Diabetes Mellitus | Abnormal sugar metabolism. Three types are diet controlled, medication controlled and insulin-dependant | Evidence of tight glycaemic control should be presented before we shall consider performing liposuction on a patient with any form of diabetes mellitus |
| Discolouration of skin | Spots of hyperpigmentation Cutus marmorata | Avoid vaser in regions where it is not required e.g. inner knees, some outer thighs. |
| Grooves in the skin | Furrows and grooves can occur with possible faulty technique | Applying good technique with fine specialist cannulas will help prevent this phenomenon. Luckily it also settles given sufficient time. |
| Haematoma | Most common postoperative complications seen in liposuction/gland removal of the male chest. | Compression garments and firm application of a binder. Suction draining for a day or longer is usually sufficient to prevent this complication from occurring. |
| Infection | A fairly common surgical complication however not very common in liposuction. If it occurs it usually affects regions close to the perineum. | Antibiotics are routinely prescribed. The lidocaine additive to the tumescence fluid also appear to have some bacteriostatic power Diabetic patients should ensure tight control. |
| Lack of insight | The success of the lipo in some people’s understanding is dependant on the technology in use. | The surgeon and the patient together determine the success. The technologies in use (vaser, RF, PAL, Bodytite) are simply pieces of equipment that make the task easier. |
| Lidocaine toxicity | Very rare. The risk exists when there is a miscalculation in the maximum allowed dosage. | Intralipid is an injectable drug that reverses lidocaine toxic effects, prevention by calculation of safe lidocaine dosage based on patient weight. |
| Lumpiness | Lumps and bumps of the skin are integrally part of the healing process. | MLD and constant wearing of a garment should help decrease the lumpiness. The lumpiness will subside over a few weeks but occasionally take a bit longer to return to normal by becoming smooth. |
| Lumps, lumpiness | Lumpiness of the skin can develop in the healing phase 4-8 weeks post-op. | Massage and compression garments will expedite healing. |
| Nerve damage | See below ‘numbness’. | Nerves are never severed but can be bruised during liposuction. This is totally reversible. This is rare and when it occurs it usually is associated with liposuction of the chin/neck region |
| Numbness | Bruising of nerves. Most common after lipo to the chin area and can be diagnosed presents with a droopy corner of the mouth | Resolves over the .weeks that follow. |
| Obesity | Liposuction is not a weight-loss procedure | The BMI should be below 32 before liposuction is considered. There are rare exceptions to this rule. |
| Pacemaker | Radiofrequency (BODYTITE) is not compatible with individuals wearing a pacemaker. | Always advise us if you wear a pacemaker. Vaser technology is safe to use with pacemakers. Radiofrequency treatment (involving electrical current is not). |
| Pain | Trauma to subdermal layer, healing with inflammation. | Resolves over weeks that follow. Pain will always settle over time. Areas that are more prone to pain are areas of liposuction close to the rib cage. |
| Perforation | The cannulas we use are blunt-tipped but in very rare instances they can find thier way into the chest cavity or abdominal cavity and can cause trauma to the liver, spleen, lungs. | Technique and skill of the surgeon rule this complication out fully. |
| Return of the fat | During liposuction the fat cells are removed, it can almost be described as an amputation of part of the adipose tissue. The remaining cells with an unhealthy diet and lifestyle can lead to bloating of the remaining cells. | Exercise, healthy lifestyle, toning of muscles and maintaining core strength. |
| Scarring | Incisions of the human skin can be followed by hypertrophic scars and keloid formation | We only use stealth incisions, not more than 6-7 mm in length. Incisions are always sutured resulting in optimal healing. The sutures are dissolvable or can be removed after 5 days. Hypertrophic and keloid scars can be treated with steroid injections should it be a problem. Fortunately, keloid and hypertrophic scarring are extremely rare and rarely, if ever, seen in our patients. |
| Sedation | All sedative drugs have side effects and risk. These will be fully discussed by your anaesthetist. | Remain nil per mouth for 6 hours before your procedure. Mention all known allergies. |
| Seroma | A very common phenomenon after liposuction. This is especially prevalent after aggressive liposculpting, for example, hight definition work in the male abs. | Avoidance of alcohol. Meticulous use of compression garments and regular MLD massages. |
| Skin burns | Vaser and Bodytite radiofrequency probes can be associated with burns. Vaser probe vibrates and causes a friction burn, Bodytite causes a thermal burn. | Proper technique, sufficient tumescence fluid and skill will totally prevent any risk of burns. |
| Skin discolouration | Cutus marmorata | This is associated with vaser. It consists of pigment deposits. It can be prevented by avoiding vaser in certain anatomical regions e.g. the outer thighs are rather prone to pigment changes |
| Skin laxity | Genetic predisposition, pregnancy, chronological ageing, Massive weight loss all associated with lax skin. | Our mission is fat removal and if we are lucky we will get some skin tightening due to neo collagenases after the trauma to the subnormal layer. We often offer BodyTite as an add on treatment with great results. Should there be too much loose skin one should rather consider a tummy tuck, Surgical thigh lift and surgical neck lift. |
| Skin necrosis | Extremely rare, Associated with certain types of infection age clostridium welchii that causes gas gangrene. | Antibiotics Stringent aseptic technique. |
| Smoking | Smoking affects healing. There are liposuction surgeons out there that will refuse to operate on a smoker. | The best option is quitting altogether. |
| Surgical shock | Extremely rare. | This is mentioned as part of the consenting process. Largely prevented by installation of tumescence fluid. |
| Swelling | Swelling is always part of of the recovery phase after liposuction. It is caused by inflammation associated with healing. It starts developing after a few days. | Swelling is well controlled by wearing the compression garments and regular MLD massage. Swelling always fully resolves after a few weeks. |
| Tethering of the skin | The thin skin of the chin & posterior arms are prone. It gets worse with increasing age. Inner thighs are also occasionally affected. | Surgical technique and use of the optimal cannula. This phenomenon is prevented by leaving a thin layer of fat behind, to help keep the skin smooth. |
| Unhappy with outcome | Unrealistic expectations | Ageing skin, genetic laxity and genetic predisposition might affect less than expected outcomes. Be realistic. Do not buy the brand, but get to know the surgeon and do not hesitate to ask any questions. Do not always believe what is read online, especially before and after pictures can be very deceiving. |
| Unrealistic expectations | Unhappiness with the results of liposuction by not being familiar with what is achievable. | I shall discuss all the detail at consultation and will be transparent. “A sixty year old skin will never look like a twenty-year-old.” There should be an open mind about “no surgery at all” |
| Weight Gain After Liposuction | Bloating of remaining fat cells when not adhering to a healthy lifestyle | Patients should be conscious of healthy living. Liposuction procedures are high value and your investment must be protected by long term healthy living. |