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Is lipo a lie?

Understanding the risks of liposuction


By Dr. Kaycee Reyes


Type “liposuction” on a web search engine and you will immediately find thousands of articles, stories, and testimonials about liposuction. Reactions about liposuction range from positively life-changing transitions to unsafe, risky, or, worse, fatal procedures. Liposuction started in the ’70s but was developed in the ’80s. Increased awareness, social and media influence, and accessibility have made liposuction as one of the most common cosmetic procedures today. The misconceptions about liposuction, however, are also as common. Ask your friends about it, and you’ll surely get more questions than answers. “Isn’t that scary?” “Did you hear what happened to her?” “Can lipo really be fatal?”

What is lipo? Liposuction, also called lipoplasty, suction-assisted lipectomy, or lipo, is a surgical cosmetic procedure that removes fat by inserting a narrow tube or a cannula to drain or remove the fat from the body. The stomach, back, buttocks, arms, neck, and thighs are common areas where liposuction is performed. Contrary to popular belief, however, liposuction is not a procedure to treat obesity. The ideal candidates for liposuction are healthy individuals who have stubborn fat in a specific area of their body.

How is lipo done? To quash the misconceptions about liposuction, it is important to understand how liposuction is performed. There are four types of liposuction techniques:

The Dry Technique requires general anesthesia before it extracts the fat. This is no longer used because it causes extreme blood loss on the patient. The Wet Technique also uses general anesthesia, but local anesthesia is also injected at the site before extraction. While less blood is lost using this technique, it is still significant. The Super Wet Technique still uses general anesthesia, but the blood loss is much lower than the Wet Technique as the amount of local fluid injected is equal to the fat removed. Some or all of the techniques above usually require extended hospital care and/or blood transfusion due to the blood lost.  The Dry Technique, Wet Technique, and Super Wet Technique are conventional liposuction procedures under general anesthesia, largely practiced by plastic surgeons. These procedures last for two to three hours, and can remove large amounts of fats and save time for the surgeon.

The following disadvantages, however, can also be seen:

  1. General anesthesia risks plus the requirement for hospitalization
  2. Use of large cannula increases risk of damage to tissues and more bleeding, thus probability of significant blood loss that may need blood transfusions.
  3. Recovery time is slow after general anesthesia.

Meanwhile, the Tumescent Technique differs from the rest as it requires no general anesthesia. A large volume of fluid injected makes blood loss at a minimum, and since no general anesthesia is required, downtime is shorter. There are are fewer side effects and less pain and risks are lower.  Tumescent is comparatively slower than the conventional liposuction, taking three to four hours to perform, and the amount of fat to be extracted is most of the time limited to about four to five liters.  The term tumescent liposuction excludes the use of additional anesthesia such as intravenous and gaseous anesthesia.  It should be noted that compared to conventional liposuction where mortality and severe complications have been reported, the risk of systemic complication with tumescent liposuction was found as low as 0.07 percent (Venkataram, 2008).  This technique, introduced by Dr. Jeffrey A. Klein, a dermatologic surgeon, in 1985, is still being used, preferred, and considered as the ideal method to this day. It was previously thought that this technique will only be effective in small amounts of fat removal, but it has been proven that it also works with large volume fat loss. Moreover, dimples and lumps are almost rare in this technique, as compared to previous methods where these irregularities are common.

 So, is lipo really fatal? Possibly, depending on the technique used. The techniques discussed above, the Dry, Wet, and Super Wet techniques, all run the risk of becoming fatal due to reasons such as too much fat removal at a time, multiple procedures done at once, general anesthesia complications, excessive blood loss, hemorrhagic necrosis of fat, and pulmonary thromboembolism (blood clot on the lungs), among others. On the other hand, no deaths have yet been reported with the Tumescent Technique. In fact, since no general anesthesia is given, the patient may even stand and assess the target area, minimizing future repeat procedures, which thus, results in higher patient satisfaction.

It’s no big fat lie: liposuction does come with risks, but so do other surgical procedures as well. It is best to always consult a physician or surgeon, especially in surgical procedures like this. Arm yourself with questions, not only about lipo, but about the surgeon’s credentials, too. What liposuction technique will be used? Is the clinic or hospital registered to operate? Is the physician board-certified and trained for the procedure? How many patients has the physician treated? Also, check for before and after photos of your physician’s patients. Risks do come with liposuction, but as long as patients are well-informed, and they have done the right preparations and precautions with proper guidance, then liposuction can just be one of the best decisions and transformations in their lives.

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