Jan. 21, 2000 (Atlanta) -- New techniques have made liposuction a more attractive cosmetic procedure, both for physicians and for patients. But a new survey concludes that there is still an unacceptable death rate following the surgery.
The study, which appears in the latest issue of Plastic and Reconstructive Surgery, showed a death rate of about 20 in every 100,000 patients who underwent liposuction between 1994 and 1998. The authors point out that this number is higher than the death rate for motor vehicle accidents in the United States. But it's a dramatic improvement from what most would consider the "bad old days" of liposuction -- the 1970s -- when death rates were eight times higher.
However, a statement released by the American Society for Aesthetic Plastic Surgery (ASAPS) offers some explanations for the study's findings. According to the statement, the ASAPS assembled a task force of plastic surgeons who attempted to uncover the reasons behind the increasing reports of liposuction deaths and complications. The group determined that the main factors increasing the risks of liposuction are poor patient health, excessive fat removal, using too much fluid and local anesthesia during the procedure, and performing multiple procedures during the same surgical session.
"As a result of the task force's investigation and recommendations, many plastic surgeons have altered their approach to [liposuction]. Consequently, since about 1998, we have seen the rate of serious complications plummet," ASAPS president Fritz E. Barton Jr., MD, is quoted as saying in the statement.
Still, one of the authors says there's reason for concern. "Liposuction has become trivialized, really," Rudolph H. de Jong, MD, from Thomas Jefferson Medical College in Philadelphia, tells WebMD. "It's a far more major procedure than it appears on the surface. The article was published as a way to warn the medical community. ... [T]his serves as a precautionary yellow traffic light."
Other plastic surgeons contacted by WebMD agree with the 'yellow light' symbolism, but they say it mainly applies in this respect: Be careful about what you read into the study.
"This data is nowhere near being valid," says Rod J. Rohrich, MD, professor and chairman of the department of plastic surgery at the University of Texas Southwestern Medical Center in Dallas, who says that recent studies have put the liposuction death rate much lower than this one. "This is one study. Obviously, it caught all of our attention, but I don't think some of the data is necessarily valid because of how it was collected."
Rohrich is referring to the "census survey" method used in the study, in which more than 1,200 board-certified plastic surgeons were sent one-page questionnaires -- twice -- asking whether they knew of, or had experience with, deaths from liposuction procedures. More than 900 physicians responded, giving the authors a death count of 130.