Liposuction Safer Than Previously Thought

From the WebMD Archives

May 4, 2001 -- Contrary to the highly-publicized results of an older study showing a high death rate following liposuction to remove unwanted fat, a new study shows that the procedure is as safe as such commonly performed operations as hernia or gallbladder removal -- when it's performed by board-certified plastic surgeon.

The new study, presented Thursday at a meeting of the American Society for Aesthetic Plastic Surgery (ASAPS) in New York, found that the mortality or death rate from liposuction was one in 46,415. By comparison, the mortality rate for hernia or gallbladder removal falls between 1 in 45,000 to 1 in 50,000.

The older study on liposuction safety found that approximately 1 in every 5,000 people undergoing liposuction dies. In the report, which appeared in the January 2000 issue of the journal Plastic and Reconstructive Surgery, the major cause of death among liposuction patients was blood clot in the lungs, accounting for 23.1% of the deaths.

In response to the negative findings from the first study, over the last few years the ASAPS sought to determine the main factors increasing the risks of liposuction. They found that poor patient health, excessive fat removal, using too much fluid, local anesthesia during the procedure, and performing multiple procedures during the same surgical session are the factors that are most likely to increase the risk of a patient dying.

Then, the group launched an education campaign aimed at alerting plastic surgeons on liposuction risk factors and selecting appropriate candidates for the procedure.

The findings released from the latest study suggest that this campaign was effective, according to researcher Charles E. Hughes III, MD, a plastic surgeon in private practice Indianapolis.

Hughes looked at 94,000 people who underwent liposuction by board certified plastic surgeons from September 1998 to September 2000. During liposuction, localized deposits of fat are removed to recontour one or more areas of the body through a tiny incision. A surgeon inserts a narrow tube to vacuum the fat layer that lies deep beneath the skin. The fat cells are then suctioned out.

Hughes found that the risks are highest when liposuction was combined with other procedures.

For example, when liposuction is performed with a surgical procedure called an abdominoplasty, or "tummy tuck," the rate of deaths was 14 times higher than when it was lipoplasty was performed alone.

Other risk factors include excessive removal of fat and operating on someone in poor health, Hughes says. The new results suggest that fewer surgeons are doing large volume liposuction and 98.4% of plastic surgeons said they would deny the procedure to people with a serious medical problem.

The new findings "translate to a remarkable safety record and means that patients can have a sense of security about elective cosmetic surgery," he says.

One of the problems with the surgery is that "liposuction is done by surgeons, nonsurgeons and people with no credentials whatsoever in their office," Hughes says.

Daniel C. Morello, MD, president of the American Society for Plastic and Aesthetic Surgery and a plastic surgeon in White Plains, N.Y., agrees.

"Sony TV's are a product and if it comes sealed in a box, you will buy it where the cost is lowest," Morello explains. "But when it comes to liposuction, we are dealing with a service, not a product."

Morello cautions against going to a surgeon who has had a weekend course in liposuction -- and yes -- that could happen. People interested in liposuction should go to a board-certified plastic surgeon who has hospital admitting privileges.