Tumescent anesthesia numbs the area for up to 18 hours, and blood lidocaine peaks 12 to 14 hours after infiltration begins. Many liposuction deaths in a census occurred the first night after discharge.[1][2]
Home / Procedures / Liposuction / Recovery and risks
Recovery and risks
Liposuction removes fat from the treated area, and the body defends its total fat. In a randomized trial of 32 women, thigh fat stayed reduced at 1 year, total body fat returned to the level of untreated women, and fat c
Recovery
Tumescent anesthesia numbs the area for up to 18 hours, and blood lidocaine peaks 12 to 14 hours after infiltration begins. Many liposuction deaths in a census occurred the first night after discharge.[1][2]
With tumescent anesthesia, microcannulas, open incisions and compression garments, Klein's patients returned to work in 1 to 2 days. In a randomized trial, 87% were free of pain at day 4 after power water-assisted liposuction and 3.6% after traditional liposuction.[1][2]
Swelling is common and lasts weeks. Klein's first office visit came 5 to 6 weeks after surgery.[1][2]
Altered or heightened skin sensation improves over 3 to 6 months. Visceral fat rose 10% by 6 months in women who did not exercise after abdominal liposuction.[1][2]
Swelling of the ankles and calves may last 6 months to a year. Darkened skin, seen in 18.7% of one series, usually cleared within a year.[1][2]
In a randomized trial, thigh fat stayed reduced at 1 year while total body fat returned to the level of untreated women. After large-volume liposuction, weight and body composition held steady from 10 weeks to 4 years.[1][2]
Risks
In 31,010 liposuctions in a US insurance database, 0.7% of patients having liposuction alone needed an emergency visit, a hospital stay or a second operation within 30 days. Combining other operations raised the risk 4.8 times.[1]
A census counted 19.1 deaths per 100,000 liposuctions from 1994 to mid-1998, about 1 in 5,224. A survey of dermatologic surgeons reported no deaths in 66,570 tumescent procedures from 1994 to 2000. A European survey found 72 severe complications, including 23 deaths, from 1998 to 2002.[1][2][3]
Pulmonary embolism caused 23.4% of deaths in the census. Perforation of the abdomen or bowel caused 14.6%.[1][2]
Klein set the safe upper dose at 35 mg/kg in 1990, and a 1996 study found no toxicity in 60 patients at a mean of 57 mg/kg. In New York City, five deaths after tumescent liposuction from 1993 to 1998 followed lidocaine doses of 10 to 40 mg/kg, with other drugs such as midazolam.[1][2][3]
Fat embolism syndrome brings low blood oxygen, brain and nerve symptoms and a pinpoint rash, and has no specific treatment. About 10 to 15% of patients with the syndrome die. Surgeons reporting on 198,857 buttock fat grafts listed 32 fatal and 103 nonfatal fat emboli.[1][2][3]
Uneven contour is the most common complication, at 2.7% in a review. In a series of about 600 cases, surface irregularities followed 8.2%, over-correction 3.7% and asymmetry 2.7%.[1][2]
In the same series, fluid collections formed in 3.5%, darkened skin in 18.7% and raised scars in 1.3%. After high-definition liposculpture, 125 of 417 patients had a seroma.[1][2]
Large-volume liposuction means 5,000 mL or more of total aspirate in one operation. Excess fluid and anesthetic, excess fat removal, several operations at once, poor patient selection and poor monitoring raise the risk of death.[1]
How long results last
Liposuction removes fat from the treated area, and the body defends its total fat. In a randomized trial of 32 women, thigh fat stayed reduced at 1 year, total body fat returned to the level of untreated women, and fat came back in the abdomen. In another trial, treated abdominal fat did not regrow, but visceral fat rose 10% by 6 months in women who did not exercise, and exercise prevented the rise. After large-volume liposuction, weight and body composition held steady from 10 weeks to 4 years.[1][2][3]