Large-volume liposuction in 181 patients

Liposuction is a commonly performed cosmetic surgery procedure that is associated with complications, including fatalities. Many of these have been associated with large-volume liposuction. During 1998 the American Society of Plastic Surgery Task Force on Lipoplasty and the Plastic/Cosmetic Surgery Committee of the Medical Board of California have both arbitrarily defined large-volume liposuction as greater than 5000 cc and asked that surgeons not remove any more than this volume except in specific circumstances such as a hospital-type setting [1]. This study includes 181 patients who have had greater than this amount of total aspirate removed in a single procedure. From January 1, 1996, to February 11, 1997, we used tumescent liposuction only (31 patients). From February 12, 1997, to June 30, 1998, we used a combination of ultrasonic liposuction using the Lysonix 2000 Ultrasonic Liposuction Unit and tumescent liposuction (150 patients). During the last part of the latter series we calculated the blood loss of 45 patients derived from preop and 5-day postop hematocrits. The results show that (1) there is no correlation between the aspirate volume and the calculated blood loss; (2) the majority of the calculated blood loss is not in the cannister; and (3) no deaths occurred, but one patient suffered a deep venous thrombosis and two patients suffered pulmonary emboli. As others have pointed out [2-6] large-volume liposuction can be performed relatively safely if this procedure is treated with the respect it deserves and the practitioner exercises sound surgical judgment, uses appropriate technique, and does not try to cut corners to save money for the patient by performing this surgery in minimal settings.