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Liposuction: How safe is it? An Analysis of 31,010 Cases
Jose R. Ramirez, MD1, Varun Gupta, MD1, Julian Winocour, MD1, Robert B. Shack, MD, FACS1, James C. Grotting, MD, FACS2, Kent Higdon, MD, FACS1.
1Vanderbilt University, Nashville, TN, USA, 2University of Alabama-Birmingham Medical Center, University of Wisconsin Medical Center, Birmingham, AL, USA.

PURPOSE: Suction-assisted lipectomy, or liposuction, is the most commonly performed aesthetic surgical procedure in the US according to the ASAPS Cosmetic National Database (363,912 procedures performed in 2013). Liposuction is being performed increasingly in combination with other surgical procedures to enhance outcomes. This study analyzed the risk factors and significant complications after liposuction, alone and in combined procedures.
METHODS: Prospectively enrolled patients undergoing liposuction between 2008 and 2013 were identified from the CosmetAssure database (total of 183,914 procedures). CosmetAssure is an insurance program that provides coverage for treatment of significant complications following aesthetic surgery. Univariate and multivariate analysis was performed on identified risk factors including age, smoking, BMI, gender, diabetes, multiple procedures and type of surgical facility.
RESULTS: A total of 31,010 liposuction procedures were identified; 11,490 (37.1%) were performed as a solitary procedure. The incidence of significant complications was 0.7% with liposuction alone, 3.8% when combined with abdominoplasty and 12% when combined with abdominoplasty, breast and another body contouring procedure. Most common complications were infection (0.7%), hemorrhage (0.6%) and possible or confirmed DVT/PE (0.6%). Combined procedures (RR 4.75), BMI>=25 (RR 1.58), and procedures performed in hospital/surgical centers rather than office-based surgical suites (RR 1.65) were independent predictors of complications on multivariate analysis.
CONCLUSION: Liposuction alone is associated with a low complication rate. When combined with other aesthetic procedures or performed on overweight and obese patients, complication rates rise significantly.


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