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LIPOSUCTION
possible problems and complications of ultrasonic liposuction
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Complications with ultrasound-assisted lipoplasty can occur but major problems seem uncommon. They may be more common when large volumes are removed and when the tissue closest to the skin is aggressively suctioned. Many of the risks are the same as Traditional liposuction These include bruising, swelling bleeding, infection, and change in nerve function.
• surface irregularity: asymmetry or unevenness can occur in up to 3% of patients but only a third of these need additional surgery.
• brown discloration of skin: this may occur in up to 4% of patients. The brown pigment is due to hemosiderin (an iron containing material which is produced when red blood cells break down) and increased pigment due to inflammation. It may be long lasting and seems to be more common when the inner thigh is suctioned.
• nerve change: sensory, or feeling, nerves may be damaged in up to 6% of patients. Pins and needles and aching pain are the most common problems. Damage to the nerve that supplies the lower face muscles (VII nerve) has been seen after suctioning along the jaw. It appears to recover on its own and no treatment is needed. The outer sheath of many nerve cells is a fatty layer called myelin and the nerve damage may be due to stripping of this layer.
• fat fibrosis and necrosis: up to 4% of patients may experience small lumps and texture change in the skin. Small pieces of fat may break off during the suctioning. These may be felt as small sausage shaped areas deep to the skin and just above the muscle.They may act as trigger points for pain and discomfort.
• prolonged drainage: drains are sometimes used after surgery but in some patients the drainage may be persistent. This consists of a mixture of the wetting solution, small particles of fat and residual oils.
• seromas: this is a collection of fluid or serum and in some series is the most common complication of ultrasonic liposuction.
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- • skin laxity: after surgery the skin may not contract and in situations where large amounts of fat are removed this may require additional surgery. An advantage of ultrasonic liposuction is that it appears to tighten the skin more than traditional liposuction.
- • skin necrosis: the ultrasonic probe can damage the blood supply to the skin or cause burns directly. This may lead to the death of a small area of skin.
- • burns: may occur in up to 4% of patients however with the introduction of skin protection at the entry point it is likely that this will be much less. The superwet method is used to reduce the risk of burns in the cavity being suctioned.
- • long term effects: the effects of ultrasound in the cavity are still under study but at this time no adverse affects are known. _
- • free radicals: because free radicals may be created by the surgery some doctors recommend antioxidant medications before and after surgery. The significance of this is unclear but seems minor. This is one reason that some surgeons are reluctant to use ultrasonic liposuction on the breast. This seems a theoretical objection to breast reduction using ultrasonic liposuction and there is no reason to suggest that current studies will show any conection between breast cancer or other problems of this type and ultrasonic liposuction.
- • blisters from dressings or bandages: although less common as surgeons have gained more experiece, blistering from foam bandages can be significant and may leave scars on the skin.
 ultrasonic liposuction should not be used in patients who have a pacemaker.
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