Learning Objectives: After studying this article, the participant should be able to: 1. Adequately evaluate a patient preoperatively for liposuction. 2. Formulate a surgical treatment plan to safely perform liposuction. 3. Postoperatively diagnose immediate, early, and late complications and formulate a treatment plan for the complications. 4. Classify the anesthesia status of a potential liposuction patient and select the appropriate type of anesthetics to be used. 5. Understand large-volume liposuction and the added risks inherent in this type of liposuction procedure.
Summary: The purpose of this liposuction article is to provide a broad overview of the procedure, currently one of the most common operations performed by plastic surgeons. The important medical history that must be obtained, including comorbidities and conditions that increase the risk of deep venous thrombosis, is discussed. Specifics of the physical examination are highlighted. Anesthesia for liposuction is an extremely important factor for the success and safety of the procedure. The anesthetic agents and the wetting solutions used in liposuction are explained to promote safety and good results. A surgical treatment plan for a successful outcome, including the types of lipoplasty, is presented. Outcomes of the procedures, including potential complications, are covered. The rare complication of intestinal or organ perforation from the cannula is discussed to increase the surgeon's level of awareness of the problem and its avoidance. Deep venous thrombosis, associated with pulmonary embolism and death, is the most frequent serious complication of liposuction. This and other sequelae of liposuction are discussed so that the surgeon can evaluate his or her surgical outcomes to improve the results and promote patient safety.
The Maintenance of Certification module series is designed to help the clinician structure his or her study in specific areas appropriate to his or her clinical practice. This article is prepared to accompany practice-based assessment of preoperative assessment, anesthesia, surgical treatment plan, perioperative management, and outcomes. In this format, the clinician is invited to compare his or her methods of patient assessment and treatment, outcomes, and complications with authoritative, information-based references.
This information base is then used for self-assessment and benchmarking in parts II and IV of the Maintenance of Certification process of the American Board of Plastic Surgery. This article is not intended to be an exhaustive treatise on the subject. Rather, it is designed to serve as a reference point for further in-depth study by review of the reference articles presented.
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center.
Received for publication July 2, 2006; accepted September 21, 2007.
Ronald E. Iverson, M.D.; The Plastic Surgery Center; 1387 Santa Rita Road; Pleasanton, Calif. 94566-5643; email@example.com
Disclosure: Neither author has any commercial associations that might pose or create a conflict of interest with information presented in this article. This includes (but is not limited to) consultancies, stock ownership or other equity interest, patent licensing arrangements, and payments for conducting research or publishing or publicizing any of the information or conclusions expressed in the article.
The test for the MOC-PS–aligned CME article “Liposuction” by Iverson and Pao is available at http://www1.plasticsurgery.org/ebusiness4/OnlineCourse/CourseInfo.aspx?Id_14903.