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Is There a Safe Lipoaspirate Volume? A Risk Assessment Model of Liposuction Volume as a Function of Body Mass Index

Chow, Ian B.A.; Alghoul, Mohammed S. M.D.; Khavanin, Nima B.S.; Hanwright, Philip J. M.D.; Mayer, Kristen E. B.S.; Hume, Keith M. M.A.; Murphy, Robert X. Jr. M.D., M.S.; Gutowski, Karol A. M.D.; Kim, John Y. S. M.D.

Plastic and Reconstructive Surgery: September 2015 - Volume 136 - Issue 3 - p 474–483
doi: 10.1097/PRS.0000000000001498
Cosmetic: Original Articles
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Background: No concrete data exist to support a specific volume at which liposuction becomes unsafe; surgeons rely on their own estimates, professional organization advisories, or institutional or government-imposed restrictions. This study represents the first attempt to quantify the comprehensive risk associated with varying liposuction volumes and its interaction with body mass index.

Methods: Suction-assisted lipectomies were identified from the Tracking Operations and Outcomes for Plastic Surgeons database. Multivariate regression models incorporating the interaction between liposuction volume and body mass index were used to assess the influence of liposuction volume on complications and to develop a tool that returns a single adjusted odds ratio for any combination of body mass index and liposuction volume. Recursive partitioning was used to determine whether exceeding a threshold in liposuction volume per body mass index unit significantly increased complications.

Results: Sixty-nine of 4534 patients (1.5 percent) meeting inclusion criteria experienced a postoperative complication. Liposuction volume and body mass index were significant independent risk factors for complications. With progressively higher volumes, increasing body mass index reduced risk (OR, 0.99; 95 percent CI, 0.98 to 0.99; p = 0.007). Liposuction volumes in excess of 100 ml per unit of body mass index were an independent predictor of complications (OR, 4.58; 95 percent CI, 2.60 to 8.05; p < 0.001).

Conclusions: Liposuction by board-certified plastic surgeons is safe, with a low risk of life-threatening complications. Traditional liposuction volume thresholds do not accurately convey individualized risk. The authors’ risk assessment model demonstrates that volumes in excess of 100 ml per unit of body mass index confer an increased risk of complications.


Chicago, Ill.; and Allentown, Pa.

From the Division of Plastic and Reconstructive Surgery, Northwestern University, Feinberg School of Medicine; the American Society of Plastic Surgeons; Cosmetic & Reconstructive Specialists of the Lehigh Valley, Lehigh Valley Health Network; and the Division of Plastic Surgery, University of Illinois.

Received for publication January 12, 2015; accepted February 26, 2015.

Disclosure: Dr. Kim receives research funding from and is a consultant for the Musculoskeletal Transplant Foundation. Mr. Hume is employed by and Dr. Murphy is the past president of the American Society of Plastic Surgeons. All other authors have no relevant financial relationships to disclose. This particular research received no external funding.

John Y. S. Kim, M.D., Division of Plastic and Reconstructive Surgery, Northwestern University, Feinberg School of Medicine, 675 North St. Clair Street, Galter Suite 19-250, Chicago, Ill. 60611,

©2015American Society of Plastic Surgeons