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Evidence-Based Medicine: Liposuction

Chia, Christopher T. M.D.; Neinstein, Ryan M. M.D.; Theodorou, Spero J. M.D.

Plastic and Reconstructive Surgery: January 2017 - Volume 139 - Issue 1 - p 267e-274e
doi: 10.1097/PRS.0000000000002859

Learning Objectives: After studying this article, the participant should be able to: 1. Review the appropriate indications and techniques for suction-assisted lipectomy body contouring surgery. 2. Accurately calculate the patient limits of lidocaine for safe dosing during the tumescent infiltration phase of liposuction. 3. Determine preoperatively possible “red flags” or symptoms and signs in the patient history and physical examination that may indicate a heightened risk profile for a liposuction procedure. 4. Provide an introduction to adjunctive techniques to liposuction such as energy-assisted liposuction and to determine whether or not the reader may decide to add them to his or her practice.

Summary: With increased focus on one’s aesthetic appearance, liposuction has become the most popular cosmetic procedure in the world since its introduction in the 1980s. As it has become more refined with experience, safety, patient selection, preoperative assessment, fluid management, proper technique, and overall care of the patient have been emphasized and improved. For the present article, a systematic review of the relevant literature regarding patient workup, tumescent fluid techniques, medication overview, and operative technique was conducted with a practical approach that the reader will possibly find clinically applicable. Recent trends regarding energy-assisted liposuction and body contouring local anesthesia use are addressed. Deep venous thromboembolism prophylaxis is mentioned, as are other common and less common possible complications. The article provides a literature-supported overview on liposuction techniques with an emphasis on preoperative assessment, medicines used, operative technique, and outcomes.

New York, N.Y.

From the Manhattan Eye, Ear & Throat Hospital.

Received for publication August 20, 2015; accepted April 15, 2016.

Disclosure:Dr. Chia and Dr. Theodorou are consultants for InMode Corporation. Dr. Neinstein has no financial disclosures.

Christopher T. Chia, M.D., 128 Central Park South, New York, N.Y. 10019,

Copyright © 2016 by the American Society of Plastic Surgeons