Board-certified plastic surgeons perform more than 172,000 liposuction procedures each year. But because the field is open to many doctors, the actual total could be more than double that number. The popularity of liposuction poses a risk to patients. The survey says "liposuction has become trivialized" at a time when "the extent of complications may well be underreported."
The surgery is more complex than it looks. The drugs commonly used by anesthesiologists can cause dangerous "hangovers" that can threaten patients who go home after surgery. Removing too much fat or performing other cosmetic procedures at the same time raises the risk of complications.
The topical anesthetic lidocaine, pumped into the area under the skin where fat accumulates, helps limit pain during the procedure and during the recovery. But when large amounts of fat are removed - some doctors have been known to suction out as much as 20 pounds during a procedure - a larger quantity of lidocaine is used sometimes. In the hours after the procedure when the patient is at home, dangerous levels of lidocaine can accumulate in the bloodstream.
High levels of lidocaine can kill by causing the heart to slow and misfire and the blood pressure to fall. Experienced plastic surgeons say some patients should be kept overnight in a hospital, and they generally avoid removing large amounts of fat in a single procedure.
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