ABSTRACT
Liposuction was first introduced as a fat-removal procedure in 1979 and since then has evolved dramatically, resulting in better outcomes and fewer complications. In the early days of liposuction, general anesthesia as well as aggressive fluid and blood loss replacement were often necessary and patients undergoing liposuction faced the risks of a major surgical procedure. Tumescent liposuction, which is today’s standard of care, is performed on an ambulatory basis and requires neither heavy surgical anesthesia nor volume replacement. Tumescent liposuction is performed by definition under local anesthesia, specifically excluding additional anesthesia medications at dosages that may impair the protective airway reflexes and respiratory drive. Expected and common complications of liposuction such as bruising, edema, and contour irregularities are for the most part self-resolving or easily treatable. No significant morbidity or mortality has been reported in association
with tumescent liposuction alone under local anesthesia with or without oral sedation. Cases of severe complications and deaths have only been described when liposuction was performed under general anesthesia, conscious sedation or with concomitant additional procedures such as surgical lipectomy. These isolated events have led to the development of conservative guidelines of care and recommendations by the different medical specialties involved in liposuction. Tumescent liposuction is considered as a safe and effective procedure when performed in medically fit patients by qualified physicians. In this chapter the common sequelae as well as the uncommon and rare complications of tumescent liposuction are discussed (Table 1).
