At what volume does liposuction become unsafe?
According to a new study, there is no concrete data to help physicians answer that question. Instead, they rely on their own estimates, professional-organization advisories and institutional or government-imposed restrictions. With this in mind, the authors set out on what they say is the first attempt to quantify the comprehensive risk associated with varying liposuction volumes and subsequent interaction with body mass index (BMI).
Researchers from Northwestern University’s Feinberg School of Medicine, the University of Illinois’ Division of Plastic Surgery, and the Lehigh Valley (Pa.) Health Network identified suction-assisted lipectomies from the Tracking Operations and Outcomes for Plastic Surgeons database. Multivariate regression models showing the interaction between liposuction volume and BMI were used to assess the influence of liposuction volume on complications and to develop a tool that generates a single adjusted odds ratio for any combination of BMI and liposuction volume. Recursive partitioning was used to determine whether exceeding a threshold in liposuction volume per BMI unit significantly increased complications.
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The study found that 1.5% (69 of 4,534) of the patients who met inclusion criteria experienced a post-operative complication. Liposuction volume and BMI were significant independent risk factors for complications. With progressively higher volumes, a higher BMI reduced risk. Liposuction volumes in excess of 100 mL per BMI unit were an independent predictor of complications.
“The most important finding [of our study] is that liposuction in the hands of properly trained surgeons is an exceedingly safe procedure with low morbidity,” study co-author John Y. S. Kim, M.D., of the Feinberg School of Medicine, tells Cosmetic Surgery Times. “BMI plays a role in outcomes of liposuction volumes, and higher-BMI patients may be able to tolerate more liposuction than lower-BMI patients.”
Dr. Kim says that given the limits and guidelines imposed by some states’ regulatory agencies, “studies like this may help provide a more evidence-based approach to considering or re-considering liposuction volumes.”
The study appears in the September issue of Plastic and Reconstructive Surgery.