The Body
Contour irregularities
This is a common complication. That is why all our patients who have undergone liposuction are placed in a standing position at the end of the procedure to see if any corrections are necessary.
Even with thousands of liposuction procedures under my belt, I always say:
“The contour of a lying body does not show the contour defects of a standing body.”
When we use sedation or general anaesthesia, we wake the patients up, wait about 30 to 45 minutes for them to be fully awake, and then stand them up for a check-up.
When we perform liposuction under local anaesthesia, we immediately place the patient in a standing position at the end of the procedure.
I am not aware of any other clinics in the world that automatically do this after general anaesthesia. It is our signature procedure at the Bellefontaine Clinic. This is done solely to minimise the risk of post-operative irregularities.
However, there is another irregularity that we cannot control: post-operative subcutaneous scarring, as you will read about below. Some patients scar more intensely under the skin in certain areas than others, which is why they may have other irregularities in those areas.
These changes may be permanent. Things usually improve with time. In some cases, touch-ups are necessary. For this, you must wait at least 6 months after the procedure.
We perform fewer than 10 touch-ups per year at the Bellefontaine Clinic (out of approximately 300 to 400 liposuctions performed per year).
Skin wrinkling
In cases of pregnancy, rapid weight gain or loss before the procedure, and of course with the effects of ageing, the skin may already be damaged by stretch marks or sagging.
I always tell my patients that they should imagine liposuction as deflating a ball: the air in the ball is the fat and the circumference of the ball is the skin. Automatically, the skin will have less tension and may therefore begin to wrinkle.
Certain areas are more at risk, such as the inner thighs and stomach (which is why I never remove all the fat from these areas).
This is a complication that I have encountered before, but in high-risk areas, I warn my patients of this risk before the procedure. To combat wrinkling, Renuvion treatment can be performed during the procedure, and in extreme cases, a lift of the area.
It is quite rare, but it can happen.
Fluid accumulation (seroma)
This is a moderately common complication that mainly occurs in the abdomen.
To avoid this, it is essential to follow our post-operative protocol to the letter and, above all, to take it easy for the first two weeks and wear the compression garment day and night for three weeks (except when showering).
It is very important to take it easy for the first two weeks and avoid standing for too long, especially if liposuction has been performed on the abdomen.
In general, we allow standing for 3 hours a day during the first week and a little longer during the second week.
Despite this, temporary pockets of fluid, called seromas, can sometimes form under the skin.
Seromas develop because fluid naturally accumulates in the empty spaces created by the removal of fat, almost always in the abdomen.
- If they are very small, no action is taken: they resolve on their own.
- If they are a little larger, they may need to be drained with a needle.
- If they are larger, they can cause significant subcutaneous scarring as they resolve and lead to deformities that are often difficult to correct.
Currently, we only have about 1 to 2% of small seromas at the Bellefontaine Clinic, as I am very strict on this subject.
Changes in skin sensitivity after liposuction
This is a common complication, which hardly deserves the term as it is so common and reversible.
After the procedure, it is normal to feel numbness in the treated areas. These sensations may feel strange, but they are not usually painful and fade over time.
Depending on the area, it takes between 3 to 6 months to recover, and I have never had a patient tell me that this discomfort persisted beyond that time frame.
This is because the nerve endings, or small nerves under the skin, can be damaged during fat removal.
As the body heals, these small nerve endings gradually grow back and recover.
The LPG Endermologie treatment we offer at the Bellefontaine Clinic aids this recovery process.
Induration under the skin
From the second week after liposuction, the vast majority of my patients experience hardening under the skin. This mainly occurs in the love handles, stomach, back and arms, and very rarely in the thighs.
To combat this, we use LPG Endermologie from the second week onwards. These indurations can sometimes last up to 6 months.
In cases where there has been seroma (small or large), the induration may remain for life!
This is why it is important to follow our post-operative protocol carefully.
Swelling and bruising
Swelling and bruising after liposuction are almost inevitable. This cannot really be considered a complication. It is a normal reaction of the body to surgery.
Some areas are more prone to post-operative swelling, such as the thighs and stomach, while others are less prone, such as the love handles.
To remedy this, patients must wear compression garments, undergo lymphatic drainage sessions (we use LPG Endermologie at the Bellefontaine Clinic), elevate the area if possible, and follow the post-operative instructions to the letter.
If the bruising is really severe, I prescribe a heparin-based cream to help it fade more quickly.
We also recommend Arnica in granule or cream form.
Risks of infection
Skin infections are very rare, but possible. The risk is low because a large amount of the tumescent solution containing the local anaesthetic used is released after the procedure through the small scars, thus reducing the risk of bacteria entering the body.
Patients may notice redness, warmth, tenderness or discharge at the incision sites.
If the patient has a fever, the infection is already well advanced. Even in sterile environments, the body is temporarily more vulnerable during healing.
Prompt treatment with antibiotics can cure infections before they become serious.
I have only had one infection from my liposuction procedures, which was successfully treated with prolonged antibiotics.
Bleeding
One of my colleagues, who is very well known for BBL in southern Spain, told me that he transfuses about 1-2% of his patients!
Here too, I am fortunate: I have never had to transfuse any of my patients. Sometimes, some patients bleed a little more than average during liposuction. In these cases, we use an adrenaline-based solution to reduce the bleeding.
If, postoperatively, we see that they are bleeding a little more than usual, we apply pressure bandages, and so far this has stopped all types of bleeding.
Nerve damage
Nerve damage can occur when surgical instruments pass close to delicate nerve pathways during fat removal.
Cette perturbation peut affecter temporairement la communication entre les nerfs, entraînant des changements dans les sensations.
This disruption can temporarily affect communication between nerves, leading to changes in sensation.
I have never experienced any long-term (more than 6 months) changes in sensitivity or motor function.
Fat embolism
Fragments of fat can break off and lodge in a blood vessel, then travel to the lungs or brain.
Patients may experience sudden shortness of breath and/or chest pain.
This is extremely rare and, fortunately, has never happened to me, either during liposuction or lipofilling.
Internal perforation
If the cannula used during the procedure penetrates too deeply, it can perforate an internal organ.
This may require emergency surgery to repair the organ.
I saw two colleagues perforate intestinal hernias during liposuction while I was training to be a plastic surgeon.
This is why I always request an ultrasound scan of the abdominal wall to check for hernias before the procedure.
Fortunately, I have never encountered this complication myself.
Third sector
When large volumes of fat are removed during liposuction, fluid can shift in the areas that have been operated on: this is called a third sector.
This can then cause electrolyte imbalances in the blood (sodium, potassium, etc.).
This can lead to potentially fatal kidney, heart and lung problems.
This is why I stop liposuction after 5 or a maximum of 6 litres of fat.
When more is removed, it is called mega-liposuction, and patients generally need to be monitored in intensive care after this type of procedure.
There are no such centres in Switzerland.
I have never encountered this complication.
Lidocaine toxicity
Lidocaine is a drug used in the tumescent solution that is used for all liposuction procedures. It helps to relieve pain.
Although lidocaine is safe, toxicity can occur if too much is used.
Klein, a Californian dermatologist, invented the concept of the tumescent solution, in which lidocaine is diluted.
It is currently known that up to 35 mg/kg of lidocaine can be used if diluted in one litre of 0.9% NaCl solution.
This limit must be respected, and then there is no problem.
I have never experienced this complication: Klein’s solution is a very safe solution.
Simply adhere to the maximum dosage according to the patient’s weight and do not exceed it.
Skin necrosis
Although it has been described, I have never seen it in a colleague or in my liposuction cases.
I imagine that this complication occurs mainly when liposuction is performed too aggressively on the same area.
If it were to occur, unfortunately, the correction would involve additional scarring or even skin grafts.
🩺 In summary
In conclusion, I hope you have found this article on the dangers of liposuction useful and informative. As you can see, I have been completely transparent in sharing my conclusions on each type of possible complication, as well as their actual frequency where relevant. You will see that these cases remain extremely rare, representing very low statistics out of more than 4,000 liposuction procedures performed by me.
In other words, despite the exhaustive list of possible complications, truly serious situations remain exceptionally rare. Liposuction remains a very safe procedure, provided it is performed by experienced professionals who perform it regularly.
Even though liposuction is a common and well-established procedure, it remains a surgical procedure with rare serious risks.
The surgeon’s experience, rigorous post-operative follow-up and compliance with protocols can significantly reduce these risks.
At the Bellefontaine Clinic, we do everything possible to ensure your safety, the quality of the results and the well-being of our patients.
