Liposuction Risks and Complications: Data-Informed Consent

Liposuction is the most common cosmetic surgery in the U.S. (~300,000/yr). While generally safe, complications occur.

Complication Rates (Large Series & Meta-Analyses)

• Overall: 3–5% (minor: seroma, contour irregularity, paresthesia); major: 0.5–1.5%.
• Mortality: 1:5,000–1:10,000 (pulmonary embolism, fat embolism, lidocaine toxicity, sepsis).

Common Complications

Complication	Incidence	Management
Seroma	3–10%	Compression, aspiration, sclerotherapy
Contour irregularity	5–20%	Massage, revision lipo, fat grafting
Paresthesia	10–30% (transient)	Observation, gabapentin if persistent
Skin necrosis	<1%	Wound care, debridement, grafting
DVT/PE	0.1–0.5%	Prophylaxis: compression, early ambulation, chemoprophylaxis (high risk)
Lidocaine toxicity	Rare	Limit dose ≤35 mg/kg (tumescent); monitor CNS/CVS

Risk Amplifiers

• Large volume (>5 L aspirate), multiple areas, BMI >30, combined procedures, inexperienced surgeon, poor candidacy (poor skin elasticity, visceral obesity).

Mitigation

Board-certified plastic surgeon, accredited facility, tumescent technique, staged large-volume cases, VTE prophylaxis, preoperative optimization.