Liposuction is big business: A recent study found that it was 2016’s second most popular type of plastic surgery in the United States (after breast augmentation), with an average cost per procedure of $3,200. Overall, about 235,000 fat-sucking operations were performed last year.
And while the procedure is generally safe, a new article in BMJ Case Reports highlights a complication that nearly cost one 45-year-old woman her life. The paper details doctors’ experience diagnosing and treating a patient who developed a rare but serious condition called fat embolization syndrome shortly after a routine nip and tuck.
Fat embolization occurs when globules of fat break free from surrounding tissue and travel through the body, becoming lodged in blood vessels or the lungs and blocking the flow of blood or oxygen. It’s common after bone fractures or major trauma, but it has also been documented—at least two other times in medical literature—after liposuction.
Unfortunately, the doctors wrote in their report, the condition is “notoriously difficult to diagnose,” and many plastic surgeons don’t know that they should be on the lookout for symptoms.
In their paper, the doctors recall the case of an obese British woman who had undergone lower leg and knee liposuction two days earlier at a local hospital. “The surgery had been planned to remove some of the bulk of her lower legs to help her mobilize and subsequently begin the weight loss process,” they wrote.
The procedure itself was uneventful, and about 10 liters of fat were removed from the woman’s lower body. About 36 hours after the operation, however, the woman became drowsy and confused, and doctors noticed her heart rate was unusually high.
The woman’s condition worsened, and she was transferred to the intensive care unit, where doctors determined she had dangerously low oxygen levels in her body. After further tests, doctors realized that her symptoms were caused by fat embolization.
Once a diagnosis was made, the woman was treated with oxygen and drugs to help restore her oxygen levels, heart rate, and breathing to normal. She recovered fully and was released from the hospital after two weeks. But if not for her doctors’ quick thinking, things could have been much worse.
Fat embolization is not only hard to recognize, say the report’s authors, but there is no standardized set of criteria to help physicians make an official diagnosis. Although liposuction is not usually considered a high-risk procedure, people who are morbidly obese, who have fluid retention, or who have large volumes of fat removed are more likely to suffer from complications, they say.
Anyone considering liposuction or any other type of cosmetic surgery should talk with their doctor about the potential benefits and risks; it’s also important to interview surgeons carefully and choose one who’s certified by the American Board of Plastic Surgery. Make sure he or she operates in an accredited hospital or medical facility. Don’t fall for non-licensed “pros” who tout cosmetic surgery on social media.
If you do choose to go under the knife, following your surgeon’s post-op instructions can help reduce your risk of dangerous complications. But as with any medical procedure, always speak up if something doesn’t feel right.