With an increasing number of people going in for liposuction or lipoplasty, improving patient safety is a priority for plastic surgeons. Modern plastic surgery technology is specifically designed to improve patient safety. In the effort to ensure safety of the patients undergoing this fat removal procedure in hospital and ambulatory surgery settings, the Patient Safety Committee of the American Society of Plastic Surgeons (ASPS) has developed a liposuction practice advisory to support physicians. This cannula manufacturer advisory describes a range of generally acceptable approaches to diagnosis, management, or prevention of specific diseases and conditions. The advisory also anticipates the necessity to approach needs of some patients in a different way.
Practice Advisory Recommendations for Liposuction Procedures
Liposuction techniques: There are various liposuction techniques that a physician can choose from such as ultrasound assisted procedure, laser-assisted surgery and dry techniques. A single lipolysis technique will not work for all patients as they may most likely have different issues. Plastic surgeons should consider all factors such as patient’s overall health, estimated amount of fat to be removed and the number of sites to be addressed to determine the right technique for each patient. According to clinical studies, performing liposuction while the patient is awake may compromise patient safety.
Types of cannulas: The plastic surgeon extracts excess fat using a cannula, a small stainless steel tube which is inserted into the skin. There are different types of cannulas such as suction-assisted, power-assisted, or ultrasound-assisted. In power-assisted lipolysis, the cannulas used are small, flexible, and similar in length and diameter to standard suction-assisted liposuction cannulas. Depending on the technique chosen and the volume of fat to be removed, the surgeon should determine the cannula best suited for a specific patient.
Anesthesia: Various anesthesia or anesthesia combinations are used for liposuction. Anesthetics may be administered by a qualified physician. A certified registered nurse anesthetist or another qualified health care provider can also administer anesthesia under physician supervision. The responsible physician has to be physically present in the operating room throughout the conduct of the anesthetic. General anesthesia can be safely used in the ambulatory setting and is especially useful for complex procedures as it allows precise dosing, controlled patient movement and airway management. For small volume liposuction, infiltrate solutions containing local anesthetic agents are fine to provide adequate pain relief.
Patient selection: Not all patients are ideal liposuction candidates. The surgeon should perform a thorough physical examination and evaluate the complete preoperative history of the patient to determine candidature. It is also important to ensure that the patient has realistic expectations.