Ann Plast Reconstr Surg | Volume 1, Issue 1 | Case Series | Open Access

Lipoplasty and Lipolysis: Negative Outcomes and Medicolegal Consequences

Michel Costagliola^1*, Bishara Atiyeh², Florence Rampillon³ and Benoit Chaput⁴

¹Plastic, Reconstructive and Aesthetic Surgery, Toulouse University, Toulouse, France
²American University of Beirut Medical Center, Beirut, Lebanon
³Clinique du Parc, 33 rue des Bûchers, Toulouse, France
⁴Plastic and Reconstructive Surgery, Toulouse-Rangueil University Hospital, France

^*Correspondance to: Michel Costagliola 

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Abstract

Liposuction (blunt suction lipectomy) is now a well-established technique which generally yields gratifying aesthetic results. Since it was first described in 1977 by Illouz, changes or improvements to the technique of liposuction have been introduced regarding instruments (cannulas, pumps, syringes, and various devices), depth of suctioning (deep or superficial), volume of fluid infiltration (wet, superwet, tumescent) and osmolarity (isotonic, more or less hypotonic). Many other changes or “innovations” have also been described that needs to be denounced. We report several complications resulting in severe skin necrosis following liposuction and lipolysis methods of questionable scientific merit: ultrasonic liposuction, infiltration of hypo-osmolar solution, lipolysis without aspiration, or, unfortunately, after accidental infiltration of hypertonic saline solution. The ensuing skin necrosis required surgical debridement followed by prolonged secondary wound healing, resulting in severe aesthetic and functional sequelae and the inevitable legal malpractice implications. It is essential that plastic surgeons be careful about using techniques widely advertised by the media but not yet scientifically validated. Basic precautionary principles must be respected (light hypo-osmolar infiltration about 200 mOsm is safe). Surgeons should not be dispensed from applying rigorous monitoring and strict safety measures in the operating room (check-list, traceability, qualification of nursing staff, etc.).

Citation:

Costagliola M, Atiyeh B, Rampillon F, Chaput B. Lipoplasty and Lipolysis: Negative Outcomes and Medicolegal Consequences. Ann Plast Reconstr Surg. 2017;1(1):1003.