Major New Survey Reports Turnaround in Lipoplasty Safety
New York, NY (May 3, 2001) —The safety of lipoplasty (liposuction) has increased dramatically since 1998, according to results of a major new survey in the current issue of Aesthetic Surgery Journal (ASJ), the peer-reviewed journal of the American Society for Aesthetic Plastic Surgery (ASAPS). The report covers more than 94,000 lipoplasty procedures performed from September 1998 through August 2000. Based on these results, the estimated risk of death from lipoplasty performed as an isolated procedure (not in combination with any other surgeries) is 1 per 47,415 procedures.
"The goal of any surgical procedure is absolute safety," says Charles E. Hughes, MD, of Indianapolis, IN, who authored the journal article and released the survey results today at a New York press briefing. "Realistically, every surgery carries some risk. Estimated risks as low as 1 in 47,000 translates to a remarkable safety record and means that patients can have a sense of security about elective cosmetic surgery."
Last September, a four-page survey was sent to 1432 board-certified plastic surgeons who are members of the American Society for Aesthetic Plastic Surgery (ASAPS). ASAPS members reported on a total of 94,159 lipoplasty procedures performed during the 24-month study period. The survey was underwritten by ASAPS, with all data sent directly from survey respondents to an independent research organization, Industry Insights in Columbus, OH, for tabulation. An independent statistician at New York University further analyzed data for accuracy.
Earlier studies had examined procedures performed prior to mid-1998 and had suggested mortality rates as high as 1 in 5,000. "ASAPS wanted to know if the educational efforts we have conducted over the past two years to alert plastic surgeons to lipoplasty risk factors had, in fact, produced any effect on the procedure’s safety record," says ASAPS President Daniel C. Morello, MD. "The survey shows that, on the basis of safety guidelines that we helped develop, plastic surgeons have taken a more conservative approach to performing lipoplasty since mid-1998. Nearly one third of the responding plastic surgeons had modified their lipoplasty practice within the 24 months of the survey period. Of those indicating they had made changes, the most frequent modification was that they were less likely to perform lipoplasty in combination with certain other procedures. Almost as common, however, were stricter patient selection criteria, limiting the length of surgery, and removing a smaller volume of fat."
"Only 5% of the patients in this study underwent ‘large-volume’ lipoplasty," says Dr. Hughes.
In all, 66% of the procedures were lipoplasty only; 20% were lipoplasty combined with other surgical procedures excluding abdominoplasty ("tummy tuck"); and 14% involved lipoplasty in combination with abdominoplasty, with or without any other procedures.
"Our study shows that when lipoplasty is combined with other procedures, the risk is significantly higher," says Dr. Hughes. "We need additional studies to find out why this is true. For example, it might be the particular procedures that are combined or some other factor, such as longer operating time." Dr. Hughes says the survey suggests that the combination of lipoplasty and abdominoplasty presents the highest risk.
"There are things that we, as surgeons, can do to minimize some of these risks. For example, intermittent compression of the legs, the use of certain drugs, and getting patients up and walking as soon as possible after surgery all have been shown to reduce the incidence of deep vein thrombosis or pulmonary embolism – life-threatening conditions that can occur after any type of surgery," says Dr. Hughes.
While the current study does not answer every question about lipoplasty safety -- particularly how additional preventive measures might impact the risks of lipoplasty combined with other procedures -- it nevertheless shows that significant progress has been made in making lipoplasty a safe operation. "These results make a strong case for lipoplasty safety when the operation is performed by a qualified, American Board of Plastic Surgery certified physician according to established guidelines," says Dr. Hughes.
The survey also showed that 61% of all cosmetic procedures performed by ASAPS members during the study period took place in office-based surgical facilities. The majority of these facilities were state-licensed, Medicare-certified or accredited by a national or state-recognized accrediting organization. Complications from surgeries in office-based facilities were no more common than for surgeries performed in accredited hospitals.
Currently, in most states, any licensed doctor – even one without formal surgical training -- can perform lipoplasty and other surgeries without oversight in an unaccredited office. Many states, however, are considering the establishment of office surgery guidelines including required accreditation of surgical facilities and tougher standards for surgeon credentials. "In the foreseeable future, office facility accreditation may well be the key factor in limiting certain surgeries to those physicians who are legitimately trained to perform them," says Dr. Morello.
The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world's leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body. ASAPS is comprised of over 2,600 Plastic Surgeons; Active Members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and nonsurgical aesthetic procedures. International Active Members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.
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