Complications from laser lipo when not performed by plastic surgeons
| October 03, 2013
I’m pleased to announce that our paper on complications associated with laser lipo when performed by nonplastic surgeons has been released. It’s being published in the October issue of Aesthetic Plastic Surgery Journal. If you’re interested in reading the abstract, you can click here.
But if you don’t want to purchase the whole article — or if you don't want to read the full article — you can read my synopsis below:
Liposuction is a technique where a long metal tube (the cannula) is connected to suction and removes fat from stubborn areas in the neck, arms, abdomen or hips.
Traditional liposuction requires two steps: 1) a fluid consisting of epinephrine is injected into the fatty tissues first, which constricts blood vessels such that when you actually perform 2) liposuction, there’s minimal blood loss.
Laser liposuction requires three steps: 1) injection of the epinephrine-containing fluid, 2) followed by melting of the fat using the laser and finally 3) sucking out the fat.
The laser is powerful and requires training to avoid burning of the skin and extensive scarring. The problem is that most doctors using laser lipo are typically the least trained in liposuction techniques because they aren’t plastic surgeons.
Often times, the doctors who are doing laser lipo in their office — away from the oversight of health regulations found in hospitals, surgery centers or other accredited operating rooms — are not trained in cosmetic plastic surgery. They could be ER doctors or orthopedic surgeons.
They may call themselves cosmetic surgeons but anyone can call themselves that and almost anyone can join the American Academy of Cosmetic Surgeons — a group that has minimal admission requirements.
This paper I co-wrote with Drs. Blum and Sasser discusses the complications that arise when inappropriately trained doctors are left to work with a powerful machine that can cause collagen to overly contract, producing a wrinkled appearance, and can also cause third-degree burns.
Most of these complications arose because these doctors were unable to perform the procedure that would most appropriately address the patient’s concerns, so they just treated them with laser lipo even though that wasn't necessarily the best technique.
This brings to mind the quote, “When all you have is a hammer, the whole world is a nail!” The other big problem with these types of complications when caused by nonplastic surgeons is that these doctors are provided minimal training in how to do the procedure and no training in how to take care of complications.
Rather than continuing on my soap box, below are some pictures from our paper. As you know, pictures are worth a thousand words:
Before and after laser lipo to the neck as performed by an orthopedic surgeon. The wrinkles to the neck are due to the laser heat contraction of collagen in the neck skin. The problem is that this patient didn't have any fat to remove — he needed a necklift (removal of skin) but an orthopedic surgeon isn't trained to do a necklift. And apparently this orthopedic surgeon doesn't know how to do laser lipo either.
Before and after laser lipo by the same orthopedic surgeon. This person had no fat, so laser lipo wasn't the appropriate technique. At the most, maybe this patient needed muscle tightening of the abdomen but since the doctor didn't know how to do the right procedure, he did the only procedure he could offer. Yes, those are third-degree burns of the abdomen from the inside-out.
Before and after photos of the abdomen after laser lipo as performed by an ER doctor. I’m not sure what was wrong with her abdomen in the first place, but after laser lipo she now has divots and other contour deformities to the abdomen.
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