[Safety of tumescent liposuction]

Liposuction surgery is increasing in frequency and is the most commonly performed cosmetic procedure to date. Regularly, complications and fatalities are reported by tabloids. The anaesthesiogical techniques used, however, are usually not reported. Tumescent liposuction has to be clearly separated from liposuction with intravenous sedation or under general anaesthesia. In tumescent liposuction, tumescent fluid containing saline, lidocaine and adrenaline is injected into the undesired fat deposits and the pain is controlled locally. In contrast, when liposuctions are performed either with intravenous sedation or under general anaesthesia, the patient is unconscious. In this study, the different anaesthesiological techniques currently used for liposuction were compared with each other. Reported fatalities were reviewed and it was determined, whether liposuction was performed as tumescent liposuction or if systemic sedation was used. To date, no fatalities were reported when tumescent liposuction was performed and a total of 396 457 liposuctions (including own unpublished data) was counted. Fatalities, however, were reported, when either intravenous sedation or general anaesthesia was performed, and a mortality rate of 2.6-19.1 per 100000 cases was counted. Liposuctions should therefore, whenever possible be performed as tumescent liposuction. Intravenous sedation or general anaesthesia should be more carefully considered.