If you’re planning a liposuction procedure, it’s important to know what to expect after the procedure, including the signs of infection after liposuction. In this guide, we review the signs of infection including cellulitis infection after liposuction and necrosis after lipo symptoms.
In this guide, we review the Signs Of Infection After Liposuction, cellulitis infection after liposuction, necrosis after lipo symptoms, and belly button infection after liposuction.
Signs Of Infection After Liposuction
Plastic surgery comes with different risks, and among them is the risk of infection. Infection is due to the presence and multiplication of bacteria. There are a few ways on how the bacteria is introduced to the site, including exposure to unclean hands during handling of the incision, moist incision site, and unsterile tools or operating room during surgery.
There are few signs of infection that patients should watch out for. These would include fever, swelling, pain, redness, warmth on the incision site, the presence of discharge, and a foul odor coming from the wound. In order to treat the infection, antibiotics can be administered orally or intravenously.
Infection can be fatal, and it would be best not to get it in the first place. There are a few ways on how to lessen the risk of developing an infection, such as following the surgeon’s post-operative instructions, attending follow-up check-ups, proper handling and cleaning of the incision site, and providing adequate rest and nutrition to the body.
Infection after plastic surgery
Going through a plastic surgery can cause positive changes in the body of the patient. This is one of the main reasons why patients go through surgery even if it involves risks. Infection is one of the most dangerous and most common risks that come with any plastic surgery.
Infection is caused by bacteria that thrives and multiplies in the body. It gains access to the internal part of the body because of the incision that was made. Infections can be severe enough to cause the death of the patient. This is why it should be diagnosed and treated as early as possible.
Causes of infection after plastic surgery
Due to the incision, the body is more at risk for bacteria that can cause an infection. The main site where the infection usually takes place is the incision site. It is where there is a break in the skin. This break prevents the natural barrier that protects the internal part of the body from the environment to do its job.
An infection can develop after the surgery due to a variety of conditions. One of them is when the patient’s hand is not clean when it touches or handles the incision site. An unclean or unsterile hand can introduce bacteria to the incisions. It is very important to make sure to clean the hands when handling the incision or changing the dressing. It is also not advised to touch the incision site when you don’t really have to.
Bacteria on the skin near the site of the incision can also be a cause of infection. This is why it is important to clean the incision site properly. The incision sites should also be kept dry because a moist incision site will only be beneficial to the multiplying bacteria.
It is also possible that the bacteria that caused the infection got access to the body during the surgery. The tools used during the surgery as well as the operating room itself must be sterile. If not, there is likely to be an infection even if the patient cleanses the incision site well after the surgery.
Lots of infections may occur due to poor practices of those who perform the surgery. These are the ones that may offer plastic surgery at a very low cost. The problem with these kinds of plastic surgery is the increased risk of infection after the surgery. There is also no post-surgery follow-up appointments, which is why patients unknowingly develop an infection without being immediately treated.
There are patients who die due to infection because the infection is not immediately treated. The infection may have already reached the blood and spread throughout the body. This kind of infection could lead to death, which is why patients need to see their doctor even after surgery to assess whether they are recovering properly or not.
Signs of infection after plastic surgery
There are a few signs and symptoms of having an infection after plastic surgery. Patients need to be mindful of their bodies so they can easily spot if they already have an infection or not.
One of the most common signs of having an infection is pain. Although pain is normally felt after the surgery, pain that doesn’t get better or becomes worse as the patient recovers may be a sign of infection. There can also be swelling, redness, and warmth on the site of the infection.
A discharge from the incision site can also be observed. This discharge is different from the discharge that comes from a seroma. The discharge found on the site of infection can be a yellowish or greenish color.
The infected incision site can also have a foul odor. This is due to the bacteria present. The foul odor may also be due to the necrotic tissue that develops as a result of the infection.
Fever is also a very common sign of infection. The body is reacting to the bacteria present and it is trying to kill it by increasing the body temperature. This is why patients who have an infection develop a fever.
Treatment of infection
In order to treat the infection, antibiotics will be prescribed by the surgeon. Usually, surgeons will prescribe antibiotics that would be taken starting the day of the surgery. The antibiotics should be taken at regular intervals and should be completely consumed.
When antibiotics are not completely taken in, it is highly possible for the patient to become infected again. With the reinfection, a stronger kind of antibiotic may be needed to heal completely.
Antibiotics can be taken in orally at regular intervals, or they can also be administered intravenously. Most infections can be treated with oral antibiotics, but when a patient’s case is severe, intravenous antibiotics may be used. It is also possible for the patient to be admitted to the hospital to monitor their condition.
Reducing risk of infection
Infection can cause death. This is why it is better to avoid getting an infection in the first place than trying to treat it when it is already too late. Infection is a risk with any kind of plastic surgery, but there are a few ways on how to reduce that risk, such as:
– Surgeon’s post-operative instructions should be followed: Surgeons have their own set of instructions as to what to do after surgery. All of these should be followed because they are the ones who operated on you and they know what is best. It is especially important to follow the surgeon’s instructions regarding antibiotics. The antibiotics are usually given during recovery whether you have an infection or not. It is a precaution because surgeons want to make sure about the patient’s safety.
– Follow-up appointments should be attended: Surgeons will schedule follow-up check-ups for their patients in order to assess how the incision is healing. They also assess whether the patient is developing an infection or any other complication through the follow-up check-ups. Patients shouldn’t skip these even if they don’t feel anything strange because it is a good precautionary measure to take.
– Make sure the incision is clean and change the dressings as recommended: The incision site should always be kept clean and dry. The surgeons will provide instructions as to how and how often patients should change the dressing and bandages. These should all be followed. Patients should also make sure their hands are clean when they handle their incision.
– Rest and provide adequate nutrition to the body: The body can fight off bacteria and prevent it from multiplying at a very fast rate when you provide it with what it needs. The body doesn’t only need nutritious foods and water but also adequate rest or sleep. It is during sleep that the cells recover fast. The faster the incision closes, the less time the body is easily exposed to bacteria.
cellulitis infection after liposuction
Liposuction has become one of the most popular cosmetic surgeries in China. However, few studies have discussed infectious shock caused by C. perfringens as one of the causes of death after liposuction.
Case presentation
A 24-year-old woman was brought to the emergency department (ED) of Guangzhou Chinese Overseas Hospital for treatment. The patient had undergone liposuction in her bilateral lower limbs two days prior. At the ED, the patient was unconscious, and had bilateral equal-sized (diameter, 6 mm) round pupils, no light reflex, a blood pressure (BP) of 71/33 mmHg, a heart rate of 133 bpm, and an SpO2 of 70%. She had bilateral limb swelling, extensive ecchymoses in her lower abdomen and bilateral thighs, local crepitus, blisters, weak pulses on her femoral artery and dorsalis pedis, high skin tension, and hemoglobin of 32 g/L. The patient was diagnosed with Clostridium perfringens infection, and she underwent debridement surgery and supportive treatment. But the patient’s BP could not improve. At 8:28 pm on the day of admission, the patient was declared clinically dead after the electrocardiograph showed a horizontal line and spontaneous respiration ceased.
Conclusions
Failure to meet surgical disinfection and environmental standards may be the cause of infection of C. perfringens through wounds. Therefore, it is necessary to strengthen the environmental disinfection of the operating room, and standardize the sterile conditions of the operation staff and patients before and during operation. Liposuction surgery necrotizing fasciitis is a rare but fatal complications, especially if diagnosis delay, therefore it is critical for early diagnosis and treatment of gas gangrene.
Background
Liposuction is defined as the removal of localized subcutaneous fat deposits by suction and curettage or blunt cannulation for the cosmetic correction of obesity or other esthetic contour defects . In China, liposuction can be performed in a hospital, a surgeon’s office, or a private cosmetic clinic. It is one of the most popular cosmetic surgical operations currently known worldwide . However, with the increasing prevalence of liposuction, the occurrence of its complication is also increasing, such as postoperative infection, thromboembolic disease, skin irregularity, fat embolism, pulmonary edema, lidocaine intoxication, and intraabdominal visceral lesion, among others . Although liposuction is a low-risk office-based procedure, there is still a life-threatening risk if infected. Therefore, analyzing different cases of liposuction can provide plastic surgeons with more information and experience about rescue plans performed after certain complications, helping them in their clinical practice.
Infection after liposuction is rare at less than 1% . Some severe infections after liposuction can manifest as toxic shock syndrome, necrotizing fasciitis, cellulitis, staphylococcal abscess, and rapidly growing atypical mycobacteria; gas gangrene is relatively rare .
Several studies have reported infection after liposuction in the past, but only a few of these cases involved gas gangrene or infectious shock as one of the causes of death. The incidence of postoperative infection after liposuction is relatively low following standard and clean procedures, but postoperative infection is usually caused by Staphylococcus aureus, Streptococcus group A, and Streptococcus pyogenes. However, here we discuss a mortality from postoperative gas gangrene caused by C. perfringens contracted after liposuction, outlining the details of the rescue plan performed.
Case presentation
A 24-year-old immunocompetent woman was admitted to the emergency department (ED) in a state of coma. The patient had liposuction done in her bilateral lower limbs two days ago, but the specific procedure done remains unknown. After her operation, the patient went shopping and had some street food. The patient then went home with no complications.
In the evening, the patient had swelling and pain in her right lower limb. She was given analgesic treatment, but it did not have any significant symptomatic relief.
Twelve hours after her operation, the patient visited the local hospital and was given tramadol for analgesia. But she still had no symptomatic relief, reporting persistent bilateral swelling, pain, and a poor spirit.
Sixteen hours after her operation, the patient visited a plastic and reconstructive surgery clinic and was administered analgesic and cooling treatment. At that time, the patient’s body temperature was 39.0 ℃. The patient was found to have scattered ecchymosis on her bilateral lower limbs with blisters.
Twenty-two hours after her operation, the patient visited the ED of Shenzhen Hospital with a body temperature of 37.1 °C, bilateral limb swelling, extensive ecchymoses on her lower abdomen and bilateral thighs, local crepitus, blisters, weak pulses on her femoral artery and dorsalis pedis, and high skin tension. Then patient accepted emergency CT and was started on cefamandole + ornidazole (anti-infective), intramuscular tetanus anti-toxin, fluid replacement, and dopamine to raise her blood pressure.
Twenty-eight hours after her operation, the patient became unconscious with an SpO2 of 87%. She was given an endotracheal intubation with a ventilator to assist her respiration. The patient’s vital signs improved to an SpO2 of 100% and a heart rate (HR) of 139 bpm with regular blood pressure monitoring. For further diagnosis and treatment, the patient’s families contacted an ambulance and the patient was sent to the ED of Guangzhou Overseas Hospital.
Thirty-one hours after her operation, the patient arrived at the ED of Guangzhou Chinese Overseas Hospital. Physical examination revealed unconsciousness, bilateral round pupils of equal size with a diameter of 6 mm, no light reflex disappeared, 71/33 mmHg BP (with dopamine support), a HR of 133 bpm, and an SpO2 of 70% with endotracheal intubation to assist respiration. Doctors in the ER started her on dopamine to maintain blood pressure. She was then admitted to Guangzhou Chinese Overseas Hospital with the following diagnosis: “(1) Finding the cause of lower limb infection accompanied by soft tissue infection; (2) Infectious shock; (3) Postoperative status after bilateral lower limb liposuction.”
Physical examination after admission revealed that she had extensive ecchymoses on her abdomen, waist, buttock, perineum, and bilateral lower limbs with blood blisters (Fig. 1). Bloody exudates were observed in areas with skin damage. Her bilateral lower limbs were highly swollen, especially in the right lower limb, in which the skin tension was high with local crepitus. A weak carotid artery pulse was palpable, but her peripheral artery pulses were unpalpable. Both her pupils were round and of equal size at a diameter of 5.0 mm, but she had no light reflex. She had an HR of 143 bpm with regular rhythm. Muscle tone in her bilateral upper limbs was at level 2, but no limb movements were observed in her bilateral lower limbs. No pathological reflexes were observed.
Laboratory examination
Her blood panel showed High sensitivity C-reactive protein (HsCRP) at 197.23 mg/L, white blood cell (WBC) at 18.18 × 109/L, monocyte percentage (MONO%) at 1.3%, eosinophil percentage (EOS%) at 0.1%, neutrophil (NEU#) at 9.82 × 109/L, lymphocyte (LYM#) at 8.05 × 109/L, red blood cell (RBC) at 2.13 × 1012/L, hemoglobin (HGB) at 37 g/L, hematocrit (HCT) at 11.3%, mean corpuscular volume (MCV) at 53.2 fL, mean corpuscular hemoglobin (MCH) at 17.6 pg, and red blood cell distribution width (RDW-CV) at 33.2%. Her coagulation functions showed an activated partial thromboplastin times (APTTs) of 110.1 s, a prothrombin time (PT) of 45.8 s, an international normalized ratio (INR) of 4.84, a fibrinogen degradation product (FDP) of 43.72 μg/mL, and a d-dimer (DD) of 8600 ng/mL. Finally, her myocardial infarction examination showed a creatine kinase-MB (CK-MB) of 118.0 ng/mL, a high sensitivity troponin-1 (HSTNI) of 0.669 ng/mL, and a brain natriuretic peptide (BNP) of 35,000 pg/mL (Additional file 1).
Rescue process
The patient was unstable, had multiple organ dysfunction (MODS), was in a coma, and had weak spontaneous respiration. Her left pupil diameter was 6.0 mm while the right pupil diameter was 5.0 mm. The patient was intubated and was persistently hooked to a ventilator. She patient had circulatory failure and was therefore given high-dose noradrenaline (54 mg), high doses of intravenous blood products (RBC 11U, plasma 3000 mL, albumin 200 mL, and fibrinogen 2 g), volume expanders, and fluid replacement to rescue her symptoms. However, her BP still fluctuated greatly with the patient reaching critical condition.
At 2:00 pm on the day of admission, the patient underwent debridement surgery and vacuum drainage in the Orthopedics Department. During the operation, doctors found a large amount of subcutaneous, red, and foul-smelling effusion, which was sent for bacterial culture. Necrotic and devitalized fat tissues were removed. The infection was mostly located outside the muscle (Fig. 2). However, the patient’s BP still could not be lifted even after giving her multiple vasopressors in large doses.
At 6:40 pm on the day of admission, her BP dropped to 58/20 mmHg, HR dropped to 86 bpm, her left pupil diameter remained at 6.0 mm, and her right pupil diameter increased to 5.5 mm. She still had no light reflex, and there were large amounts of exudates in her wounds.
The patient was given a 500 mL dextran injection to expand her volume, adrenaline to increase BP, and intravenous RBC and plasma. At 7:00 pm, the patient’s BP rose to 72/23 mmHg with an HR of 100 bpm. Succinyl gelatin injection, dextran, and albumin were given to her for volume expansion. Despite these efforts, her BP continued to decrease. Bacterial examination revealed positive results for C. perfringens. According to the bacterial examination, the antibiotic regimen was adjusted to given imipenem and cilastatin sodium 1 g Q12h, penicillin 800 × 105iu Q8h and linezolid 600 mg Q12h.
At 8:28 pm,she still had no light reflex. What’s worse ,She no longer had palpable pulses, and her electrocardiograph monitoring showed a horizontal line. The patient had absence of spontaneous respiration and was declared to have clinical death.
The patient’s family agreed to have the patient undergo a postmortem examination. The recorded cause of death were as follows: (1) Extensive soft tissue infection (C. perfringens infection) and (2) Multiple organ dysfunction syndrome (DIC, kidney, liver, circulation, respiration, central nervous system). The recorded diagnosis of death were as follows: (1) Gas gangrene (C. perfringens infection), (2) Infectious shock, (3) Multiple organ dysfunction syndrome (DIC, kidney, liver, circulation, respiration, central nervous system), and (4) Postoperative liposuction in the bilateral lower limbs.
Discussion and conclusion
In this case, the patient’s death was caused by gas gangrene. Two diagnoses should be differentiated from gas gangrene. The first is cellulitis, which can also be caused by C. perfringens. However, it typically does not involve muscle pain . The second condition is necrotizing fasciitis. However, this is rarely caused by C. perfringens .
Gas gangrene is commonly caused by C. perfringens , which is a gram-positive, anaerobic pathogen commonly found in the gastrointestinal tracts of humans and animals. It produces extracellular enzymes and toxins (α and θ toxins) that act synergistically . α toxins (phospholipase C) form pores on the cell membrane, leading to tissue and cell necrosis, exudate formation, and malignant edema . In an in vitro experiment, it was shown that α toxins can inhibit the function of cardiac cells . On the other hand, θ toxins break endothelial cells and cause hypoxia in the regional tissue. Other toxins have multiple enzyme activities that can further breakdown and liquify tissue, further spreading and exacerbating the infection.
C. perfringens multiply in different tissues and decompose carbohydrates and proteins, producing a large amount of gas that leads to tissue expansion . X-rays and other imaging typically illustrate this subcutaneous gas build-up. Protein decomposition produces foul-smelling hydrogen sulfide, and the breakdown of vascular endothelial cells leads to regional edema. The combination of regional ischemia and other exotoxins further worsens tissue deterioration and necrosis. Macrophages and antibodies cannot reach necrotic tissue, leading to extensive tissue infection and exotoxin absorption, ultimately causing infectious shock. Some exotoxins directly invade the heart, liver, and kidneys, leading to locoregional necrosis or even multiple organ dysfunction. Under specific conditions, infections can spread to the whole body within one day, leading to shock or even death.
C. perfringens infection often occurs in patients with food poisoning, open injuries, and foreign bodies in the body. They may also occur after unsterile procedures, or in immunocompromised patients . In this case, we speculate that the gateway of entry for C. perfringens in this patient was wound infection. The C. perfringens infection in this case may be attributed to a few reasons.
First, this operation was performed in a private cosmetic clinic. In recent years, the market for cosmetic surgery in China has been booming without strong regulation . The hygiene problem of private cosmetic clinics in China has aroused great concern. In 2019, 86% of medical aesthetics entities in China were illegal, and 72% of medical aesthetics practitioners were non-licensed . Therefore, the incidence of infection is high in these private cosmetic clinics. Some of these facilities may not conform to surgical standards for sterility, and C. perfringens may be carried and left in the operating room environment. In addition, preoperative patients may not have enough disinfection of the surgical site, allowing opportunistic pathogens-C. perfringens to enter the body through wound infection.
To decrease the risk of unsterile operations, all surgical procedures should follow standard surgical guidelines . For example, the patient should be placed in a private ward, and an ultraviolet radiator and air sterilizer should be used to further sterilize the room after terminal disinfection.
Additionally, the patient went out for shopping after her operation and ate street snacks in the afternoon. After surgery, decreased immunity leads to an increased risk of infection. In addition, patients go shopping in a complex environment after surgery, which also increases the risk of infection. Although the skin incision of liposuction is small, the range of subcutaneous damage is large. Once infection occurs, it will provide a favorable environment for C. perfringens growth and reproduction. Therefore, after liposuction, the wound should be wrapped aseptically .The patient should be hospitalized for observation to avoid exposing the wound to unclean environment, preventing the infection of C. perfringens through the wound.
Although gas gangrene is a high-mortality disease, it can still be rescued given enough time . To increase the possibility of survival, doctors should start treatment early, which includes active resuscitation, early application of antibiotics, and hyperbaric oxygen therapy . Radical debridement, unobstructed drainage, and rinsing with a large amount of normal saline can effectively reduce the survival space of C. perfringens thereby reducing toxin absorption into the blood. The first-line antibiotic for gas gangrene is penicillin as high doses of penicillin and tetracycline can inhibit pyogenic infections. Meanwhile, hyperbaric oxygen therapy can inhibit the growth and proliferation of anaerobic bacteria, and to a large extent, narrow the area of necrotic tissue. Supportive therapy should also be considered throughout the treatment process, which includes giving a minimal number of blood transfusions, fluid replacements, vitamins, and high-protein and high-calorie diets. Analgesic, sedative, and antipyretic treatments should also be administered if necessary.
In addition to these treatment options, a vaccine for C. perfringens has been explored in recent years. However, most of the work on these vaccines and the toxins of C. perfringens have only involved animals . We hope that we can also benefit from the work on animal C. perfringens vaccine and accelerate the development of C. perfringens vaccine for humans.
Liposuction is becoming increasingly popular in China. However, most medical aesthetics entities and practitioners in China are illegal or unlicensed, which is very risky because their operating rooms and procedures are unlikely to meet surgical standards, creating conditions for bacterial infection through the wound. This might be responsible for the C. perfringens infection-related death in this case. Gas gangrene is not a common cause of postoperative liposuction infection under standard surgical procedures, and treatment with gas gangrene should be initiated early with supportive treatment. In addition, education related to care after liposuction is critical. Patients should be told to rest in bed .Doctors and other practitioners should monitor the patient’s postoperative status and provide appropriate advice when needed.
necrosis after lipo symptoms
A surgical complication is defined as any undesirable result of surgery. Minor complication has little risk that the patient will die. The causes for minor complications include unpredictable factors such as a patient’s wound healing ability, misjudgment by the surgeon, patients’ failure to follow instructions, or just bad luck such as an unexpected allergic reaction to a drug. Ultimately any result that produces an unhappy patient, is a complication.
Unrealistic Expectations
Unrealistic Expectations are the most frequent source of disappointing liposuction results.
If a patient has unrealistic expectations before surgery, then it is almost impossible for the surgeon to achieve results that will make the patient happy. To avoid unrealistic expectations surgeons must ask what the patient expects to achieve with liposuction. Surgeons must clearly state how much improvement is likely to be achieved. Patients must honestly state their hopes and expectations with the surgeon. Patients must not expect perfection. It is realistic to expect a significant improvement, but it is unrealistic to expect perfect results. This entire web site is dedicated to providing patients with information so that they can make a well-informed decision about having liposuction.
Skin Irregularities and Depressions
Significant irregularities and depressions of the skin are frequently the result of the surgeon’s inattention to detail. For example, if a liposuction surgeon attempts to do too much on a single day, and becomes fatigued, then the result may be inattention to detail, and undesirable cosmetic results. A liposuction cannula is stainless steel tube inserted through an incision in the skin that is employed to suction the fat. The size of the liposuction cannula can influences the smoothness of the skin after liposuction. The use of large cannulas tends to create irregularities more commonly than microcannulas (outside diameter less than 3 millimeters). Surgeons who do total-body liposuctions tend to use larger cannulas.
Focal Excessive Liposuction
Focal Excessive Liposuction is the removal of an excessive amount of fat from localized area of the body. Removing too much fat yields an unnatural and unattractive appearance. If uneven or irregular excessive liposuction of a single area occurs, it produces depressions (lipotrops) or lumps and bumps (liponots). If smooth or uniform, focal excessive liposuction can appear abnormal and disproportionate. The goal of liposuction is not to remove the maximum amount of fat, but rather to produce an optimal cosmetic improvement and maximize patient happiness. The normal female body has subcutaneous fat. Thus, the complete lack of subcutaneous fat on part of the female body appears abnormal, and feels peculiar to the touch. Patients should not ask for or expect “maximum fat removal”. Dr. Pierre Fournier has said, “It is not the fat that is removed, but the fat that remains after liposuction that determines success.”
Excessive Superficial Liposuction
Excessive superficial liposuction can produce significant cosmetic complications. The use of the tumescent technique and microcannulas allows the surgeon to do liposuction more superficially and to produce smoother results than could be done with old-fashioned techniques that used larger cannulas. Some surgeons mistakenly believe that scraping the undersurface of the skin with the liposuction cannula will cause the skin to contract. There is no scientific evidence to support the theory that intentional injury to the skin by doing excessive superficial liposuction produces improved cosmetic results. Excessive superficial liposuction can injure the superficial blood and lymphatic vessels located on the immediate undersurface of the skin resulting in significant complications including scars, lumpiness, permanent irregular coloration, and full thickness necrosis (death) of the overlying skin. Skin naturally contracts after liposuction because 1) skin naturally contains elastic fibers, 2) skin is relieved of the gravitational effect of subcutaneous fat, and 3) liposuction naturally results in contraction of the collagen in subcutaneous fat. Surgeons who advocate superficial liposuction must be careful to avoid excessively superficial liposuction.
Erythema Ab Liporaspiration
Erythema Ab Liporaspiration is a permanent blotchy (net-like pattern) pink-brown discoloration of the skin resulting from rasping the undersurface of the skin during superficial liposuction. Inadvertent or intentional rasping of the undersurface of the skin will injure the superficial vascular network. Unfortunately, there is no treatment for this chronic discoloration. It does not seem to improve with time.
Hematomas and Seromas
Whole blood consists of red blood cells plus serum (clear yellow fluid). A hematoma is a lake-like collection of whole blood that has leaked out of injured blood vessels and become trapped inside the body. The vasoconstriction produced by the tumescent technique for liposuction has virtually eliminated the occurrence of hematomas. A seroma is a volume of serum that has leaked out of blood vessels and collected as a “lake” of fluid within some part of the body.
Full Thickness Skin Necrosis
Full Thickness Skin Necrosis (death of the affected skin) can result from excessive superficial liposuction that injures the vascular supply of the overlying skin. Deliberate trauma to the undersurface of the skin can injure the vascular supply to the skin and cause partial or full thickness necrosis of the skin. A partial thickness dermal necrosis may become a full thickness necrosis if it is complicated by an infection. Other causes of full thickness dermal necrosis following liposuction include infection (necrotizing fasciitis) , blood vessel thrombosis (clotting inside a blood vessel), injury to blood vessels, and vasculitis (blood vessel inflammation). For example, in patients who have a disease known as cryoglobulinemia (cold-induced blood clots), the application of ice-packs to the skin after liposuction can produce clotting in blood vessels of the skin and full thickness skin necrosis.
Blisters from Reston Foam
Reston foam is an adhesive-backed 3/8 inch thick foam that some surgeons apply to patients’ skin to reduce bruising after liposuction. The manufacturer of Reston foam, 3M Corp., has warned against the use of Reston foam for liposuction. Reston foam is not intended to be applied to patients’ skin. An allergic reaction to the adhesive on the foam (similar to an allergic reaction to poison oak or poison ivy) can cause blisters and an increased the risk of necrotizing fasciitis, a potentially lethal infection. An allergic reaction of this type can also cause a prolonged discoloration of the affected skin.
Hyperpigmentation of Incision Sites
Any inflammatory injury of the skin can cause rupture of skin cells containing pigment with release of melanin pigment granules into the surrounding skin. Escaped pigment is regarded as a foreign substance by the body. Scavenger (macrophage) cells ingest this pigment where it can persist a long time causing prolonged hyperpigmentation. In most individuals who have little natural pigmentation in their skin, post-inflammatory hyperpigmentation resolves in less than a 4 to 6 months. In people who naturally have darkly pigmented skin, the hyperpigmentation can last for a number of years. Trauma from the friction of a liposuction cannula moving in and out of a skin incision can cause inflammation and hyperpigmentation. Prospective liposuction patients who naturally have darkly pigmented skin must be informed of their increased risk of such pigmentation. In darkly pigmented patients, the surgeon must take extra care to minimizing the number of incisions, and to choose incision sites that are easily covered by clothing or bathing suits.
Fainting (Vasovagal Syncope)
Fainting or vasovagal syncope is a reflex reaction involving the brain and the heart that produces a sudden brief reduction of blood flow to the brain and loss of consciousness that resolves spontaneously. When a person faints it is usually when they are sitting or standing upright. Events that can trigger a fainting episode include anxiety, pain, or even the sight of blood. Fainting can occur before, or after any surgical procedure, and even during surgery if the surgery is done under local anesthesia. For example one patient fainted prior to liposuction while the surgeon was taking preoperative photographs. Another example involved the husband of a liposuction patient. While helping his wife change her dressing the morning after liposuction, the husband fainted at the mere sight of the blood-tinged absorptive pads, and immediately afterwards, the wife also fainted at the sight of her fainted husband. Head or neck trauma resulting from a fall is the greatest risk associated with fainting.
Vasovagal Symptoms
Vasovagal Symptoms in the O.R. Fainting (loss of consciousness) is unusual in the operating room (O.R.) when the patient lying flat. Instead, an awake patients who starts to faint will linger on the verge of fainting with vasovagal symptoms that include lightheadedness, cold sweats, and nausea or vomiting. Vasovagal symptoms typically occur in predisposed individuals who have a history of fainting or becoming dizzy or lightheaded at the sight of blood or at the thought of a medical procedure.
Vasovagal Near-Syncope Syndrome
In the operating room setting during tumescent liposuction totally by local anesthesia, true syncope is unusual. However, the syndrome of vasovagal near-syncope (light-headedness, cold-sweats with nausea or vomiting) is not uncommon and represents the early phase of fainting that simply stops short of the complete loss of consciousness. The first hint of the syndrome is typically a vague sensation of feeling queasy and lightheaded. Shortly thereafter, the patient’s skin will appear ashen or pale, with damp, moist, clammy skin, perhaps with visible beaded perspiration, and dilation of pupils. Within a few brief moments, the patient experiences a slow heart rate and low blood pressure. Although vasovagal near-syncope is not dangerous, it is unpleasant. Treatment consists of a small intravenous dose of atropine (0.5 mg) after which the patient soon feels dramatically better.
Preventing Vasovagal Syndrome in the Operating Room
If a patient has previously experienced sudden lightheadedness or fainting for any reason, for example when having blood taken for a laboratory test, then he or she has a predisposition for the vasovagal syndrome. The vasovagal syndrome in the operating room can be prevented by giving 0.3 mg of atropine intravenously immediately prior to surgery. Every patient who is scheduled to have liposuction totally by local anesthesia should be asked the question, “Have you ever fainted or suddenly become light-headed for any reason?”
Post-Liposuction Syncope at Home
Post-liposuction lightheadedness and fainting most commonly occurs after urinating the morning after liposuction. Fainting after urination is called post-micturition syncope that occurs commonly in postpartum women the morning after childbirth upon standing up immediately after urination. Other stimuli that can trigger a fainting episode after liposuction include: 1) the sight of the blood-tinged anesthetic drainage on the absorptive pads, and 2) decompression of the lower extremities upon removal of postoperative compression garments. For at least 24 hours after tumescent liposuction, patients are generally in a state of mild fluid overload due to all the tumescent fluid remaining in the patient’s system. Except in cases of excessive liposuction, it is unlikely that post-liposuction syncope is caused by a deficiency of intra-vascular fluids.
Wrong Areas Treated
Miscommunication between patient and surgeon may lead to confusion about which areas are to be treated. It is important that the patient and surgeon agree on which areas are to be treated by liposuction, and that this agreement be put in writing so that there is no confusion. This is especially important if the surgeon who does the consultation is not the same surgeon who does the liposuction. It is also important if liposuction is done under general anesthesia, because the patient will not be able to alert the surgeon who is about to treat the wrong area. Patients must insist that the areas to be treated are listed in writing.
belly button infection after liposuction
Liposuction removes excess body fat deposits from a patient who is unable to lose them with exercise and diet. It is one of the more commonly performed plastic surgery procedures in the world. Problem body areas are contoured and reshaped with liposuction. In most cases, liposuction is done as an outpatient procedure, and it can take several weeks for full recovery. While this procedure is relatively safe, all surgical procedures come with some risk.
Knowing some of the most common warning signs to look after your liposuction surgery can help ease headaches and stress. Four of them include:
As with all surgical procedures, liposuction has a risk of infection. An infection may be indicated by extreme redness, warmth, irritation, and pain at the site of the incision. A high fever of over 101.5 can also be an indicator of infection. Contact your plastic surgeon immediately if you notice any of these warning signs.
Following liposuction, the skin on the surgical area can die. There is more than one reason this occurs, but when it does the skin first changes color and then falls off. In the majority of cases, this is part of a normal healing process. However, this can lead to an increased risk for infection. Also, if you notice your surgical site has an abnormal appearance, consult with your surgeon.
A hematoma is a buildup of blood outside of a blood vessel and can be somewhat normal following plastic surgery. A hematoma typically results in a swollen or bruised appearance where the blood has collected. In the majority of cases, there is no reason to be concerned. However, the hematoma can become painful and blood flow to the area can be decreased when it becomes too large. It is best to call your surgeon if this occurs as some of the blood may need to be removed with a syringe.
On occasion, an accumulation of lymphatic clear fluid can occur around the surgical site. A seroma is similar to a hematoma and is not dangerous unless it becomes too big or grows a bacteria. Your surgeon may wish to remove the excess fluid with a syringe if it builds ups.
LUMPY and BUMPY HARD SPOTS
Another issue that occurs after Liposuction is an inflammatory response that produces lumps, bumps, and hard knots. This is also a problem when the right type of compression garment isn’t worn after Liposuction or when a abdominal binder is used. This binder causes a ridge or shelf above and below especially when sitting and flexed during the day.
WAVY DIPS OR CONTOUR IRREGULARITY
Sometimes patients may notice wavy or uneven Dips after a Liposuction procedure. This is due to poor compression garment fitment or scar tissue that retracts and pulls the tissue in. It can also be a result of uneven suctioning during the Lipo procedure.
Aspen Rehabilitation Technique
The Aspen Rehabilitation Technique is an effective way of treating lumps, bumps, hard knots and Contour Irregularities after liposuction surgery. This is a painless, non-invasive procedure that results in a flatter, smoother stomach. The Aspen Rehabilitation Technique is a patented process available through Aspen After Surgery Center located in Coral Springs, Florida and offers a 1-week FAST TRACK for qualified patients.
Typically, the cost of travel and treatment is less than surgery and comes with none of the risks. If you are considering plastic surgery or have already gone through the process, call us today to speak with one Aspen’s experts.
As surgery has a high re-occurrence rate for these issues happening over and over, The Aspen Treatment can also be provided in a patient’s surgeons office. Ask your surgeon for the Aspen After Surgery Treatment as an inexpensive option to surgery.