As with all surgical procedures, Vaser Liposuction can have complications. However, surgeons can manage and avoid most of these with highly developed skill and careful planning.
1. Hyperpigmentaiton secondary of hyper-inflammation of melanocytic cells
Avoid this complication by utilizing several measures including:
- Addition of dexamethasone to the tumescent solution in the operating room
- Administration of Medrol dose pack in the early postop period
- Application of topical hyrdocortisone for the first 2 weeks
- Patients are also asked to avoid direct sunlight for first 3 months after surgery
- If hyperpigmentation is noted, patients are treated aggressively with topical hydroquinone 4% topically and placed on glutathione therapy (topical oral and intravenous)
- Identify patients prone to this complication who are olive skin and/or Asian
2. Scarring
Minimize risk of this complication by avoiding postoperative swelling and/or inadvertent injury to the skin during Vaser liposuction.
- Post op swelling avoided by suppressing hyperinflammatory elements during surgery and afterwards.
- Minimizing edema can be achieved with dexamethasone in the tumescent solution intraoperatively
- Administration of Medrol dose pack taken by mouth in the early postoperative period will minimize swelling
- Strict wearing of customized compression garments for two weeks after surgery critical to restricting swelling
- Skin compromise is avoided intraoperative with meticulous technique to avoid heating or burning of the skin
- Another technical modification involves performing all superficial vaser ultrasound immediately following tumescent solution injection in order to avoid heat transmission to the skin
- Precise ultrasound application allows for emulsification of the fat, but without heat injury to the skin
- Newer Vaser pmachines have a heat sensitive shut-off mechanism that avoids burn injuries
- Use of 5 ring instead of 2 ring helps avoid focal energy and subsequent burns as well
Finally, liposuction techniques have been optimized to avoid scarring and irritation of the subdermal plexus:
- Avoid scarring and tissue complications by aggressive topical treatment of any areas that demonstrate vascular(blood flow) compromise as observed by mottling or bruising; these measures include application of:
- Xeroform which contains bismuth molecule which soothes the skin to optimize healing
- Bacitracin provides antimicrobial molecules that help against an infection
- Nitropaste increases blood flow to the injured areas to avoid vascular compromise
3. Contour Irregularities
Several measures taken to avoid in intraoperative and postoperative period contour irregularities include:
- During the intraoperative period, we caution against irregularities by performing accurate and uniform fat removal during both VASER emulsification of fat and during suction liposuction of fat
- In the early postoperative period, we minimize risk of irregularity with use of foam in-lays that are customized to ensure uniform pressures to ensure that fat cells settle evenly
- Aggressive lymphatic massage daily for 10 days to avoid any clumping of the fat cells as they convert back to a solid sate
- Early postoperative, encourage to reinitiate workout regime which will further ensure quick resolution of swelling and uniform settling of fat cells
- Weight maintenance is critical to ensure optimized results
