Complications of Vaser Liposuction - Avoid and manage

Managing and avoiding complications of Vaser Liposuction

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

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