A French surgeon, Dr. Illouv is the creator of the procedure known today as Liposuction. The earliest liposuctions were performed in a dry manner, with no added fluids. This was found to be unsatisfactory as there was heavy blood loss during surgery when removing the fat. Nowadays liposuction is performed using a wet technique (Tumescent or super humid), which means the introduction of a solution with adrenalin, prior to suction, sufficient to reduce the bleeding during the procedure. Liposuction is now the number one aesthetic surgical procedure performed in the world.
As the population has gotten larger and as plastic surgery is increasingly turned to as a means to correct weight issues, plastic surgeons have been taking ever increasing percentages of body weight from their clients. There are several schools of thought about how many liters of fat, liquid and blood can be taken without causing harm to a patient.
The American Society of plastic surgery and The Brazilian Society of plastic surgery opinions differ on this issue, but the average opinion is between 7 to 10 % of the total body weight. For the average patient that means around a gallon of fat, liquid and blood which equals generally less than 6 pounds total weight loss realized 2-3 months after surgery. This is an average, but as you can see it is not a weight loss fix but a way to sculpt the body into a better shape.
For patients that want to have more than 7 to 10% of their body weight liposuctioned are categorized as Large Volume Liposuction (LVL). Large Volume Liposuction is a liposuction performed over the 7 to 10% limits, but with an increased risk to the patient. This is still Liposuction, but with a completely different set of safety requirements.
The trauma placed upon the body during LVL is very similar to the trauma a third degree burn victim may encounter. The patient loses large amounts of intravascular fluids which causes a sharp decrease in blood pressure and severe dehydration. In rare cases it has been reported that patients have gone into cardiac arrest during LVL due to the large loss of intravascular fluid.
To avoid these and other complications it is critical to have a senior anesthesiologist and surgeon that can manage the patient as an intensive care patient during and after the surgery with expansion fluids and blood transfusions.
Blood transfusion in LVL are performed as auto transfusion (using your own blood) to avoid blood related diseases. In a period of one or two months before the surgery blood from the patient is collected until there are 3 or 4 units for the surgery. With the auto transfusion we can take 15 to 20% of the body weight or 2 1/2 gallons of liposuction fluid. This must be performed in a hospital with a critical care unit for safety. LVL will involve two days in the hospital minimum for the patient.
Large Volume Liposuction is indicated to reduce major volumes of localized fat such as thighs and hips or other special cases. It is not indicated nor safe to perform multiple areas LVL. LVL will not replace the personal commitment to loosing weight, good nutrition and exercise.
