Patients happy with liposuction procedure

Study also documents safety of procedure

A high level of patient satisfaction and a wide range in the number of body parts upon which surgeons performed liposuction were two of the results that stood out in the recently released Liposuction 2004-2005 Report by the Institute for Quality Improvement (IQI), part of the Accreditation Association for Ambulatory Health Care.

Most patients were happy with their decision to undergo liposuction, with 91% of the patients responding to this question indicating that they thought they had made the right decision. Of the 89% of patients responding to questions about satisfaction with the procedure and the outcome, 85% of them reported high levels of satisfaction or 5 on a scale of 1 to 5).

"This is significant because it shows that patients got what they wanted," says Naomi Kuznets, PhD, director of IQI. While this result indicates that patients were well prepared for the actual procedure as well as results that could be expected, IQI will be adding a question specific to pre-procedure education in the next study, she says.

Dermatology Physicians and Surgeons in Barrington, IL, one of the 23 participants in the study, starts educating the patient at the initial consultation, says Mary Kaiser, RN, staff nurse. "We talk about what happens during the day of surgery and what each patient should expect following surgery," she says. Because the patient's body doesn't look the same following liposuction, a description of what is normal during recovery is given to all patients, Kaiser adds. "We also call the patient the day after surgery to make sure there are no questions or concerns."

Although average costs, waiting times, procedure times, and discharge times were included in the study, the results should be viewed with the understanding that the type of procedure varied widely, says Kuznets. The number of body areas per procedure ranged from one to eight, with 72% of the cases involving between one and three body areas. "The more body areas that are involved, the longer the case will be and higher costs will be involved," she explains.

Body areas receiving liposuction most frequently during this study were:

  • abdomen (61%);
  • flank/waist (50%);
  • hips (35%). (Editor's note: these numbers add up to more than 100% because multiple procedures were performed on the same patient in many cases.)

Although her facility performs liposuction on all areas of the body, Kaiser's program reported the lowest discharge time of all study participants, with 22 minutes. Other facilities posted discharge times up to 167 minutes, with an average discharge time of 72 minutes. "We perform liposuction on all areas of the body, but we perform only tumescent liposuction and use no anesthesia other than the local," says Kaiser. "We will give an oral sedative if needed."

The key to the early discharge is the fact that the patient is awake and alert throughout the procedure and rarely needs pain medication other than an extra-strength acetaminophen before leaving the office, she says. "We also have one nurse assigned to the patient throughout the entire process, so the patient is less anxious because someone is there to answer questions," Kaiser explains.

Study participants reported a complication rate of 6%, but Kuznets points out that few of the complications were serious.

"A few of the complications, such as arrhythmia, excessive bleeding, and hypotension-shock, are serious, but they were associated with cases that were more intrusive, affected more areas, and used more anesthesia," she says.

Overall, Kuznets was pleased to see that most cases did not exceed recommended guidelines for tumescent fluid infused, total lidocaine dose, total epinephrine dose, and extracted supranatant fat and fluid. "More than 5,000 ml of fluid was extracted in only 7% of the cases in the study," says Kuznets.

The American Society of Plastic Surgeons' guidelines recommends that the procedure be performed inpatient if the amount of anticipated aspirate is greater than 5,000 ml. The American Society for Dermatologic Surgery and the American Academy of Dermatology Guidelines of Care recommend that no liposuction be performed on an inpatient or outpatient basis if the amount of aspirate will exceed 5,000 ml.

Source/Resources

For more information about the Liposuction 2004-2005 Report, contact:

  • Naomi Kuznets, PhD, Director, AAAHC Institute for Quality Improvement, 5200 Old Orchard Road, Suite 200, Skokie, IL 60076. E-mail: nkuznets@aaahc.org.

To order a copy of this study, contact the Institute for Quality Improvement by phone at (847) 853-6060 or fax at (847) 853-9028. Copies of the study also can be purchased by going to www.aaahciqi.org and clicking on "order products." The cost of the study for organizations that did not participate is $85 for a CD-ROM and $110 for a hard copy. Shipping and handling charges start at $12.