[Cheongdam OK Clinic] Is Liposuction Really a Safe Surgery?

Hello.

I’m Dr. Seong Hyun-ju, the "Extraction King," here to help you remove your fat one by one. 😊

I heard liposuction can even be fatal!

I heard there have been cases of death during surgery?

Have you ever heard stories like this?

If you hear something like that,

it’s only natural to feel anxious.

In fact,

someone once asked me,

“What if a pulmonary embolism occurs?”

Other people usually ask,

“How many cc can you remove?”

“Will my arms get slimmer?”

But this person asked about the side effect called “embolism.”

Today, I’d like to talk about

“fat embolism,”

which is not widely known but can sound frightening just to hear about.

What is embolism?

One of the medical terms,

embolism

refers to a phenomenon in which a substance formed somewhere in the body blocks a blood vessel.

Types of embolism

Depending on the type of foreign substance,

it can be classified as thromboembolism, air embolism, fat embolism, and so on.

During liposuction,

a fat embolism can occur very rarely if tiny fat particles enter a blood vessel.

How fat embolism progresses

Thromboembolism: blood (a clot) blocks a blood vessel

Air embolism: air enters a blood vessel

Fat embolism: fat travels through a blood vessel

When a mass of fat that has traveled through the bloodstream blocks the blood flow to major organs such as the lungs, heart, brain, or liver,

it can cause serious damage to the affected organ,

and a dangerous situation that can even lead to death may occur.

What are the actual reported cases of fat embolism?

A paper published in Taiwan in 2023 analyzed

38 reported cases of fat embolism worldwide.

Excerpt from a research paper on fat embolism

(Source: Kao Y.-M. et al., Healthcare 2023; 11(10):1391)

Occurrence timing: within 24 hours after surgery

Cardiac arrest rate (overall): 38%

Mortality rate (overall): 33%

In other words,

this is a very serious complication

that leads to death in 1 out of 3 people.

But

a very important point here!

This statistic should be understood under the premise that

fat embolism is an extremely rare side effect.

In general liposuction surgery,

the mortality rate is less than 1 per 100,000 people,

that is,

an extremely low rate of 0.00001% or less.

So then,

should liposuction not be done?

I’ll give you the conclusion first.

You do not need to worry excessively about fat embolism itself.

That is because

the incidence is very low,

there are clear prevention methods,

and initial response protocols are in place.

In fact,

you should pay more attention to side effects that occur more often after surgery,

such as infection, hematoma, necrosis, pigmentation, and unevenness (lumpy results).

Possible side effects of liposuction

How can we prevent fat embolism?

Medically,

fat embolism is largely related to three factors.

If each factor is carefully managed,

the likelihood of occurrence can be reduced to nearly zero.

1. Sedation or local anesthesia rather than general anesthesia

All reported cases of fat embolism so far

were surgeries performed under general anesthesia.

During general anesthesia,

because the patient cannot move or respond on their own,

it is difficult for the medical team to detect danger signals immediately,

even if they occur in the body.

In addition,

oxygen is delivered through a ventilator under positive pressure,

which can increase the pressure inside the lungs

and raise the risk of fat particles entering the bloodstream.

Liposuction can be performed sufficiently with sedation or local anesthesia alone,

and in that case, spontaneous breathing is maintained, so the risk of embolism is much lower,

and immediate response is possible if something abnormal occurs,

making it a safer choice.

2. Avoid large-volume liposuction

Removing more fat is not always better.

The amount of fat that can be removed

depends on the individual’s weight, body shape, and health condition.

According to research,

large-volume liposuction of 5,000 cc or more

can increase the risk of complications such as fat embolism, bleeding, and fluid imbalance.

If a clinic says,

"We can remove more than 10,000 cc,"

that is not much different from saying,

"We’re going to put you at risk."

For liposuction, what matters more than "how much is removed"

is

"how safely the fat is removed into a line that suits your body shape."

Considering each person’s condition comprehensively

and removing an appropriate amount in a planned way

is the best approach.

3. Avoid deep-layer liposuction

Fat is divided into

superficial fat just beneath the skin

and deep fat.

Among these,

if liposuction is forced too deeply,

the risk of muscle and blood vessel injury increases,

and the possibility of fat entering the blood vessels also increases.

Skill in controlling the suction depth is important

Therefore,

liposuction is not simply a "technique for removing a lot."

It is important that it be performed by experienced medical staff who can accurately distinguish the thickness of each layer

and finely control the depth.

If fat embolism does occur,

fast and accurate response is the most important thing.

In an emergency,

symptoms such as decreased oxygen saturation, decreased consciousness, and convulsions

may appear.

If these signs are observed,

the surgery should be stopped immediately,

and the following emergency measures should be taken.

▪ Endotracheal intubation and oxygen supply

▪ Fluid administration

▪ Cardiac monitoring

▪ Transfer to the intensive care unit and intensive treatment

With prompt and accurate initial response,

most patients can recover completely.

On the other hand,

if response is delayed,

or if the patient is left without appropriate emergency measures,

it can lead to fatal results.

Before liposuction,

4 points you must check

The safety of liposuction

depends on the skill of the medical team

and the hospital system.

Before surgery,

be sure to check the items below.

✅ Whether the procedure can be done with sedation or local anesthesia rather than general anesthesia

✅ Whether excessive suction volume (large volume) is not being recommended

✅ Whether emergency response equipment and manuals are prepared

✅ Whether the medical team is experienced and able to finely control suction depth

If a clinic has these four things in place,

it can maximize the safety of liposuction.

Information defeats fear

On the internet, you may often see sensational expressions like "liposuction = death."

However,

if you look at it based on medical standards

and statistics,

liposuction is a very safe surgery when performed in an environment that follows safety standards.

▪ Mortality rate for cesarean section: 0.02% ▪ Mortality rate for appendectomy: 0.1% or less ▪ Mortality rate from traffic accidents in Korea: 0.01% ▪ Mortality rate for liposuction surgery: 0.00001% or less

Just by looking at these numbers,

you can see that accurate information and the right choice are more important than vague fear.

To sum up,

fat embolism is extremely rare,

but preparation is absolutely necessary.

General anesthesia, excessive liposuction, and deep-layer suction

are risk factors.

Sedation anesthesia + appropriate amount + appropriate layer suction

—if these are properly followed,

the surgery can be performed safely.

This is

the responsibility of the person performing the procedure.

As for me as well,

for safe surgery,

I will strictly follow preventive guidelines,

thoroughly educate all staff and build response manuals,

and carefully check emergency equipment

without neglecting any part of the process.

Dr. Seong Hyun-ju, the "Extraction King"