Obesity Surgery

, Volume 19, Issue 12, pp 1642–1645 | Cite as

Safe Limits for Aspirate Volume Under Wet Liposuction

  • João Cantarelli
  • Moacir F. GodoyEmail author
Clinical Research



Hypovolemia is a hemodynamic disorder occasionally associated with liposuction. The purpose of this study is to settle a safe limit for the volume of aspirate under wet liposuction relating this volume to body weight. The criteria used to establish this limit were based on the Advanced Trauma Life Support (ATLS).


Thirty patients underwent wet liposuction and were submitted postoperatively to a 24-h noninvasive monitoring control of vital signs. Tachycardia (over 100 bpm) and systolic hypotension (below 100 mmHg) were recorded as well as urinary volume and respiratory rate. Hemoglobin, hematocrit, and leukocyte counts were determined preoperatively and also determined 1 and 6 h postoperatively.


The volume of aspirate ranged from 1,480 to 3,980 ml (2.6% to 6.9% of body weight). Hemoglobin count decreased around 6 h postoperatively compared to the immediate preoperative period (p < 0.0001). An increase of leukocytes was observed around 6 h postoperatively when compared with the preoperative period—nearly 30 min before surgery (p < 0.0001). No association was found between hemoglobin or leukocyte counts and volume of aspirate. In 15 patients, tachycardia and/or hypotension were recorded postoperatively. These hemodynamic disorders were associated to volumes of aspirate higher than 5% of body weight.


Under wet liposuction, a volume of aspiration not superior to 5% of body weight is proposed as a safe limit. It has been found as a clue to avoid hypovolemia and subsequently the shock. This statement is in agreement with ATLS guidelines.


Wet liposuction Volume of aspirate Hypovolemia Tachycardia 


  1. 1.
    Illouz Y-G. Body contouring by lipolysis: a 5-year experience with over 3000 cases. Plast Reconstr Surg. 1983;72:591–7.CrossRefGoogle Scholar
  2. 2.
    Fournier PF, Otteni FM. Lipodissection in body sculpturing: the dry procedure. Plast Reconstr Surg. 1983;72:598–609.CrossRefGoogle Scholar
  3. 3.
    Pitman GH, Teimourian B. Suction lipectomy: complications and results by survey. Plast Reconstr Surg. 1985;76:65–9.CrossRefGoogle Scholar
  4. 4.
    Rao BR, Ely SF, Hoffman RS. Deaths related to liposuction. N Engl J Med. 1999;340:1471–5.CrossRefGoogle Scholar
  5. 5.
    Grazer FM, Jong RH. Fatal outcomes from liposuction: census survey of cosmectic surgeons. Plast Reconstr Surg. 2000;105:436–46.CrossRefGoogle Scholar
  6. 6.
    Teimourian B, Adham MN. A national survey of complications associated with suction lipectomy: what we did then and what we do now. Plast Reconstr Surg. 2000;105:1881–4.CrossRefGoogle Scholar
  7. 7.
    Klein JA. The tumescent technique for lipo-suction surgery. Am J Cosmet Surg. 1987;4:263–7.CrossRefGoogle Scholar
  8. 8.
    Samdal F, Amland PF, Bugge JF. Blood loss during liposuction using the tumescent technique. Aesth Plast Surg. 1994;18:157–60.CrossRefGoogle Scholar
  9. 9.
    Cárdenas-Camarena L, Tobar-Losada A, Lacouture M. Large-volume circumferential liposuction with tumescent technique: a sure and viable procedure. Plast Reconstr Surg. 1999;104:1887–906.CrossRefGoogle Scholar
  10. 10.
    Karmo FR, Milan MF, Silbergleit A. Blood loss in major liposuction procedures a comparison study using suction-assisted versus ultrasonic assisted lipoplasty. Plast Reconstr Surg. 2001;108:241–9.CrossRefGoogle Scholar
  11. 11.
    Viterbo F, Ochoa JS. Vibroliposuction: a study of rate of aspiration. Aesth Plast Surg. 2002;26:118–22.CrossRefGoogle Scholar
  12. 12.
    Kenkel JM, Lipschitz AH, Luby M, et al. Hemodynamic physiology and thermoregulation in liposuction. Plast Reconstr Surg. 2004;114:503–13.CrossRefGoogle Scholar
  13. 13.
    Courtiss EH, Kanter MA, Kanter WR, et al. The effect of epinephrine on blood loss during suction lipectomy. Plast Reconstr Surg. 1991;88:801–3.CrossRefGoogle Scholar
  14. 14.
    Commons GW, Halperin B, Chang CC. Large-volume liposuction: a review of 631 consecutive cases over 12 years. Plast Reconstr Surg. 2001;108:1753–67.CrossRefGoogle Scholar
  15. 15.
    Brown SA, Lipschitz AH, Kenkel JM, et al. Pharmacokinetics and safety of epinephrine use in liposuction. Plast Reconstr Surg. 2004;114:756–63.CrossRefGoogle Scholar
  16. 16.
    Hetter GP. Blood and fluid replacement for lipoplasty procedures. Clin Plast Surg. 1989;16:245–8.PubMedGoogle Scholar
  17. 17.
    Trott SA, Beran SJ, Rohrich RJ, et al. Safety considerations and fluid resuscitation in liposuction: an analysis of 53 consecutive patients. Plast Reconstr Surg. 1998;102:2220–9.CrossRefGoogle Scholar
  18. 18.
    Jong RH, Grazer FM. Perioperative management of cosmetic liposuction. Plast Reconstr Surg. 2001;107:1039–44.CrossRefGoogle Scholar
  19. 19.
    Rohrich RJ, Leedy JE, Swamy R, et al. Fluid resuscitation in liposuction: a retrospective review of 89 consecutive patients. Plast Reconstr Surg. 2006;117:431–5.CrossRefGoogle Scholar
  20. 20.
    Goodpasture JC, Bunkis J. Quantitative analysis of blood and fat in suction lipectomy aspirates. Plast Reconstr Surg. 1986;78:765–72.CrossRefGoogle Scholar
  21. 21.
    Dolsky RL. Blood loss during liposuction. Dermatol Clin. 1990;8:463–8.CrossRefGoogle Scholar
  22. 22.
    American Society of Plastic and Reconstructive Surgeons (ASPRS). Clinical practice guidelines: lipoplasty. Arlington Heights: American Society of Plastic and Reconstructive Surgeons (ASPRS); 1998.Google Scholar
  23. 23.
    American College of Surgeons. Chapter 3: shock. In: American College of Surgeons, editor. Advanced Trauma Life Support (ATLS). Student manual. 6th ed. Chicago: American College of Surgeons; 1997. p. 87–124.Google Scholar
  24. 24.
    Fredricks S. Lipoplasty and blindness. Aesthetic Surg J. 2006;26:586–7.CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  1. 1.Department of Cardiology and Cardiovascular SurgeryFAMERPSão José do Rio PretoBrazil

Personalised recommendations