Fat Dissolver Has Backers, But Critics Say Evidence Thin

By IRENE MAHER News Channel 8 Medical Editor

It’s being touted by some as the newest way to lose inches without diet, exercise or surgery. Instead, patients receive injections of a cocktail of FDA-approved solutions that dissolve fat from the body’s most notorious trouble spots: love handles, saddlebags, bra bulges and the jelly belly.

It’s called LipoDissolve, and just about every doctor involved in aesthetic medicine offers it. But not all of them make the same claims. Lisbeth Roy, an osteopathic physician and co-owner of Spa Tampa, says, “This is not a weight-loss tool. It really isn’t. It’s for discrete areas of fat.”

Roy says the ideal candidate for LipoDissolve eats a healthy diet, exercises regularly and is in good physical shape. They just Such people have what she calls “those nagging areas that bother them.”

Sarah Kennedy, 47, is a patient of Roy. She exercises almost every day, three times a week with a personal trainer. In her spandex workout clothes, it’s obvious exercise is a priority. But despite all her hard work, Kennedy felt the St. Petersburg resident believed her tummy just wasn’t flat enough, and she couldn’t reduce the love handles on either side of her waist. She said no amount of exercise was going to eliminate those bulges.

“If it was, they would have gone away. Trust me,” she says. “I work very, very hard.” After investigating her options, Kennedy decided to try LipoDissolve, primarily because there was very little down time following each treatment. She says she has been very happy with the results.

Previously, liposuction was the only reliable method for removing stubborn fat from these areas. It’s an expensive, invasive medical procedure that sucks out fat deposits below the skin and can leave some people out of commission for several weeks to a month, depending on the area treated.

LipoDissolve requires no anesthesia, and patients are back to normal activity in a day or two.

But, LipoDissolve has its critics. Michel Murr, an associate professor of surgery at the University of South Florida and director of bariatric surgery at Tampa General Hospital, says there have been no controlled, long-term scientific studies to prove the benefits of LipoDissolve.

“There’s lots of skepticism in the scientific community on these treatments,” Murr says. “The data is just not there.”

Christopher Schaffer, a plastic surgeon at Morton Plant Hospital in Largo, agrees, and says he worries about overselling the procedure to obese patients who may see it as an alternative to weight loss. He believes fat dissolving should be limited to treating very small areas of the body. “I’m talking about maybe a golf ball-sized or lemon-sized area. A love handle is a big area. I certainly would not recommend injecting a substantial love handle with anything.”

The primary ingredient in LipoDissolve is phosphatidyl choline, a soybean derivative that breaks down fat cells, which are then excreted from the body naturally. While LipoDissolve is approved by the Food and Drug Administration for certain medical purposes, it is not FDA-approved for use in cosmetic fat removal. Most physicians add their own proprietary combination of ingredients to the phosphatidyl choline – including vitamins, plant extracts, hormones, anti-inflammatory medications, antibiotics and pain killers – creating a custom, fat-dissolving cocktail.

Some practitioners, such as Roy, prepare patients by applying a pain-killing cream to the area to be treated 45 minutes before the procedure. Patients then receive what may amount to dozens of injections spaced about an inch apart.

Kay Allen, 47, of Fort Myers has had the backs of her upper arms treated and also plans to do the area of her back that bulges around her bra straps. She doesn’t mind the 2 1/2-half hour drive to Tampa for treatment, or the cost: $200 for each 4-inch by 6-inch 4-by-6-inch area that is treated.

Most patients will need three treatments spaced a week or two apart. Allen doesn’t care how many it takes as long as she can one day leave home wearing a sleeveless top.

“I’m hoping I will be able to go out in public in something like [that] and feel comfortable,” she says.

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ARTICLE INACCURACIES: Media reports are inaccurate to claim there are no studies on Lipodissolve. There has been numerous studies published in medical journals, both clinical studies and University studies as well as more than 100,000 clinical safety and patient reports.

Lipodissolve Survey: Excellent safety data from ‘adverse reaction’ survey

Over 400 ASAL certified physicians in the United States were issued questionnaires on their Lipodissolve treatments during 2007/2008. The aim of the study was to investigate the potential side effects observed from ASAL Lipodissolve treatments. The total feedback from physicians reported an overwhelming level of safety from treatments. Less than 1% of all treatment cases reported adverse reactions. Adverse reactions were associated with changes to standard treatment protocols, demonstrating the importance in maintaining a standardized treatment regime.

Lipodissolve clinics with prior certification in ASAL Lipodissolve were contacted to provide data on Lipodissolve sessions from their clinical practice. Over 11,650 Lipodissolve treatments with the ASAL protocols were reported from the responders. The data focused on feedback with particular regard to observations on adverse side-effects from Lipodissolve injections.

As with any medical treatment, potential side effects (although shown to be mild from Lipodissolve injections) do exists and vary according to injection site, dose, frequency of injections, and the amount of physician expertise. Most side effects- such as slight pain, tenderness, or bruising at the injection site-are temporary and occur and often disappear within a few hours after treatment, with longer side effects remaining for an average of two weeks after treatment. The most common side effects from injections of the (i.e.) abdomen, include extensive swelling, slight burning immediately after injections, tenderness and temporary bruising; whilst a small number of cases experienced temporary nodules and hyper pigmentation which dissolved or disappeared after a few months.

Adverse effects: less than 1%

Recent feedback on Lipodissolve treatments from 2007 was issued by licensed physicians across the United States. The overwhelming responders confirmed adverse side effects to be extremely rare in their observations with Lipodissolve. The term ‘adverse’ was used to distinguish observations caused from treatments that required minor or major medical interference to correct or treat the complication. The physicians reported feeling very safe with the treatment overall and had positive results with the ASAL protocols and with high patient satisfaction. Some decrease in patient satisfaction, comfort, and posed safety concerns were reported in modified or changed treatment protocols although more specific details were omitted in several cases. As has been observed in the past, clinics reported about 6% of patients having no response to the treatment. Additional observations were made of the visual difference of cosmetic results, dependent on the origin of the pharmaceutical compounds. Examination of the feedback also led to the opinion that criticism against Lipodissolve had been exaggerated, and turf-protection was viewed as the main cause of this. The overall feedback from clinical observations concluded that the ASAL Lipodissolve protocols continue to be safe and more positive than imitation procedures. Imitation therapies such as mesotherapy or non-standard ‘Lipodissolve’ treatments contain various additional pharmaceutical agents including deoxycholate, as well as unknown medications.

Deoxycholate use

Of all reported treatments from this study, less than 1% of a total 11,650 cases involved adverse reactions. The survey was specific to feedback on adverse reactions. Prolonged pain was reported in 2% of cases out of 236 sessions and less than 1% of these reported pain lasting longer than two weeks, which was unusual.

The most noteworthy cases included observations of minor patches of skin necrosis. All in all, 0,017% of 11,650 cases reported serious skin breakdown. It’s necessary to add that almost all, except two cases, showed adjustments to the standard protocol, either in total injection volume of area treated or with addition of deoxcyholate and/or other substances.

Adding increased levels of deoxycholate is not a part of standard ASAL Lipodissolve protocol. It has not been recommended by the developers. In spite of this the individual use of additional deoxycholate in the treatment is popular amongst some clinical users. Deoxycholate in subcutaneous use started to grow in popularity in the United States in 2005 after aggressive promotion in various presentations. The product has been believed to give a more aggressive treatment method, although Lipodissolve developers have always been opposed to excessive deoxycholate being used in this treatment. Deoxycholate acid is highly potent and adds new risks to the treatments, with potential damage to muscles and tissue. The cosmetic results in deoxycholate use give insignificant improvement compared to the milder PPC use. Contrary to popular belief, deoxycholate has been shown to cause lipoclasis, not lipolysis. The substance is further limited in its potential use because of its toxic nature; it cannot be issued in sufficiently large volume as to be dramatically effective, making it rather pointless for subcutaneous cosmetic use. Apart from increased risks, the dissolvent acid causes substantially higher discomfort levels and pain, deterring patients from returning for further treatment sessions. Deoxycholate use has become popularized in the United States after commercially sponsored studies were published in 2004 [Dr Rotunda, Dr Roy; Dermatologic Surgery, Volume 30, Issue 7, Page 1001-1008, Jul 2004]. The substance was thereafter aggressively marketed to encourage its use in cosmetic procedures.

It would be reasonable to conclude that the overall total percentage of adverse reactions may have been lower if all 400+ certified physicians had responded to the survey.

ASAL administration states, “The secret of Lipodissolve is not to simply inject any phosphatidylcholine. Several factors are significant in the manufacturing process including raw materials used and how the product is processed during compounding to be effective. The active ingredient has no toxicity reports in extensive international studies from many years in intravenous and oral use. The substance is known to be rapidly absorbed, rapidly metabolized, and rapidly cleared from plasma and tissues. Intravenous studies confirm that the product is tolerated even in high doses on a daily basis. Lipodissolve contain lower doses and a single treatment dose about once a month. Daily doses are discouraged for several reasons. The high safety reports do not make the treatment guaranteed risk free and risk factors are very much dependent on patient cases, contraindication groups, etc. Allergic reactions are the immediate risk with any medical treatment. Other factors include the knowledge and skill of the provider, safe and reliable medical supplies, and very important; how patients manage and maintain the injected areas after treatments, etc., to mention a few. It is important that patients disclose all past medical history during consultation and inform their physicians of any supplements or medications they may be on, as it may indicate potential outcome that would otherwise remain unknown. But overall, Lipodissolve compared to most cosmetic treatments, have excellent safety record with minimal immediate risks known to us in the past four years of international feedback.”

Long-term studies are lacking in Lipodissolve use, but exist on medical use of phosphatidylcholine for injectable use.

What does this tell us?

ASAL Lipodissolve injections are considerably safe compared to most cosmetic medical treatments available. The side effects of Lipodissolve injections are usually exactly as indicated they may be and swelling, bruising and tenderness are all common in other medical treatments. It cannot be ruled out that adverse reactions are more commonly prevalent in ‘experimentation’ where the standard ASAL Lipodissolve protocols are either changed or adjusted. It’s crucial to inject into the right area and avoid muscles, and follow the protocols with the appropriate recommended dosage.

None of the clinics responding to the feedback had any monetary compensation, or were offered any products, discounts, or benefits. All feedback was voluntary and objective. ASAL has received no commercial support from manufacturers or companies related to any Lipodissolve data, products, marketing, or feedback response.

This report is prepared to be published at a later date in more detail.

Journal Publications and References:

(Related Lipodissolve and PPC studies)
1. Fat tissue after lipolysis of lipomas: A histopathological and
immunohistochemical study.
J Cutan Pathol 2006

2. Lipodissolve for Subcutaneous Fat Reduction and Skin Retraction.
Aesthetic Surg J 2005; 25:530-543.

3 PC treatment to induce lipolysis.
Journal of Cosmetic Dermatology Volume 4, Issue 4, Page 308-313, Dec 2005.

4. Lipomas treated with subcutaneous deoxycholate injections.
J.Am Acad Dermatol,53(6):973-8, dec 2005

5. Cosmetic Use of Injectable PC on the Face. Otolaryngol Clin N Am 38 (2005) 1119-1129

6. Examination of blood values after subcutaneous administration of PC.
Academy of cosmetic surgeons, EACS, Austria

7. Treatment of lower eyelid fat pads using PC: clinical trial and review.
Dermatol Surg 2004; 30: 422-7.

8. The use of PC for correction of localized fat deposits.
Aesthetic Plast Surg 2003; 27: 315-8.

9. PC in the treatment of localized fat.
J Drugs Dermatol 2003; 2 : 511-8.

10. The use of PC for correction of lower lid bulging due to prominent fat pads.
Dermatol Surg 2001; 27 : 391-2.

11. Efficiancy of Injections of PC into Fat Deposits: A Non-surgical Alternative in Body-contouring?
Scientific Presentation, ‘Operative Dermatology’ Congress, 28-31 October, 2004, Frankfurt Germany.

13. The effect of PC on subcutaneous fat.
Aesthet Surg J 2003;23: 413-7.

14. Intralesional Lipolysis with Phosphatidylcholine
for the Treatment of Lipomas.
Arch Dermatol, Mar 2006; 142: 395 – 396

15. Injection lipolysis for effective reduction of localized fat in place of minor surgical lipoplasty.
Volume 26, Issue 2, (March 2006-April 2006)

Biochemical/Pharmaceutical Studies:
1. A mixed micellar formulation suitable for the parenteral administration of Taxol.
Alkan-Onyuksel H, Ramakrishnan S, Chai HB, Pezzuto JM. Pharm Res 1994, 2003;11: 206-12.

2. Preclinical safety evaluation of intravenously administered mixed micelles.
Teelmann K, Schlappi B, Schupbach M, Kistler A. Arzneimittelforschung 1984;34: 1517-23.

3. Increasing drug solubility by means of bile salt-phosphatidylcholine-based mixed micelles.
Hammad MA, Muller BW. Eur J Pharm Biopharm 1998;46: 361-7.

4. Structural and kinetic studies on the solubilization of lecithin by sodium deoxycholate.
Lichtenberg D, Zilberman Y, Greenzaid P, Zamir S. Biochemistry 1979;18: 3517-25.

5. Investigation on mixed micelle and liposome preparations for parental use on soya phosphatidylcholine. Durr M, Hager J, Lohr JP. Eur J Pharm Biopharm 1994;40: 147-56.

Liposuction No Longer the Most Popular Surgical Procedure According to New Statistics

American Society for Aesthetic Plastic Surgery reports 10.2 Million Cosmetic Procedures in 2008

NEW YORK, NY (March 16, 2009) – Over 10.2 million cosmetic surgical and nonsurgical procedures were performed in the United States in 2008, according to statistics released today by the American Society for Aesthetic Plastic Surgery. The Aesthetic Society, after collecting multi-specialty procedural statistics since 1997, says the overall number of cosmetic procedures has increased 162 percent since the collection of the statistics first began. The most frequently performed nonsurgical procedure was Botox injections and the most popular surgical procedure was breast augmentation.

“For the first time in the twelve years these statistics have been collected liposuction is a runner up in popularity to breast augmentation. There is no doubt that this turnabout will generate discussions in the medical community and the public at large,” Alan Gold, MD, Aesthetic Society president, reflects that “changes in fashion, i.e. décolletage baring styles, might be a factor behind this change.”
TRENDS AND DEMOGRAPHIC DATA

Top surgical and nonsurgical cosmetic procedures among men and women in 2008:
Surgical # procedures Nonsurgical # procedures
Breast Augmentation: 355,671 Botox 2,464,123
Lipoplasty (liposuction) 341,144 Laser Hair Removal 1,280,964
Eyelid Surgery 195,104 Hyaluronic Acid
(including Hylaform, Juvederm, Perlane/Restylane) 1,262,848
Rhinoplasty 152,434 Chemical Peel 591,808
Abdominoplasty 147,392 Laser Skin Resurfacing 570,880
Top cosmetic procedures for WOMEN:
Surgical # procedures Nonsurgical # procedures
Breast augmentation 355,671 Botox 2,239,024
Lipoplasty 309,692 Hyaluronic Acid
(including Hylaform, Juvederm, Perlane/Restylane) 1,200,420
Eyelid surgery 166,426 Laser Hair Removal 1,101,255
Abdominoplasty 143,005 Chemical Peel 554,492
Breast Reduction 139,926 Laser Skin Resurfacing 532,008
____________________________________________________________________________________________________
Women had almost 92 percent of cosmetic procedures. The number of procedures (surgical and nonsurgical) performed on women was over 9.3 million, a decrease of over 11 percent from the previous year. Surgical procedures decreased 15 percent; nonsurgical procedures decreased by 11 percent. Since 1997, surgical procedures increased 104 percent, while nonsurgical procedures have increased 233 percent.

Top cosmetic procedures for MEN:
Surgical # procedures Nonsurgical # procedures
Liposuction 31,453 Botox injection 225,099
Rhinoplasty 30,174 Laser hair removal 179,708
Eyelid Surgery 28,678 Hyaluronic Acid
(including Hylaform, Juvederm, Perlane/Restylane) 62,428
Gynecomastia 19,124 IPL laser treatment 46,887
Hair transplantation 18,062 Microdermabrasion 39,824
____________________________________________________________________________________________________
Men had over 8 percent of cosmetic procedures. The number of procedures (surgical and nonsurgical) performed on men was over 800,000 a decrease of over 21 percent from the previous year. Surgical procedures decreased 18 percent; nonsurgical procedures decreased 22 percent. Since 1997, surgical procedures have decreased over 15 percent while nonsurgical procedures have increased 239 percent.
Frequency of cosmetic procedures by AGE GROUP:
% of total Age # procedures Top surgical procedure Top nonsurgical procedure
45% 35-50 4.6 million Liposuction Botox
26% 51-64 2.7 million Eyelid Surgery Botox
22% 19-34 2.2 million Breast augmentation Laser Hair Removal
6% 65 and over 634,667 Eyelid Surgery Botox
2% 18 and under 160,283 Rhinoplasty Laser Hair Removal
Racial and Ethnic Distribution

Racial and ethnic minorities accounted for 20 percent of all cosmetic procedures in 2008. Hispanics again led minority racial and ethnic groups in the number of procedures: Hispanics, 8 percent; African-Americans, 6 percent; Asians, 4 percent; and other non-Caucasians, 2 percent.

Location and Fees
Over fifty-three percent (53 percent) of cosmetic procedures in 2008 were performed in office-based facilities; 26 percent in freestanding surgicenters; and 19 percent in hospitals. Americans spent just under $12 billion on cosmetic procedures; $7.2 billion was for surgical procedures, and $4.6 billion was for nonsurgical procedures.
About the ASAPS Cosmetic Surgery National Data Bank

ASAPS, working with an independent research firm, compiled the 12-year national data for procedures performed 1997-2008. A paper-based questionnaire was mailed to 16,000 Board-Certified physicians (6,000 Dermatologists, 6,000 Otolarynologists, and 4,000 Plastic Surgeons). A total of 894 completed and valid responses (461 Plastic Surgeons, 277 Dermatologists, and 156 Otolaryngologists) were received in time for tabulation.

Final figures have been projected to reflect nationwide statistics and are based exclusively on the Board-Certified Plastic Surgeons; Otolaryngologists; and Dermatologists. The findings have been aggregated and extrapolated to the known population of 23,600 physicians who are Board Certified in these specialties. Though the confidence intervals change by procedure, depending on the grouping’s sample size and the response variance, the overall survey portion of this research has a standard error of +/- 3.21% at a 95% level of confidence.

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REFERENCE: THE AMERICAN SOCIETY FOR AESTHETIC PLASTIC SURGERY (ASAPS) .

ASAPS reports: A Possible Cure for Unsightly Cellulite? Lipodissolve a positive option

Combination Treatment Shows Reduction in Lumpiness and Dimpling

New York, NY (January 20, 2009) – Findings from a new study published in the November/December 2008 issue of Aesthetic Surgery Journal suggest that a combination treatment using laser energy and fat transplantation shows promise in significantly improving cellulite. Cellulite is a common condition that gives the appearance of lumpiness and dimpling across the skin and is most prevalent in the thigh, hip, and buttock areas. Currently some treatments may provide temporary improvement in the dimpled appearance of cellulite, but to date there is no proven, permanent “cure” for cellulite.”Cellulite is caused by bands of fibrous tissue that connect the muscle to the skin,” says Alan Gold, MD, President of the American Society for Aesthetic Plastic Surgery (ASAPS). “If these bands are tight and the fat between the muscle and the skin bulges out between them, there will be dimpling over each of those bands. There is nothing otherwise special or unique about the fat itself in those areas.” Almost all women (and some men) have cellulite, stemming from genetic predisposition, hormonal changes and weight gain.

The treatment presented in the ASJ study first uses 1064-nm Nd:YAG laser energy conducted underneath the skin to stimulate collagen formation, skin tightening and, on a deeper level, to reduce fatty tissue. Laser treatment is followed by injections of the patient’s own fat to fill in the depressed areas. Along with visible improvement, there are very few adverse effects, most of which are mild and temporary.

“The search for the cause of cellulite and effective treatments is ongoing, however, the combination of a minimally-invasive pulsed laser treatment and autologous fat transplantation represents a viable option for women who have severe cases of cellulite,” says Robert Gotkin, MD, a plastic surgeon in New York, NY and one of the authors of the study. “All treatments have limitations and since cellulite is a chronic condition, the patient must understand that there are no miracle procedures and multiple treatments may be necessary.”

The doctors treated 52 women between the ages of 18-47 with severe cases of cellulite who had not undergone previous surgical treatments such as lipoplasty or subcision (cutting scar tissue just below the surface of the skin). After the laser tightening and fat injections, patients received a massage to evenly distribute the fat and returned the next day for physiotherapeutic postoperative treatments. The follow-up period ranged from a year to almost 3 years, and nearly 85% of the patients rated their results as “good” or “excellent”.

Various methods of treating cellulite have been proposed including:

* Liposuction
* Fat Injections
* Lower Body Lift
* Endermologie
* Injection lipolysis (ASAL Lipodissolve)
* Herbal and dietary supplements
* Creams and lotions

While some of these procedures, such as fat injections and lower body lift, have been shown to be beneficial in appropriately selected patients, others such as injection lipolysis and lotions do not have any scientific data supporting their efficacy. Liposuction, while highly effective in reducing fat deposits and improving contour, sometimes makes cellulite appear worse.

Nd:YAG laser lipolysis and autologous fat transplantation are proven procedures for various aesthetic conditions, and, the use of these same modalities for cellulite treatment, may offer both a safe and effective new alternative. “Although there is currently no ‘cure’ for cellulite, this study provides hope for people who have the most severe cases,” says Foad Nahai, MD, Editor in Chief of ASJ.

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Note:

1. In an animal study involving New Zealand rabbits, S.Klein, L. Prantl et al. of Regensburg University have demonstrated that Lipostabil can reduce fat. The results of the study have already been published. (Note: PPC and DOC are the correct chemical abbreviatians, PC and DC are often used in literature and in US)
2. The Institute for Pharmaceutical Technology (Dr. T. Blunk, A.Seitz), S.Klein, L.Prantl et al investigated both the individual substances and the combination of active substances contained in Lipostabil on live fat cells in vitro. The study is already completed, and a publication with the results has been submitted. Without wishing to anticipate the results, it can be stated that for the first time they furnish evidence-based proof of efficacy.
3. A study on the subject of cellulite by Prof. Nor El-Din of Cairo University is currently in progress. The goal of the study is to further improve the results of the Lipodissolve Lipolysis 3-step therapy through combination treatments.

High Liposuction Death Found by Survey

WASHINGTON – Some people are dying to get rid of that extra fat. Literally. A survey of plastic surgeons in the United States suggests that compared to other kinds of operations, more people die during liposuction.

The procedure is called lipoplasty. It involves sucking fat from specific spots on the body. The operation is often performed quickly and in doctors’ offices instead of in hospitals.

According to the American Society of Plastic and Reconstructive Surgeons (ASPRS), lipoplasty has become the most common cosmetic plastic surgical procedure in the U.S.

In their report, Dr. Frederick Grazer of Penn State University and Dr. Rudolph de Jong of the Thomas Jefferson Medical College suggest that outpatient elective lipoplasty may not be safe.

The report is published in the journal Plastic and Reconstructive Surgery.

Grazer and De Jong polled 1,200 members of the American Society of Aesthetic and Plastic Surgeons (ASAPS), asking them if they knew of any patient who died after liposuction. In 1996, ASPRS members performed 109,353 liposuctions.

The 917 respondents reported 95 deaths in more than 496,000 operations. That works out to one death in 5,224, or 19 per 100,000. The most common cause of death was a pulmonary thromboembolism, a blood clot.

The generally accepted death rate for any kind of elective surgery, the type not needed to save someone’s life, is one in 100,000.

The researchers say more people are killed in the U.S. during lipoplasty than in car accidents. The fatality rate for car accidents is 16.1 per 100,000.

The surgeons and the journal admit their survey was not scientific but they say the results are still disturbing.

Dr. Rod Rohrich, professor and chair of plastic surgery at Southwestern Medical Center in Dallas, doesn’t agree with some of the data but points out that lipoplasty is a major operation and shouldn’t be trivialized.

Rohrich says the report shows that people were not treating lipoplasty as a serious operation. Three-quarters of the patients who died were operated on in a doctor’s office instead of in an accredited hospital. They died after they returned home.

According to Rohrich, the ASAPS and the ASPRS, the two bodies that regulate and train plastic surgeons, will conduct their own study. The organizations will monitor 2,000 liposuction patients over two years.

U.S. survey finds high death rate for liposuction

CBC News

Some people are dying to get rid of that extra fat. Literally. A survey of plastic surgeons in the United States suggests that compared to other kinds of operations, more people die during liposuction.The procedure is called lipoplasty. It involves sucking fat from specific spots on the body. The operation is often performed quickly and in doctors’ offices instead of in hospitals.

According to the American Society of Plastic and Reconstructive Surgeons (ASPRS), lipoplasty has become the most common cosmetic plastic surgical procedure in the U.S.
In their report, Dr. Frederick Grazer of Penn State University and Dr. Rudolph de Jong of the Thomas Jefferson Medical College suggest that outpatient elective lipoplasty may not be safe.

The report is published in the journal Plastic and Reconstructive Surgery.

Grazer and de Jong polled 1,200 members of the American Society of Aesthetic and Plastic Surgeons (ASAPS), asking them if they knew of any patient who died after liposuction. In 1996, ASPRS members performed 109,353 liposuctions.

The 917 respondents reported 95 deaths in more than 496,000 operations. That works out to one death in 5,224, or 19 per 100,000. The most common cause of death was a pulmonary thromboembolism, a blood clot.

The generally accepted death rate for any kind of elective surgery, the type not needed to save someone’s life, is one in 100,000.

The researchers say more people are killed in the U.S. during lipoplasty than in car accidents. The fatality rate for car accidents is 16.1 per 100,000.

The surgeons and the journal admit their survey was not scientific but they say the results are still disturbing.

Dr. Rod Rohrich, professor and chair of plastic surgery at Southwestern Medical Center in Dallas, doesn’t agree with some of the data but points out that lipoplasty is a major operation and shouldn’t be trivialized.

Rohrich says the report shows that people were not treating lipoplasty as a serious operation. Three-quarters of the patients who died were operated on in a doctor’s office instead of in an accredited hospital. They died after they returned home.

According to Rohrich, the ASAPS and the ASPRS, the two bodies that regulate and train plastic surgeons, will conduct their own study. The organizations will monitor 2,000 liposuction patients over two years.