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Liposuktion—kein Problem?

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Zusammenfassung

Das Verfahren der subkutanen Liposuktion in Tumeszenzanästhesie stellt in den USA einen der häufigsten ästhetisch-korrektiven Eingriffe dar. In der Bundesrepublik Deutschland werden bei steigender Tendenz pro Jahr ca. 200.000 Liposuktionen von Ärzten verschiedener Fachrichtungen, darunter Plastische Chirurgen, Dermatologen, Hals-Nasen-Ohren-Ärzte, Gynäkologen und Mund-Kiefer-Gesichts-Chirurgen durchgeführt. Die Methode gilt als einfach erlernbar, sicher, wenig belastend und damit für den ambulanten Bereich als prädestiniert. In der Literatur finden sich zunehmend Berichte über schwere Komplikationen mit Todesfolgen, derzeit wird die Mortalität mit 1/5000 Liposuktionen angegeben. Neben falscher Patientenselektion sind als Gründe für diese schweren Komplikationen vor allem insuffiziente Hygienemaßnahmen, Megaliposuktionen mit Infiltration zu großer Mengen Tumeszenzlösung und entsprechender Medikamentenüberdosierung, multiple Eingriffe pro Sitzung, mangelhafte postoperative Überwachung sowie ein insuffizientes Komplikationsmanagement zu nennen.

Abstract

Subcutaneous liposuction in tumescent technique is the most frequent aesthetic plastic procedure in the United States. In Germany, nearly 250,000 liposuctions are done per year by a variety of surgical and nonsurgical specialists including plastic surgeons, dermatologists, gynecologists, oral surgeons, and otolaryngologists in settings ranging from hospital operating rooms to physicians' offices. The method is applied and promoted as an easy-to-learn technique that is suited as an outpatient procedure. Although major complications seem to be rare, there are definite risks, including death at a rate of 1/5,000 procedures. Major risk factors are insufficient hygiene standards, multiliter wetting solution infiltration, megavolume aspiration, multiple cosmetic procedures in one setting, sedative and anesthetic drug hangover threatening ventilation, permissive postoperative discharge, and mistakes in patient selection. When major complications occur, office-based practitioners may refer patients to hospital emergency departments, where medical personnel unfamiliar with this procedure may underestimate the risk of major complications.

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Authors and Affiliations

  1. Universitätsklinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgiezentrum, Operatives Referenzzentrum für Gliedmaßentumoren, BG-Kliniken Bergmannsheil, Ruhr-Universität Bochum

    M. Lehnhardt, H. H. Homann, D. Druecke, L. Steinstraesser & H. U. Steinau

  2. Universitätsklinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgiezentrum, Operatives Referenzzentrum für Gliedmaßentumoren, BG-Kliniken Bergmannsheil Bochum, Ruhr-Universität Bochum, Bürkle-de-la-Camp-Platz 1, 44789 , Bochum

    M. Lehnhardt

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  1. M. Lehnhardt
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  2. H. H. Homann
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  3. D. Druecke
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  4. L. Steinstraesser
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  5. H. U. Steinau
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Correspondence to M. Lehnhardt.

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Lehnhardt, M., Homann, H.H., Druecke, D. et al. Liposuktion—kein Problem?. Chirurg 74, 808–814 (2003). https://doi.org/10.1007/s00104-003-0727-2

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