Analysis of methods for reporting severe and mortal lipoplasty complications

During the past 2 years, media attention has focused on catastrophic outcom es associated with liposuction. A critical review of the lipoplasty literat ure was undertaken to determine the incidence of severe and mortal complica tions. Reported lipoplasty complications and patient outcome studies publis hed in the English literature through January I, 1999, were reviewed. From these and from ASPRS questionnaire surveys of experienced, board-certified plastic surgeons, it is apparent that (1) plastic surgeons do not often vol untarily report severe and mortal complications (either as case reports or in self-reported series), and (2) while survey studies provide the most acc urate estimate of complications due to lipoplasty, they are subject to an u nderreporting bias because they exclude complications occurring in the hand s of residents and junior attendings. The mortality from lipoplasty procedu res is higher than the 0.003 to 0.02% reported in the literature and may be as high as 0.1%.