A Road Map to Post-Liposuction Peace



Title: Lifestyle Outcomes, Satisfaction, and Attitudes of Patients After Liposuction

Authors: George Broughton II, MD, PhD, Bauer Horton, BS, Avron Lipschitz, MD,

Jeffrey M. Kenkel, MD, Spencer A Brown, PhD, Rod J. Rohrich, MD,

Liposuction is the most commonly performed cosmetic procedure1. Liposuction has a well-documented safety record2, however there are few reports in the plastic surgery literature discussing patient satisfaction after their liposuction. From the available literature, 90% (n=159) of patients were “completely or mostly satisfied”3 with their surgery. A large questionnaire survey reported in 19934 that 76% (n=990) of responders were satisfied. In a more recent survey,5 74.8% (n=123) had an “increase in self-esteem”, 80.5% were “more confident”, and 83.7% thought that “they felt happier about their shape when looking the mirror.” To our knowledge, no report has examined patient’s attitudes and post-operative opinion, lifestyle changes, weight gain changes and satisfaction of their liposuction procedure in general and by specific site. We now report on data from a survey provided to patients from two plastic surgeons at University of Texas Southwestern Medical Center at Dallas.

Method: A self-assessment survey was mailed to 600 patients who had either SAL (suction-assisted liposuction) or SAL/UAL (ultrasound assisted liposuction) surgery performed by the authors (RJR and JMK) between January 1996 and January 2003. Four hundred (400) patients had liposuction procedures by RJR and two hundred (200) patients by JMK. The questionnaire was reviewed and approved by the Institutional Review Board, University of Texas Southwestern Medical Center, Dallas, Texas. Patients responded to the survey anonymously and were instructed to check their responses to the questions. The survey asked for general information about the procedure(s), area(s) of liposuction, lifestyle habits, and satisfaction. All but two of the questions were multiple-choice, closed-ended questions. Two questions at the end of the survey asked the reader to “Please comment on your overall satisfaction with your liposuction procedure” and “If you have any additional comments please list them here”. There were half-a-dozen responses that were compliments or “thank yous”. The questionnaire was divided into five general areas:

1. Time elapsed since liposuction and areas liposuctioned

2. Post-operative discomfort and analgesic use

3. Weight gain and fat return

4. Lifestyle Habits

5. Satisfaction and appearance

There were 108 undeliverable surveys and 209 completed surveys were returned (34.8% of 600 and 42.5% of 492 surveys). Data were analyzed by Chi Square and a probability value p of less than 0.05 was considered significant.

Results: The majority of patients (80%) of the patients were satisfied with their results. Fifty-three percent thought that their appearance was either “excellent” or “very good”. Satisfaction by site treated all had 60% or more of the responders “very satisfied” or “satisfied” with their results. Weight gain was reported in 43% of the responders with 56% of them gaining between 5 to 10 pounds after six months from their surgery. Fat return was reported in 65% of the responders. The abdomen was the most common location for fat return. Approximately 75% of responders described their post-operative discomfort as mild to moderate with 60% indicating that their discomfort lasted less than 7 days (39.8% indicated their pain lasted longer than 7 days); 83% indicated that they only needed to use narcotics for 7 days of less.

Appearance assessment and overall satisfaction opinions were not affected by post-liposuction fat return (Table 1). Among all those who reported having fat return after liposuction, only 12% rated their appearance as “excellent”, 39% as “very good”, 30% as “good”, 14% as “fair” and 5% as “poor”. However, when fat return is examined with each appearance group, 46.2% of those who reported their appearance was “excellent” had post-liposuction fat return; results in the other appearance groups are: 52.4% for “very good’, 43.3% for “good’, 75% for “fair” and 66.7% for “poor”. There was a strong correlation of patients having a “fair” or “poor” appearance assessment and also reporting post-liposuction fat return (analysis with a linear regression resulted in an r2=0.94 and p=0.007). When responders are examined by fat return and overall satisfaction (Table 1) among those reporting fat return 34% were overall “very unsatisfied”, 48% were “satisfied”, 14% “unsatisfied” and 4% were “very unsatisfied”. Looking within each satisfaction group and fat return, only 37.9% of all “very unsatisfied” responders also reported having post-surgical fat return. Surprisingly, those patients who were “very satisfied” or “satisfied” with their results had a higher percentage of reported fat return (49.2% and 53.2%, respectively) than those who were “unsatisfied” or “very unsatisfied” (37% and 37.9%, respectively). The reported distribution of fat return among all four satisfaction groups was statistically significant (r2=-0.99 and p ................
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