The American Board of Plastic Surgery (ABPS) has collected data on cosmetic surgery tracers as part of the Continuous Certification (CC) process since 2005. These data offer valuable information on national trends in clinical practice. The present study was performed to analyze evolving trends in Suction-Assisted Liposuction (SAL) from the ABPS cosmetic tracer procedures.
Tracer data was review from 2005 to 2021 and grouped into an “early cohort (EC)” from 2005-2014 and a “recent cohort (RC)” from 2015-2021. Fisher’s exact tests and two-sample t-tests compared patient demographics, surgical techniques, and complication rates.
Data from 2810 SAL cases were included (1150 EC, 1660 RC). In-office procedures have increased (36%EC vs 41%RC, p<0.01), while the use of general anesthesia has remained the same (63%EC vs. 62%RC, p=0.01). Power-assisted liposuction (PAL) has increased in popularity (24%EC vs. 40%RC, p<0.001) while ultrasound-assisted (UAL) has decreased (5% vs. 2%, p<0.0001). The volume of lipoaspirate is increasing (1150cc EC vs. 1660cc RC, p<0.0001). With respect to body areas treated, the abdomen (64% EC vs. 69% RC, p<0.01), flank (60%EC vs. 64%RC, p<0.05), and back (22%EC vs. 34%RC, p<0.0001) have increased, while thighs (36%EC vs. 23%RC, p<0.0001) and knees (8%EC vs. 5%RC, p<0.01) have decreased. Position changes from prone to supine are more common (30%EC vs. 37%RC, p<0.0001) and surgeons are reporting more SAL of multiple areas in one case (28%EC vs. 36%RC, p<0.0001). Perioperative heparin use has significantly increased (2%EC vs. 7%RC, p<0.0001) during liposuction.
This study highlights evolving trends in the clinical practice of liposuction over the last 16 years. We find that liposuction is becoming increasingly common in an outpatient setting and being performed concomitantly with other procedures. Despite multiple emerging technologies, the popularity of PAL is increasing. While adverse actions have not significantly increased with these changes the authors stress careful pre-operative evaluation of patients to identify factors that increase the risk of complications, especially those associated with combined procedures and liposuctions of multiple areas.

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