Plastic Surgeon Describes Post-Operative Standard of Care for Cosmetic Surgery Patients

This case involves a male patient in his mid 30’s who underwent liposuction. He was discharged soon after he was finished with the procedure. He was sent home with drains and was supposed to be monitoring blood flow through the drains. About 12 hours following his discharge, he reportedly got light headed and collapsed. The patient broke both his wrists from the fall and was taken to the hospital for surgery. The doctors discovered that there was profuse bleeding coming from his abdomen since it was never cauterized. He was stabilized, but he had to undergo extensive rehabilitation for his broken wrists.

Question(s) For Expert Witness

1. Do you routinely treat patients similar to the one described in the case?

2. Have you ever had a patient develop the outcome described in the case?

3. What are the common complications of the procedure in question?

4. What is the standard follow-up and discharge instructions?

Expert Witness Response E-001709

In my practice I do routinely treat obese patients and perform this procedure when necessary; that said, abdominoplasty is a preferred procedure for a number of reasons. Generally, I use a range of methods to close up these patients' wounds, including cauterization. Because of the great risk of deep vein thrombosis in these patients postoperatively, it is normal to treat them with a blood thinner that does raise the risk of a bleed after the surgery. I have had patients develop bleeding after the operation before. I have served as an expert witness in the past on similar matters, and it is important for doctors to carefully monitor postsurgical bleeding in patients such as this.