Does anybody here perform the "awake tumescent liposuction"? It seems that more and more physicians who are performing this are primary care docs and several 2-3 day courses claim they'll train you for a few thousand dollars. One of the more successful docs performing this locally is a radiologist! It is done by local anesthesia mixed with epinephrine, then suction with or without laser assistance. How safe is this to do as a primary care doc? Is smartlipo the same thing? Do malpractice insurances charge an arm and a leg if you choose to add this to your practice? I know these are amateur questions but I'm just seeing what is "safe" and whats not and I'm new to this field. Any insight is appreciated!! Thanks!

The risk of complications seem to outweight doing this procedure as a PCP. I see that some of these laser assisted lipos have higher risk of bowel perforation, embolism.... while we can be trained to minimize these risks, some of these are unpreventable as it's a percentage - will the family doc who decided to do lipo have a defense if this happens? It just seem scary to offer this invasive procedure since risks are there no matter how careful you are and the hungry lawyer is drooling waiting for this to happen. Comments?

CD: Seems minimally invasive liposuction is the way to go theses days. There are some nice technologies out there such as the ProLipo, CoolLipo ect. with the superficial nature of the wand used in these procedures it seems complications can be minimized. I think most here wound agree the removing of 5-15 lbs of fat w/ conventional lipo might be best left to surgeons; the bowel-perf complics you mentioned should not be seen in the superficial plane of operation of the millimeter-sized "wand" used in newer sculpting laser-lipos. For Me, I'm hoping Ultrashape comes along soon as it looks very promising.

This depends on your current carrier and how you are classified. Most admitted markets are leary of this new procedure if you are not a plastic surgeon. There is not a lot of history of claims to draw from. Many non-admitted carriers will write the risk, but this also depends on the other services that you are performing at the present time. It is best to see if your current or prospective malpractice carrier will cover this before getting training or buying the equipment.

I have been performing lipo for 10 years and learned it from a dermatologist. I think it is fine for a primary M.D. to perform lipo as long as he is properly trained. I disagree that bowel perforations are common . An experienced lipo surgeon should never have a bowel perforation. Also true tumescent lipo awake PEs are also rare. However the comment about lawyers and insurance is very true. As a general surgeon I have been criticized about performing lipo. Icant imagine what a lawyer would use against a nonsurgeon performing lipo. Best thing to do is to start slow , have some backup and pick nice patients to operate on.