Chethana Raj's death: How fat removal surgeries can go horribly wrong for some

Time and again, one hears of liposuction surgeries that go horribly wrong. In February 2018, AIIMS in Delhi told a news magazine how they discovered during autopsy that a 34-year-old man had died during a liposuction operation due to fat embolism syndrome.

‘Fat embolism’ is one of the life-threatening risks linked to fat removal or liposuction surgeries, which doctors in Bengaluru claim, probably, took the life of 21-year-old TV actress Chethana Raj, who died from complications arising while undergoing a fat-removal surgery at a private hospital in Bengaluru on Monday (May 16).

In fat embolism, fat droplets from liposuction areas enter the veins and travel to the lungs, eventually causing the heart to stop functioning.

Chethana, who had apparently been driven to have a liposuction because of being body shamed, had checked into Dr Shetty’s Cosmetic Clinic at Rajajinagar, Bengaluru, on Monday (May 16) morning without telling her parents. However, after the procedure, fluid accumulated in her lungs and she was rushed to Kaade Hospital the same evening, where, efforts were made to revive her for 45 minutes, without any results. The hospital maintained that she was brought in dead.

The distraught parents have alleged medical negligence and plan to file a complaint against the clinic. Chethana’s death due to fat removal surgery again brings to the fore the hazards involved in such surgeries. Here’s what you need to know about this extremely popular cosmetic surgery in India and the risks involved:

What is fat-free surgery or liposuction?

Liposuction is a cosmetic procedure that removes fat that you can’t seem to get rid of through diet and exercise, according to WebMD.

A plastic or dermatologic surgeon usually does the procedure on the hips, belly, thighs, buttocks, back, arms, and under the chin or face to improve their shape.

According to Mayo Clinic, to be a candidate for liposuction, you must be in good health without conditions that could complicate surgery — such as restricted blood flow, coronary artery disease, diabetes or a weak immune system.

There are different kinds of liposuctions

Tumescent liposuction is the most common technique. The surgeon injects a sterile solution into the area where the fat is to be removed. It consists of saline – which is salt water – along with lidocaine and epinephrine. The solution makes it easier to suction the fat with less blood loss and pain.

Ultrasound-assisted liposuction, or UAL, uses sound wave energy under your skin to rupture the cell walls of the fat. This liquefies the fat so it can be suctioned out.

Laser-assisted liposuction, or SmartLipo, uses a laser to produce a burst of energy to liquefy the fat.

Risks involved in fat removal surgeries

As with any major surgery, liposuction carries risks, such as bleeding and a reaction to anesthesia. Possible complications specific to liposuction includes catching infections, numbness in the affected area or there could be an internal puncture, when a cannula that penetrates too deeply may puncture an internal organ. This may require emergency surgical repair.

Generally, according to medical websites, the risks range from severe bruising and inflammation to very serious ones such as thrombophlebitis — a blood clot forms in a vein, causing inflammation and further complications,

There’s also fat embolism. In this case, which is probably what doctors believe may have happened to Chethana, pieces of loosened fat may break away and become trapped in a blood vessel and gather in the lungs or travel to the brain. A fat embolism is a medical emergency.

According to doctors, fat embolism syndrome following liposuction is a life-threatening complication, although its incidence is low. Currently, there is no specific therapy for fat embolism syndrome, so prevention, early detection and supportive therapy are critical, said a Bengaluru doctor to the media.

Kidney and heart problems. Shifts in fluid levels as fluids are being injected and suctioned out can cause potentially life-threatening kidney, heart and lung problems.

Lidocaine toxicity. Lidocaine is an anesthetic often administered with fluids injected during liposuction to help manage pain. Although generally safe, in rare circumstances, lidocaine toxicity can occur, causing serious heart and central nervous system problems.

What precautions should one take?

Before going in for these surgeries, it is best to educate oneself about the procedure and risks, and clear doubts with the doctor to reduce the risk of complications.

One has to be totally honest about your medical history with the doctor and inform him or her about all past surgeries or sicknesses and even about allergic reactions.

Also ensure that you opt for a reputed surgeon and those who have the proper accreditation.

Doctors say that those opting for these surgeries will have to give up on smoking and alcohol and avoid doing any heavy activities or driving.