liposuction · PAL · port-site complications · skin port · UAL · VASER ·

Port-Site Complications After Liposuction: Causes and Prevention

Liposuction is one of the most common cosmetic procedures in the United States, and fat grafting continues to grow. Both depend on small access incisions, and both share a complication that gets little attention in the literature: damage at the port site.1 It's rarely dangerous, but it is visible. A dark ring or raised scar at the access point is something the patient sees long after the contour has settled.

What happens at the port

During liposuction the cannula moves back and forth through the incision hundreds of times. Each stroke rubs the skin edge. In ultrasound-assisted liposuction, contact with a hot probe can add thermal injury to the mechanical friction.2 Power-assisted devices add vibration and speed to the same movement.

Common port-site complications

  • Friction burns at the incision edge3
  • Cutaneous hyperpigmentation1,3
  • Hypertrophic scarring1
  • Wound dehiscence and infection1
  • Skin necrosis at the access site3

What the evidence shows

A 2024 retrospective study compared 60 consecutive patients: the first 30 without any port protection, the next 30 with a segment of suction tubing sutured into the incision. Port-site complications fell from 33.3% to 6.7% (p = .0093), and the protected patients needed less wound care, fewer steroid injections and fewer revisions.1 In a swine model, 20 minutes of simulated liposuction without protection produced a burn with oedema and serous discharge, while protected skin showed no burn signs.5

Options for protecting the port

Improvised protectors. Surgeons have described using cut suction tubing,1 a trimmed 1 ml syringe barrel2 and pieces of nasopharyngeal airway.3 They are cheap and available in any OR, but they have no defined sizes, need to be cut and fitted for each case, and can slip or vary between cases.

Wet towels around the port protect the surrounding skin and were part of the original VASER protocol, alongside dedicated skin ports.4

Purpose-built skin ports such as Exo-Port™ provide defined sizes matched to cannula diameter, an obturator for insertion and a suture disc to hold the port in place. They are reusable and autoclavable, so the setup is the same every case.

A practical checklist

  1. Size the port to the cannula. Match the cannula's outer diameter. Go one to two sizes up for basket or etching cannulas. See our Sizing Guide.
  2. Secure the port so it stays seated as the cannula moves.
  3. Protect the surrounding skin in energy-assisted cases, for example with wet towels next to the port.
  4. Keep the port in place for the whole time the cannula is working through that incision.
  5. Follow your device manufacturer's guidance on energy settings and technique.

Want to see whether a purpose-built port suits your technique? The Exo-Port sample pack includes all three standard sizes.

References

  1. Moyer HR, Sisson KM. Liposuction port-site protection: necessity or needless expense? Aesthetic Surgery Journal Open Forum, 2024. https://doi.org/10.1093/asjof/ojae098
  2. Bank J, Song DH. Inexpensive method of liposuction cannula port-site protection. Aesthetic Plastic Surgery, 2013;37:843. https://doi.org/10.1007/s00266-013-0130-4
  3. Salhi S, Meunier F, Cordoba C. Use of a nasopharyngeal cannula as a skin protector during lipoaspiration. JPRAS Open, 2017;12:87–90. https://doi.org/10.1016/j.jpra.2017.04.004
  4. Jewell ML, Fodor PB, et al. Clinical application of VASER-assisted lipoplasty: a pilot clinical study. Aesthetic Surgery Journal, 2002. https://www.qxmd.com/r/19331963
  5. Evaluation of the effectiveness of a modified liposuction protective device: an experimental study in swine. Revista Brasileira de Cirurgia Plástica. https://scielo.br/j/rbcp/a/GpPw5NbYngQjRGmP53Q8MQg/?lang=en

This article is written for healthcare professionals and is provided for information only. It is not medical advice.

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