case history:  piriformis syndrome caused by liposuction

A CASE OF PIRIFORMIS SYNDROME
CAUSED BY LIPOSUCTION

Liposuction Nightmare

Paravis

The picture on the left (from Wikimedia) carried the caption, “Power-assisted liposuction is the technique being performed in this image. The cannula is inserted to about 80% of its full length.”  From the picture on the right you you get a better idea of the length of a cannula.   Does a foot-long cannula that’s vigorously probed and bobbed into subcutaneous tissue (particularly FASCIA) have the potential to cause problems?  That is the topic of today’s post.

A little over a year ago, a site for plastic surgeons (Plastic Surgery dot org) proudly stated that, “The American Society of Plastic Surgeons (ASPS) reported that 15.6 million cosmetic procedures, including both minimally-invasive and surgical, were performed in the United States in 2014, an increase of 3 percent since 2013.”  Surgery dot org’s March 20, 2014 article Statistics, Surveys, and Trends stated that, “This year, liposuction replaced breast augmentation as the most frequently performed surgical procedure with a 16% increase (363,912 procedures performed) and more than one billion spent on the procedure nationwide.”  With the popularity of television shows like Nip / Tuck, there’s no argument that plastic surgery — once only for the rich and famous — is being increasingly sought by rank and file citizens.

Liposcution involves using a hollow instrument (the cannula) to “vacuum” out fatty tissue from under the skin.  Although most of the side effects of this procedure are temporary and relatively minor (swelling, pain, bruising, etc), the internet is rife with plastic surgery nightmares.  Listen to what a popular online encyclopedia had in a bullet point on a list of potential side effects for liposuction.  “Sometimes the cannula movement can cause friction burns to skin or nerves.  Sometimes the cannula can damage tissue beneath the skin, which may show up as a spotted appearance on the skin surface.”  If you want to get the low-down on liposuction, don’t simply look at the ads that parade themselves as “information,” put out by plastic surgeons.  Instead, cruise on over to the message boards and plastic surgery support groups.  You’ll quickly realize that IN SIMILAR FASHION TO OTHER MEDICAL PROCEDURES, side effects of plastic surgery (liposuction included) are dramatically under-reported.

JENNY’S STORY

I hope to be considered for treatment in your clinic.  I’ve had so much pain due to piriformis syndrome. I am a fit 66 year old female, extremely active, and do not look my age.   I am totally down now because of pain.  Sitting or standing causes a great deal of pain, and everything else causes lesser degrees of pain.   I have never had anything like this before, only once and a while lower back pain.

This pain started just after I had liposuction done on fat stomach, and mid-section.  I actually thought it went well and was pleased with the results.  I started hurting after a couple of weeks and have gotten progressively worse since.  I did make a call back to the surgeon about piriformis and she said it was unrelated, telling me to go see my primary doc.  Since then, I’ve had frequent appointments to my doctor (drugs) and chiropractor (ultrasound, adjustments, and massage) but came away with no relief at all.  Nothing has helped and I won’t take any more pills because they put me in a sickly state of mind.

Thanks for your time, Jenny

I have actually seen a fair number of people messed up by elective plastic surgery (the most common being from breast implants, which tend to leak, causing FIBROMYALGIA and AUTOIMMUNE REACTIONS).  Jenny is a small, petite woman (not OBESE OR OVERWEIGHT in the least) who had what she described as a “paunch” (the result of several children) that she wanted gone. 

Her belly has several small scars made by the holes that were created to insert the cannula (there were four in a straight line across — just like the pic above).  A couple inches underneath her right front rib cage was a fairly large lump.  Although this lump was not itself SCAR TISSUE or DENSIFICATION, the tissue just below it was (about the size of her palm).  Because PIRIFORMIS SYNDROME is often OFTEN LINKED to HIP FLEXOR PROBLEMS, I continued working downward. 

She had some fairly intense Scar Tissue arising from the area of the quad, IT BAND, and adductor magnus.  She also had a great deal of Scar Tissue on her buttock and UPPER HAMSTRING — right up to midline.  The initial treatment took approximately 1.5 hours and was followed immediately by COLD LASER.  

Jenny went back to her motel to STRETCH and heal for a few days (I sent her out with some LIGAPLEX as well), with instructions to stay in touch.  I told her that I would examine her in a few days and see if another treatment was warranted (if the first treatment does not help at all, it is far less likely that further treatment will help).    I took a look at her yesterday and told her that I would treat her on Monday morning since the BRUISING needs to be gone (or nearly so) before I could do another treatment.

What what the mechanism that caused Jenny’s mess?  Was her liposuction procedure the culprit?   Although I have no real way of knowing, my best guess is that even though she exhibited no symptoms of Piriformis Syndrome, she had some risk factors predisposing her toward this problem.   The procedure likely destabilized the area, quite possibly by traumatizing it more than she could tolerate — see the link below.

Before you drop a fat wad of hard-earned cash to have plastic surgery, I would suggest you think of Jenny.  Then head over to YouTube and watch some liposuction videos.  In this “NORMAL” LIPOSUCTION PROCEDURE (this video is actually an “advertisement” for a specific plastic surgeon), notice how the cannula is jabbed in and out over and over and over again in a manner that would not be doing it justice to describe as ‘forceful’.  I can’t help but recall the words of MY BROTHER; an MD, who was relaying the story of a friend who had died during an elective surgery.  “There’s no such thing as a ‘routine’ surgery.  All surgery is more dangerous than people realize.  Unless you really need to have it done, run far and run fast.

How much am I really going to be able to help Jenny?  I’m not sure, but will try to do an update in a few weeks.  For the record, she had no liposcution done on her back-side or her sides.  Everything was done to her lower abdomen.

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