Surgical Emphysema Post Liposuction Overseas: A Case Report

Liposuction is the most common surgical procedure performed globally. It is generally associated with low rates of major complications. Cosmetic surgery tourism has seen a steep incline in popularity and is often favorable to patients because of lower costs. However, it can be associated with higher complication rates and poorer follow-up. In this case report, the authors describe a case of severe symptomatic subcutaneous emphysema following air travel post liposuction. A 49-year-old male presented to the emergency department in the United Kingdom with pain, bruising, and swelling post liposuction to the chest, abdomen, and flanks. At Day 5 postoperatively, the patient embarked on a 5-hour plane journey, during which they experienced a significant increase in pain and swelling. On examination, there was audible crepitus at the upper abdomen and chest. A computerized tomography scan revealed extensive subcutaneous emphysema with associated skin thickening, subcutaneous fat stranding, and fluid. In this case, subcutaneous emphysema is likely a direct result of surgical technique. This case is unique in the severity of the symptoms described and the presumed role of air travel in their exacerbation. It is important that patients are adequately counseled on risks that may arise because of flying in the close postoperative period. Another issue highlighted is the increasing number of presentations to UK public hospitals following cosmetic tourism. Subcutaneous emphysema is a recognized but rare complication of liposuction. Patients should be adequately informed of adverse events that can arise following cosmetic surgery and subsequent travel. <b>Level of Evidence: 4</b> (Therapeutic).