proven safe procedure provided that the existing guidelines are meticulously followed. some side effects and complications include, but are not limited to, the following: pain, which may be temporary or chronic post-liposuction fat redistribution or post liposuction weight gain bruising infections embolisms may occur when loosened fat enters the blood through blood vessels ruptured during liposuction. pieces of fat can wind up in the lungs, or even the brain. fat emboli may cause permanent disability or, in some cases, be fatal. puncture wounds in the organs (visceral perforations) may require surgery for repair. they can also prove fatal. seroma is a pooling of serum, the straw-colored liquid from blood, in areas where tissue has been removed. paresthesias (changes in sensation that may be caused by nerve compression) is an altered sensation at the site of the liposuction. this may either be in the form of an increased sensitivity (pain), or numbness in the area. in some cases, these changes in sensation may be permanent, although typical patients recover over the span of several weeks. swelling, in some cases, may persist for weeks or months after liposuction. skin necrosis occurs when the skin above the liposuction site changes color and falls off. large areas of skin necrosis may become infected with bacteria or microorganisms. burns can occur during ultrasound-assisted liposuction if the ultrasound probe becomes hot. fluid imbalance may impact you after you go home. the condition can result in serious ailments such as heart problems, excess fluid collecting in the lungs, or kidney problems. toxicity from anesthesia due to the use of lidocaine, a skin-numbing drug, can cause lightheadedness, restlessness, drowsiness, a ringing in the ears, slurred speech, a metallic taste in the mouth, numbness of the lips and tongue, shivering, muscle twitching and convulsions. lidocaine usage has already been linked to deaths from liposuction. scars at the site of the incision are usually small and fade with time, although some may be larger or more prominent. deformities in the shape of the body may occur at the liposuction site after the procedure for about 20% of patients. death serious complications include deep vein thrombosis, organ perforation, bleeding, and infection. death occurs in about one per ten thousand cases. history in 1977, fischer and fischer reviewed 245 cases with the planotome instrument for treating cellulite in the lateral trochanteric (hip-thigh) areas. there was a 4.9 per cent incidence of seromas, despite incision-wound suction catheters and compression dressings; 2.0 per cent of the cases presented pseudo-cyst formation that required removal of the capsule (cyst) through a wider incision (>5 mm (0.20 in)) and the use of the panotome. relatively modern techniques for body contouring and removal of fat were first performed by a french surgeon, charles dujarier, but a 1926 case that resulted in the amputation of the leg of a french dancer due to excessive tissue removal and too-tight suturing set back interest in body contouring for decades. liposuction evolved from work in the late 1960s from surgeons in europe using techniques to cut away fat, which were limited to regions without many blood vessels due to the amount of bleeding the technique caused. in the mid-1970s in rome, arpad and giorgio fischer created the technique of using a blunt cannula linked to suction; they used it only to remove fat on the outer thighs. yves-gérard illouz and fournier extended the fischers' work to the whole body, which they were able to use by using different sized cannulae. illouz later developed the "wet" technique in which the fat tissue was injected with saline and hyaluronidase, which helped dissolve tissue holding the fat, prior to suctioning. lidocaine was also added as a local anesthetic. fournier also advocated using compression after the operation, and travelled and lectured to spread the technique. the europeans had performed the procedures under general anesthesia; in the 1980s american dermatologists pioneered techniques allowing only local anesthetics to be used. jeffrey klein published a method that became known as "tumescent" in which a large volume of very dilute lidocaine, along with epinephrine to help control bleeding via vasoconstriction, and sodium bicarbonate as a buffering agent. in 2015 liposuction surpassed breast augmentation surgery as the most commonly performed cosmetic procedure in the us.