Peter Attia· MD
you have to take that cannula and instead of moving outside of the plane where the fat is you you have to turn the cannula inward right right so you know the most common area of liposuction is the abdomen so if someone is liposuction in the upper abdomen you obviously have to understand the anatomy you have a ribcage there so you have to stay above the ribs but if you're not paying attention you're not feeling and aware with what you're doing it'd be pretty easy to slip underneath the rib well if you go underneath the rib the next thing you encounter there is the rectus muscle and then the diaphragm and so these thin cannulas are actually riskier a one to two millimeter cannula it's easy to just push right through the abdominal wall and into what the next layer why not use a blunt cannula instead they aren't they are blunt but it still there have been multiple multiple cases of this happening and does anyone ever do this with an outlet because if you're doing liposuction on someone who's subcutaneous fat but they're not incredibly big presumably the risk of this is lower is this more thing so but we still see it in thin patients so ultrasound guidance wouldn't help when you're in those areas it probably would it's sort of impractical because then you have to introduce an ultrasound sterile II and then you need either the person doing the liposuction knows how to use the ultrasound or they have to bring in someone else so that is not typically done I think it would increase the safety but you know a well trained surgeon who knows the anatomy and knows what they're doing have to get pretty lost to end up in the lung or the liver what's the typical path or taking to the lungs it's at inferior through the diaphragm as well yeah it's through the diaphragm or when they're liposuction in the side of the bra line which is a common area during a breast reduction or another procedure women want to get rid of that bra fat and so you have to stay outside of the ribcage so if you're the angle of the cannula is wrong you could easily puncture in and end up in the lung