Long-Term Outcomes and Complication Profile After Modern Liposuction: A Multicenter Prospective Cohort Study with Five-Year Follow-up.

BACKGROUND: Liposuction is among the most frequently performed aesthetic surgical procedures worldwide. Although short-term safety has improved with modern technologies and protocols, robust long-term prospective data regarding contour durability, weight stability, satisfaction, and complications remain limited. OBJECTIVES: This study evaluated long-term aesthetic outcomes, body contour stability, patient satisfaction, weight changes, and complications after modern liposuction using standardized clinical, photographic, and patient-reported assessments. METHODS: A prospective multicenter cohort study was conducted across 8 tertiary plastic surgery centers. Patients undergoing abdominal, flank, thigh, back, or circumferential liposuction were enrolled between January 2016 and December 2019 and followed through December 2024. Primary endpoints included contour improvement, maintenance, and complication rates. Secondary outcomes included BODY-Q scores, revision surgery, weight variation, skin quality changes, and predictors of complications. Standardized photography and anthropometric measurements were obtained at baseline, 6 months, 1 year, 3 years, and 5 years. Statistical analyses included Kaplan-Meier analysis, multivariate logistic regression, and repeated-measures mixed models. RESULTS: A total of 1,248 patients were included, with a mean follow-up of 52.4 ± 11.6 months. Mean aspirated fat volume was 3,180 ± 920 mL. Stable contour improvement was maintained in 78.6% at 5 years. BODY-Q scores improved significantly from baseline (p < 0.001). Overall complication rate was 14.8%, with major complications in 1.9%. The most frequent complications were contour irregularities (5.8%), edema (4.9%), seroma (2.6%), and fibrosis (2.3%). Revision surgery was required in 8.7%. High BMI, smoking, aspirate volume >5 L, and combined procedures predicted complications. CONCLUSIONS: Modern liposuction provides durable improvement and high satisfaction with low major complication rates.