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Background: Postoperative infections with non-tuberculous mycobacteria (NTM) are rare. Early diagnosis is important so tailored antibiotic therapy can be started. This can prevent unnecessary radiological and surgical interventions., Case Description: A 40-year old woman underwent abdominoplasty and liposuction in Colombia. One and a half months postoperatively, she presented with a wound dehiscence followed by recurrent subcutaneous abscesses. She received multiple antibiotic courses and drainage procedures. Standard bacterial cultures remained negative. One and a half years later another abscess was drained and cultures grew Mycobacterium abscessus. Tailored antibiotic therapy was initiated and so far no large abscesses have re-occurred., Conclusion: Infections with NTM should be part of the differential diagnosis in patients with postoperative wound infections, especially after cosmetic surgery performed in Latin America and the Caribbean. Unsuccessful wound healing, infection recurrence, sterile standard bacterial cultures and the lack of response to conventional antibiotic regimens should raise the suspicion of an NTM infection.

A 58-year-old woman with myositis ossificans traumatica came to our trauma outpatient clinic because of cutaneous perforation of one of the ossifications. This patient developed myositis ossificans traumatica after liposuction of both upper legs 30 years ago, which condition was complicated by a chronic infection of the ossified right quadriceps muscle, a walking limitation, and a loss of range of motion. Myositis ossificans traumatica is a rare disorder associated with trauma- triggered ossification of otherwise normal muscle tissue.

Liposuction is one of those interventions without a medical indication that are usually performed in private clinics. The control over these clinics is regulated by the government. The control of specialists who are members of a scientific society is the responsibility of the society in question. Liposuction can be fatal and a number of serious complications are known to occur, but the frequency is unknown. The physician should discuss these possible consequences with the patient before the intervention, and adequate aftercare if complications occur must be provided.

Three days after liposuction of the lower abdomen, a 41-year-old woman was admitted for toxic shock-like syndrome with necrotising fasciitis and myositis, caused by Lancefield-group-A beta-haemolytic streptococci. The patient was treated by radical debridement of the skin, subcutis, fasciae and part of the pectoral muscle, plus antibiotics. Postoperatively she required artificial respiration for respiratory insufficiency. One week after the operation the wound was covered by transplantation of autologous skin. The patient survived, but was seriously disfigured. Necrotising fasciitis is a progressive soft-tissue infection, characterised by widespread necrosis of the superficial and deep fascia, often associated with severe systemic toxic reactions. Unless quickly recognised and aggressively treated, the course is often fatal. Due to the absence of cutaneous findings in the early stages, diagnosis is difficult. Important diagnostic aids are routine laboratory tests, contrast-MRI and a combination of the finger test and frozen-section biopsy. Treatment consists of early radical debridement, broad-spectrum antibiotics and supportive care. In a later stage, soft-tissue reconstruction with autografts or artificial skin grafts and skin transposition can be performed.

Liposuction is a frequently applied technique in aesthetic plastic surgery, with which subcutaneous adipose tissue can be removed. In recent decades new techniques of liposuction were developed. This led to better results and fewer complications. Liposuction is indicated as symptomatic treatment of obesity and (or) lipomas. Liposuction is not without risks; patients have to be informed of practical consequences and possible complications of the technique.