“The Progression of Liposuction” by Dr. W. Hall
by Dr. William Hall
While two Italian-American surgeons — Drs. Giorgio and Arpad Fischer — are considered to have invented the liposuction procedure in 1974, the roots of this procedure date bake to the 1920s. What we considered the modern techniques of liposuction started with the removal of fat from the leg of a French model, who was suffering from gangrene.
In the 1960s, a procedure was developed called suction curettage; however, the results were irregular and often resulted in severe bleeding and even death. The subsequent procedures developed by Dr. Fischer used the first cannula, which was also invented by these doctors. While this represented a huge leap forward in liposuction technique, the procedure still caused many complications, including large volumes of blood loss.
A Huge Advancement Made with Tumescent Liposuction Technique
In 1985, a new liposuction method was invented by Dr. Jeffrey Klein, called tumescent anesthesia, which essentially changed the nature of liposuction surgery. Rather than requiring general anesthesia, tumescent liposuction used a local anesthesia, which was a mixture of lidocaine and epinephrine in a saline solution. This procedure is performed on an outpatient basis, with minimal side effects.
During this tumescent liposuction procedure, local anesthetic is injected into the treatment site, after which, tiny cannulas remove the fat. One of the main benefits of this method is that there is almost negligible bleeding and blood loss secondary the epinephrine’s constricting effect on the blood vessels.
Following these developments, liposuction further evolved into “liposculpture” in the 1990s. This technique used extremely small cannulaes and a cross-tunneling technique to greatly enhance accuracy and avoid irregularities under he skin. Using only local anesthesia greatly facilitated this procedure because the patients are awake and could be stood up if need be to get even more detail during the sculpting process.
Lasers Enter the Liposuction Arena
2006 saw the development of the first laser for tumescent liposculpture, called SmartLipo. This procedure was developed by Cynosure, Inc., a light-based aesthetic and medical treatment equipment manufacturer. In 2009, SmartLipo received FDA approval for use in procedures intended for the “surgical incision, excision, vaporization, ablation, and coagulation of soft tissue.”
Essentially, the SmartLipo procedure uses laser energy to soften fat in the treatment areas. Once the fat is liquefied by the lasers, it is removed using tiny cannulas. This procedure was also touted as being able to “tighten the skin” although this subject is still highly debateable in the surgical community.
As one can surmise, the improvements in the liposuction process during the past 40 years have enabled surgeons to remove more fat cells more easily and with greater accuracy. In addition, there is less blood loss, less risk, less discomfort and more rapid recovery for patients. Constant innovation in the field of liposuction will only make this procedure more dependable and sought after in years to come.
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