By Sacha Obaid
Liposuction is one of the most widely performed cosmetic procedures in the United States, with nearly half a million operations each year. Though it is now well established, fat removal through liposuction was not always so common. In fact, surgeons have been researching methods of fat removal for nearly a century; today’s successful techniques are the result of a long (and continuing) process of development, testing, and refinement.
Read on to learn about the history of liposuction, the steps (and missteps) that have resulted in the safe and effective liposuction methods available today.
Early Experiments in Fat Removal
Medical researchers have long sought a safe way to remove unwanted fat. One of the earliest attempts took place in 1921, when a French surgeon tried to carve fat deposits from a dancer’s lower legs using a curette.
Unfortunately, irreparable damage was caused, resulting in significant blood loss and partial amputation. Later attempts, though marginally more successful, still had undesirable effects including hematomas, seromas, and scarring.
Modern Liposuction Techniques Emerge
Fat removal techniques underwent a dramatic revision in 1976 when Arpad and Giorgio Fischer published a description of suction-based fat removal using a cannula—a kind of medical tube. Early cannulas had a relatively large diameter, up to 1 centimeter, which may have been a cause of problematic tissue damage in these initial applications.
Despite continuing minor issues with hematomas and seromas, the overall results achieved with Fischer liposuction were a major improvement over earlier approaches, leading to rapid developments in the field.
Liposuction Methods Mature
By using smaller cannulas and working from multiple suction sites, the tissue damage caused by earlier techniques was reduced considerably as “Liposculpture” advanced. Two French surgeons, Pierre Fournier and Yves Illouz, helped push the field even further when they ignited the “wet versus dry” debate in the late 70’s.
Also called tumescent liposuction, the “wet” technique, promoted by Yves Illouz, infused a special solution into the target area, swelling the tissue; this method had the effect of reducing blood loss and protecting nerve tissue. Though the debate continued for years, “wet” tumescent liposuction eventually became the standard method due to its superior results.
A Key Breakthrough: Tumescent Anesthesia
Until 1987, liposuction was still considered a “major” surgery, requiring general anesthesia and therefore putting each patient at risk. In that year, however, Jeffrey Klein introduced a method for providing local anesthesia. This advance simultaneously reduced the risk of infection and limited bleeding during the operation, greatly lowering the hazards involved in liposuction.
This advance has been widely adopted and is now the near-universal standard. The technique allows plastic surgeons to work much more quickly, allowing most liposuction procedures to be performed during a single office visit. Further benefits of this approach include reduced cost to the patient, faster recovery time, and an outstanding record of safety that remains unmatched.
High-Tech Lipo Options
Recent developments in liposuction have occurred in the area of lipolysis, or the destruction of fat tissue prior to suction. Both ultrasound and laser-assisted lipolysis techniques have been promoted in the media, yet there is little evidence of improved results compared to standard tumescent liposuction.