The History of Liposuction: How Today's Liposuction Techniques Came To Be

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Valerie DeBenedette, Senior Medical Editor

Valerie DeBenedette is a science writer who specializes in keeping people informed about medicine and their health. She has more than 20 years of experience writing for newspapers, magazines, and websites and has written about most areas of medicine. For many years, she was a contributing writer to Cosmetic Dermatology and to Drug Topics, the leading pharmacy trade magazine. She also was a contributing editor to The Physician and Sportsmedicine for many years. She has written about most fields of medicine, including dermatology, sportsmedicine, ophthalmology, general surgery, orthopedics, and women's health; as well as public health policy and the pharmaceutical industry. In addition, she is the author of Caffeine, a book for young people. She is a member of the National Association of Science Writers.


May 16 2008

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The History of Liposuction

The exact history of liposuction, one of the most popular cosmetic procedures in the United States, is not clear. Not only that, but several people lay claim to being either the inventor of liposuction or the person who created one type of the procedure.

The history of surgical attempts at removing fat from the body is longer than that of liposuction. Several techniques for removing fat with a scalpel were developed over the years, but none worked well and they left lumps, bumps, and really large incisions, and had a high risk of complications. The first use of suction to help remove the fat was done in Paris by a Dr. Charles Dujarier in the 1920s. Unfortunately, one of the people he worked on was a model and dancer who wanted to improve the shape of her knees. Gangrene set in and, depending on which version of the story you read, either she had to have a leg amputated or she died. The ensuing publicity stopped suction-assisted fat removal in its tracks.

Fast forward to 1974. Two Italian gynecologists, Dr. Giorgio Fischer, and Dr. Giorgio Fischer, Jr., discovered a way to cut away fat tissue within the body using a rotating scalpel inserted through small incisions. This rotating scalpel tool was essentially an oscillating blade contained within a thin metal tube called a cannula and it broke the fat up. The broken-up fat was then suctioned out through tubing by a vacuum machine, and Ecco!, liposuction was born. The Fishers' technology was primitive by today's standards, but it was liposuction.

But these early attempts at liposuction surgery were plagued by a great deal of blood loss, nerve damage, and unpredictable results. Still, other surgeons began to create their own techniques and new and better liposuction procedures were introduced through the 1970s and 1980s (and keep on being created, for that matter). During this time of experimentation and improvement, lots of surgeons tried various kinds of tools attached to suction machines.

In the late 1970s, a French plastic surgeon named Dr. Yves-Gerard Illouz started using a blunt-tipped cannula, which reduced blood loss and damage to the nerves and blood vessels and led to fewer complications and cases of shock (or worse, death). He also found that recovery times were shorter and patients had less postoperative pain.

Dr. Illouz further improved liposuction tools and techniques, in collaboration with Dr. Pierre-Francois Fournier. Surgeons from around the world traveled to France to learn from Drs. Illouz and Fournier.
Soon liposuction came to the United States, but not everyone welcomed this cosmetic procedure with open arms. There were questions about its safety and how good the results were, and just how much fat could safely be removed during one session. There were also some well-publicized deaths.

Safety and efficacy began to be improved as newer liposuction techniques were developed. Surgeons, including Dr. Illouz, infused the area to be treated with sterile saline (saltwater) to make the movements of the cannula easier, but he did not use very large amounts of fluid. Surgeons started infusing more saline and mixing it with epinephrine, a drug that reduces bleeding by constricting blood vessels, and lidocaine, a local anesthetic. Larger amounts of fluid were used and this came to be called the wet technique.

Surgeons then started using even more saline/epinephrine/lidocaine fluid and called it the super-wet technique. The idea was to prevent major blood loss and reduce bruising and pain. The fluid would swell and engorge the fat to be removed and the area around it.

In 1985, a California dermatologist named Dr. Jeffrey Klein further improved liposuction by introducing the tumescent liposuction technique. With this technique, up to three times as much solution is infused in comparison to the amount of fat to be removed and the tissue becomes very engorged (or tumescent). Tumescent liposuction is the most common type of liposuction done in the United States today and it has an excellent safety record.

But liposuction was still a relatively young procedure and improvements were still being made. In 1987, an Italian surgeon Dr. Michele Zocchi started using high frequency sound waves in liposuction. These ultrasonic waves penetrate the skin and destroy the membrane of fat cells, bursting them and making the fat easy to remove with the cannula. There is the risk of burns with ultrasonic liposuction, but it has its advocates who say that it provides excellent results.

Power-assisted liposuction (PAL) is a newer technique that uses a cannula that vibrates at high-speed. This cannula cuts through the fatty tissue with less trauma than other types of cannulae. It works especially well in areas of more fibrous areas fat tissue such as in the buttocks, saddlebags, back, and the male breast.

Development of liposuction has not stopped. Laser-assisted types of liposuction are being developed and improvements are continually being made in techniques, equipment, and aftercare to make the procedure safer and produce even better results. Liposuction's history is still unfolding