The terms are a confusing array of lipoverbs; liposuction, liposelection, liposculpture, smartlipo, smoothlipo, soundlipo, coollipo, and on and on…
Though the terms may be different, the goals are the same; the removal of undesirable fat from areas of the body to improve the contour with the least amount of damage to the other tissues.
The History of Liposuction: It all Starts with an Idea
It is certainly plausible that women since the age of Hippocrates have been asking doctors, “Gee, doc, can’t you just suck it out?”. However, modern liposuction began in the mid-1970’s. Gynecologists inGermany began using curette instruments to scrape fat from under the skin surface. The technique, modified by French surgeon and gynecologist Yves Ilouz, quickly evolved to the use of a closed, hollow suction device, similar to instruments used to perform uterine suction procedures.
Throughout the 1970’s and 80’s this new liposuction procedure gained great popularity in theU.S.and throughout the world. Unfortunately, the cannulae used to suction the fat also had a destructive effect on the other structures under the skin, namely the nerves, blood vessels, and fibrous connective tissue. The consequence was prolonged or permanent numbness, rippling of the skin, and bleeding. The latter could be problematic in cases of removal of larger amounts of fat. Anecdotal cases of severe injury and even death occurred during this period, secondary to significant blood loss. Tragic liposuction stories surfaced in the media as the interest in plastic surgery grew in theU.S.and worldwide, a safety stigma that still haunts liposuction to this day.
The Focus on Safety
In the late 1980’s improved cannula design and smaller diameters diminished the incidence of severe skin irregularities with traditional liposuction. In addition, dermatologists and plastic surgeons began using an injection of liquid solution prior to suction to both provide anesthesia and reduce blood loss.
Formulas can vary but are typically made up of salt water, a local anesthetic for pain control, and epinephrine to diminish the size of blood vessels. The solution is injected into the fat, prior to suction, to a state of “tumescence”, or tissue engorgement. Tumescent liposuction significantly improved safety and is still widely used today.
Sound Waves, the Next Generation of Liposuction
Surgeons in Europe andSouth Americabegan experimenting with the use of sound waves to dissolve fat in the 1990’s. They found that waves in the ultrasound range generated a frequency that would burst the fat cells but did little damage to the other structures (blood vessels, nerves, etc.) that were desirable to spare. Ultrasonic energy was, of course, not new to medicine, nor was it unique to plastic surgery. Pregnant women have relied on the safety and accuracy of ultrasounds for decades.
The exciting and very significant improvement offered by ultrasonic lipoplasty, however, was the specificity with which fat could be liquefied and gently removed without collateral damage to nerves, blood vessels and other structures. The procedure is also used in conjunction with tumescent fluid infiltration, so blood loss is negligible. As with most procedures, it requires a skilled and experienced surgeon to achieve the optimal results.
The Laser makes its’ Mark
Recently laser technology, initially utilized for elimination of facial wrinkles, has been adapted for use in body contouring. Catchy terms like “smartlipo”, “coollipo” and “smoothlipo” have been cleverly utilized as marketing tools to sell these very expensive devices to surgeons and, in turn, to patients.
The benefits of laser liposuction are still under review by skeptical plastic surgeons. The procedure is slow, can create significant burns, and requires the use of the old fashioned, traumatic, traditional liposuction. In order to achieve the advertised benefits, patients need to insist that the entire procedure be performed using the laser.
Liposuction has evolved since its’ introduction in the mid-1970’s. Advances in technique and equipment have improved the safety and results associated with liposuction. It continues to be one of the most popular procedures in plastic surgery.
About Dr. Perez
Jorge A. Perez, M.D., F.A.C.S. was one of 10 U.S. physicians selected as F.D.A. clinical investigators for ultrasonic lipoplasty. He has performed hundreds of procedures and has lectured to thousands of surgeons in over 25 countries worldwide on the subject of liposuction and body contouring.
Dr. Perez has been selected among Castle Connolly/U.S. News and World Report’s America’s Top Doctors. To schedule a consultation with Dr. Perez call (954) 351-2200. To learn more about his practice or any of these procedures, visit www.PerezPlasticSurgery.com