Before liposuction fat removal was developed, unwanted fat deposits could only be removed by cutting them out with a scalpel. This method never really gained in popularity because of the propensity for complications, and because the results tended to be uneven.
History of Liposuction Fat Removal
It was not until Dr. Giorgio Fischer, an Italian gynecologist, developed a method of fat removal involving a scraping instrument attached to a suction machine in 1974, that the modern-day liposuction procedure was born.
Four years later, two French doctors named Illouz and Fournier furthered Fischer’s work by developing a technique to remove excess fat from their patients through an instrument called a cannula, which was a tube-like device through which they passed a low-pressure vacuum.
This development allowed fat to be removed from patients through very small incisions, as opposed to the large ones required for other, more traditional surgeries. The tubes that were used by these doctors were smaller than the scraping instrument used by Dr. Fischer, and the holes through which the fat was suctioned were on the sides of the tubes, instead of on the end as with the earlier incantation. These advances allowed for less tissue injury, and a much more even removal of fat.
Even though the procedure was becoming more refined, there still existed a tendency for the patients to bleed profusely, and for the procedure to end in uneven fat distribution. Patients were usually instructed to donate blood a month before their surgery so that all of the blood that was lost during the procedure could be replaced.
In addition, instead of the stopping point of the surgery coming when the patient’s ideal body shape was reached, it often occurred because of too much blood loss. In addition to this, the liposuction fat removal procedure in this form always required general anesthesia, which can add a much greater chance of complication during the surgery. It was in response to these problems that a major improvement, tumescent liposuction, was made in the evolution of the procedure.
Tumescent Liposuction Fat Removal
In 1987, a physician named Dr. Jeff Klein pioneered the use of a local anesthetic during liposuction. Traditionally, local anesthetics had been used to numb very small areas. However, Dr. Klein discovered that if he used a much lower concentration of the drug, he could safely use a much larger amount of it to cover a large area.
Fat cells do not have very many nerve endings, so a high concentration of anesthetic is not needed to numb them before the procedure. Therefore, Dr. Klein injected large volumes of a diluted version of local anesthesia into his patients’ fat, causing these areas to become firm and swollen, and the tumescent technique took shape. This improvement made liposuction fat removal much safer than the traditional procedure, as all of the risks of undergoing general anesthesia were entirely avoided.
In addition, for the first time, liposuction fat removal could be performed in a surgical facility rather than a hospital, which increased the level of safety, as it lessened the chance of the patient being exposed to any infectious diseases.
This technique also greatly reduced bleeding during the procedure, and adding a vasoconstrictor to the injected solution reduced bleeding even further. This drug causes a patient’s blood vessels to temporarily constrict, which allows less blood to flow once the area suffers trauma.
Prior to this discovery, 40 percent of the fluid removed from the patients consisted of blood, but after vasoconstrictors such as epinephrine were developed, the percentage of blood in the removed fluid dropped to 1 to 3 percent.
Further advances include ultrasound liposuction, but due to a high rate of complications during this procedure it has lessened greatly in popularity. Regardless of which technique of liposuction fat removal is used, the safety and effectiveness of the procedure has vastly improved since 1974, when Dr. Fischer first developed the technique.