Liposuction: Past And Present

In considering the progress made in the field of body sculpting through liposuction

(also called lipoplasty or suction lipectomy), there are many things for which to be grateful. There have been many advances in the way liposuction is performed that make a patient's experience today much less distressing than it would have been in the past. Some of these are the development of the tumescent method and the use of smaller cannulae and local anesthetics.

Liposuction first took off in the US around 1980. Small incisions about one centimeter in length were made at targeted areas and a surgical instrument called a cannula was inserted to draw out fat tissue. The cannula is a thin, cylindrical, hollow metal rod much like an oversized syringe; if you've ever seen someone with an IV, what they have inserted into their skin is an intravenous cannula.

The original suction lipectomy utilized a dry process, drawing lipids out from beneath the skin through the cannula and connecting tube and depositing them into a bottle in the liposuction machine. The dry method is not used today because of rippling of the skin that sometimes resulted, diminishing the aesthetic appeal the patient was striving for. In addition, there were greater risks involved, including blood loss, damage to blood vessels or other sensitive tissues, and occasionally more serious disorders.

Today, every conventional liposuction uses what is called the tumescent method. Before anything is withdrawn from the body, liquid is infused through the incisions which usually consists of saline solution, anesthetic, and possibly other medications to minimize negative effects, like excess bleeding. The fluid causes adipose tissue to swell, enlarging the space between tissues and allowing the surgeon to extract the affected fat cells more easily.

The loosening of the fatty tissue through tumescent liposuction also permits smaller cannula to be used to remove fat. Cannulae used today are much smaller than those used in the past, being on average 3 or 4 millimeters in diameter. This allows much smaller slits to be made in the skin, usually no more than 5 mm in width, which leaves a smaller, less noticeable mark on the skin following surgery.

Another modern alteration is that general (or systematic) anesthesia is discouraged. Systematic anesthesia is dangerous because the patient is unable to respond if anything goes wrong, and because of the possibility of adverse reactions to the medication. Local anesthesia is preferable, allowing feedback from the patient to guide the actions of the surgeon or bring the surgery to a halt, if necessary. Less than five percent of liposuction patients are reported to have undergone the procedure under general anesthetic due to extreme fear or anxiety elicited by needles or surgery in general.

by: Christian Heftel

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