Liposuction: Permanent fat removal

Liposuction was successfully performed in1974 by Dr. Georgio Fischer, an Italian gynecologist in 1974 and it was further refined by several French surgeons. The next major advance was made by a US dermatologist, Dr. Jeff Klein, who developed tumescent liposuction in 1985. Dr. Klein's advances allowed liposuction to be performed under local anesthesia. This resulted in a major advance in the safety of the procedure, and moved it out from the hospital operating room to an outpatient or office facility. Dr. Klein also pioneered the use of microcannulas  which allow for  more precise fat removal.   

Tumescent liposuction is still the procedure of choice, and a number of studies have shown that this is the safest way to go. The microcannulas are thin tubes that break up the fat and suck it out. Initially liposuction was performed with larger cannulas that required bigger skin incisions which left larger scars. Also, with the larger cannulas, there was a greater risk of producing some dimpling or lumpiness.
Although liposuction can be performed in many areas of the body, the most common areas are the abdomen, chin/jowls and the saddle bags. We recently have begun adding limited liposuction of the cheek folds to some of our MACS-Lift (short scar facelift) procedures.
Some recent additions to fat removal procedures have been the use of laser assisted liposuction (SmartLipo) and the injection of bile acids to dissolve the fat (Lipodissolve). We don't perform either of these procedures due to safety considerations. I'll discuss them more in my next blog.

Gerald N. Bock MD
Stockton, CA