I have very much enjoyed witnessing and participating in the evolution of body contour surgery. When liposuction was introduced to this country in the mid 80’s it was relatively crude. However, it represented a significant advance over the only other option that was available at the time. Body contour surgery techniques used in the past resulted in very long scars in common locations, and this was unacceptable for most people in the United States.
The great advance of liposuction procedures in Chicago came when it was realized that through relatively small incisions, fat could be extracted using long hollow tubes called cannulas. The first liposuctions resulted in significant bleeding and bruising, and the amount of fat that could be removed safely at a single surgery was quite limited. There were also problems with the finished details of the work, since the initial cannulas were very large and tended to produce irregularities. As the design of the cannulas was made smaller and came with different tip configurations, we entered into a refinement phase, so that the procedure could allow more finesse.
The next big advance came in the early 90’s when, prior to the fat extraction, introducing fluid into the area of liposuction became a major advantage. This fluid, which is the same solution used in an IV, was mixed with a local anesthetic and a vasoconstrictor know as Epinephrine. The advantages of this, to those of us who were working with the technique at the time, were very apparent. I found that the fat came out more easily and more uniformly. There was also much less bruising and blood loss, so that it became possible to contour several zones at the same time.
By the mid 1990’s I became very intrigued with the technique known as ultrasonic liposuction. This was pioneered by an Italian surgeon. Here the concept of fat removal was fundamentally different from what had come before. Earlier techniques of liposuction essentially are a mechanical disruption of the fat and the use of suction to withdraw it. With ultrasonic liposuction, ultrasonic energy of a specific frequency is used to break apart the fat cells, and then the fatty material is removed using other specialized cannulas. When the results of this technique were better than what I was seeing with my own work at the time, I became very intrigued.
Anytime this sort of thing happens I become very interested because I always want to advance the state of the art of my patients. As with any new idea, it is important to figure out whether this is just hype or whether there really are advantages. After carefully investigating this, I began to use the technique in selected patients. I was one of the earliest adapters of this technique in the Chicago area, and as I worked with it I found that, especially in certain zones, the results that I was obtaining actually were better than what I had obtained with the classical techniques. To learn more about the evolution of liposuction, go here.