Pretty in plastic!

Liposuction

Tuesday, October 22, 2013 | 0 comments

Liposuction, also known as lipoplasty ("fat modeling"), liposculpture suction lipectomy or simply lipo ("suction-assisted fat removal") is a cosmetic surgery operation that removes fat from many different sites on the human body. Areas affected can range from the abdomen, thighs and buttocks, to the neck, backs of the arms and elsewhere.

History

Doctors Giorgio and Arpad Fischer, two Italian-American surgeons working in Rome, Italy, invented the liposuction procedure in 1974. The roots of liposuction, however, date back to the 1920s. Relatively modern techniques for body contouring and removal of fat were first performed by a French surgeon, Charles Dujarier. A tragic case that resulted in gangrene in the leg of a French model in a procedure performed by Dr. Dujarier in 1926 set back interest in body contouring for decades to follow.

Liposuction evolved from work in the late 1960s from surgeons in Europe and was pioneered in the United States by the European surgeon Leon Forrester Tcheupdjian using primitive curettage techniques which were largely ignored, as they achieved irregular results with significant morbidity and bleeding . Modern liposuction first burst on the scene in a presentation by the French surgeon, Dr Yves-Gerard Illouz, in 1982. The "Illouz Method" featured a technique of suction-assisted lipolysis after infusing fluid into tissues using blunt cannulas and high-vacuum suction and demonstrated both reproducible good results and low morbidity. During the 1980s, many United States surgeons experimented with liposuction, developing some variations, and achieving mixed results.

In 1985, Klein and Lillis described the "tumescent technique", which added high volumes of fluid containing a local anesthetic allowing the procedure to be done in an office setting under intravenous sedation rather than general anesthesia. Concerns over the high volume of fluid and potential toxicity of lidocaine with tumescent techniques eventually led to the concept of lower volume "super wet" tumescence.

In the late 1990s, ultrasound was introduced to facilitate the fat removal by first liquefying it using ultrasonic energy. After a flurry of initial interest, an increase in reported complications tempered the enthusiasm of many practitioners.

Technologies involving the use of laser tipped probes (which induce a thermal lipoysis) have been introduced in recent years and are being evaluated to examine any potential benefit over traditional techniques.

Overall, the advantages of 30 years of improvements have been that more fat cells can more easily be removed, with less blood loss, less discomfort, and less risk. Recent developments suggest that the recovery period can be shortened as well. In addition, fat can also be used as a natural filler. This is sometimes referred to as "autologous fat transfer" and in general, for these procedures, fat is removed from one area of the patient's body (for example, the stomach), cleaned, and then re-injected into an area of the body where contouring is desired, for example, to reduce or eliminate wrinkles.

Procedure

Tumescent technique

Developed by plastic surgeons in the 1980s, this has become the most popular liposuction method. It is also considered safer than other methods because it limits blood loss and does not usually require intravenous fluid replacement afterwards.

In this procedure, the doctor injects a large volume of anesthetic-containing fluid (as much as five times the fluid and tissue that is removed) into the areas containing fatty deposits. The fluid contains a local anesthetic (lidocaine), a drug that constricts blood vessels to reduce blood loss (epinephrine) and a salt solution to allow for easier fat removal. The fluid causes the fatty tissue to swell up and harden (become tumescent), making it easier to remove with the cannula. Because the fluid contains quite a bit of lidocaine, this procedure is usually performed under a local anesthetic. Although it tends to take longer than other techniques -- as many as four to five hours -- the tumescent technique has the advantages of reducing postoperative swelling, bruising and pain.

Super-wet technique

This technique is similar to the tumescent technique, with the exception that it uses less fluid (about the same amount as the amount of fluid and fat tissue removed). Although a small amount of lidocaine is sometimes added to the fluid, this technique often requires general or IV-epidural anesthesia. The procedure takes between one to two hours to perform.

Ultrasound-assisted liposuction (UAL)

This relatively new technique uses a special cannula that vibrates very rapidly and gives off ultrasound energy. As the cannula passes through the fat cells, that energy liquefies the fat cells, which are then suctioned out. The ultrasound can be administered either above the skin (with a special emitter) or below the surface of the skin (with an ultrasound cannula).

There are two types of ultrasound cannulas:

a solid probe
a hollow-core probe

The solid probe creates a collection of emulsified fat and tumescent solution beneath the skin, which is then removed with a standard, suction-type cannula. The hollow-core probe both emulsifies fat and removes it, but the doctor must usually go back in with a standard cannula to remove the emulsified fat that the probe leaves behind (Sattler, 2005).

The UAL takes longer to perform than other types of liposuction, but it is more precise and tends to be more effective, especially at removing fat from fibrous areas of the body, such as the back and male breasts. The drawback is that it generates a lot of heat. If the cannula is not removed quickly enough, it can cause a burn. What's more, doctors still don't know the long-term effects of internal ultrasound exposure.

Power liposuction Doctors now have at their disposal a motorized cannula, which moves back and forth at very rapid speeds over a distance of 3 to 5 millimeters. It can remove about 40 percent more fat per minute than manual liposuction, meaning the procedure takes less time to perform, and it provides smoother results, say doctors (Wagner, 2001).

Cost
$2982 (US), Thighs ￦7,400,000, Buttocks ￦5,400,000, Calves ￦5,400,000, Abdomen ￦6,000,000, Love Handles ￦2,700,000 (KR)