History of Liposuction

Though liposuction is a relatively new form of cosmetic surgery, it has, nevertheless, become the most commonly performed cosmetic procedure in the United States. Since it was first introduced in the US in the early 1980’s, many refinements have been made. The most significant improvement was the use of dilute local aesthetic instead of general anaesthesia: this is the Klein Tumescent Technique. Again, the Klein technique is the most revolutionary technique in liposuction to date. Dr. Klein is a California Dermatologist.

SUCTION ASSISTED LIPECTOMY OR FAT SUCTIONING

Lipectomy means removal of fat by surgery. In lipolysis the surgeon loosens and removes the fat from an area by using long or short metal tubular instruments connected to a Suction machine. The suction tubes are usually made of stainless steel. The tips are blunt. The tubes have 1 to 5 holes near the tip on one side or on different sides. The suction machines used for this purpose create very powerful negative pressures (1 ton to 35 ton at sea level). Lipolysis was started in France in late 70’s and since 1981 is in practice in the United States and other parts of the world.

Fat collections at the Hips, Thighs, Buttocks, Abdomen, Arms, Under the Chin, Upper Torso, etc., can be reduced by this procedure.

Can one’s weight be reduced by this operation? 
Who is a good candidate for Lipolysis ?

Lipolysis is neither a substitute for dieting nor a cure for obesity

Persons with reasonably normal weight and healthy elastic skin with extra localized fat in certain areas, get the best results from this procedure. (Healthy elastic skin has the capacity to shrink after the surgery). Lipolysis can be done on patients up to 45 or 50 years of age, but it is not normally done if the skin is loose in the particular area. One could have loose skin after losing lot of weight or after pregnancy,or one could lose the elasticity of skin due to old age or other reasons. In these patients in addition to lipolysis, some of the skin should also be removed, i.e. Dermolipectomy to get a satisfactory contour for which hospitalisation is required.

The fat cells that are removed for ever do not come back again. Most of fat cells are situated under the skin. The total number of fat cells present in a person’s body does not increase as one grows older or when one gains weight. When a person gains weight, the size of the fat cells increases as more fat is being deposited in it. When one loses weight, the fat is mobilised out of the fat cells and so these cells become smaller in size. Only liver and skin have the capacity to regenerate in the human body. Fat cells cannot regenerate or multiply. And so, the fat cells that are removed are removed for ever.

SURGICAL PROCEDURE:

A small cut about 4 mm to 10 mm is made a few inches away from the area to be suctioned & the suction cannulae are inserted. The cuts are usually made in the skin folds and so, the scars are not much noticeable. Depending upon the areas to be suctioned and recontoured or reduced, anywhere from 600 gms to 3000 gms of the material is removed in one sitting. If more material is removed that would require blood transfusions. The removed material usually consists of 65% to 85% fat & the remainder would be blood, plasma and serum.

AFTER THE SURGERY snug or light dressings is applied for 5 to 8 days to promote the shrinkage of the skin and to minimise the swelling. In most instances, one is required to wear a support or a girdle for several weeks or months during the healing time. One could feel localised areas of hardness or firmness in the suctioned areas for 1 to 4 months after the surgery.

One may require pain medication by mouth for one to two days after the surgery. During the healing period, numbness or discomfort could be present for varied periods of time. After the surgery, there will be swelling in the areas of the surgery. Even through most of the swelling is gone in the first 2-3 weeks. It takes 2-4 months for all the swelling to be gone. Discolouration could last up to several weeks after the surgery. Even after muitiple area lipolysis one should be able to be up and around in 1 to 2 days and back to most of the normal activities in 10 to 14 days

Results

Results depend upon the expectations of the patients and the amount of fat that is suctioned from the given area. Usually patients with good elastic skin and who come for contouring a particular area are very happy. Older patients and patients who are overweight could be unhappy. Perfection and symmetry are not possible in every patient. Also in some patients, all unwanted fat cannot be removed in certain areas in the first sitting. On these patients, the lipolysis may have to be repeated. But a second lipolysis cannot be done until all the swelling is gone from that particular area (i e. about 4 months).

On rare occasions rippled or uneven skin or areas of loose skin could result from this surgery which might require further surgeries to correct them.

Dr. Wahiguru Pal Singh Sidhu
M.B.B.S,M.S.[SURG.]M.Ch.[PLASTIC SURG.]

NOTEWORTHY HISTORICAL HIGHLIGHTS ABOUT LIPOSUCTION