The Surgeon Minute

Liposuction Techniques: Then and Now

Liposuction Techniques: Then and Now

Liposuction techniques are ever-changing, and have come a long way in 40 years. But, just exactly where did it all begin? Dr. Jason Pozner shares his insight on the inception of liposuction technology and how far it has come.

There once was a time when love handles were simply a fact of life. If you couldn’t get rid of them with diet and exercise, you were stuck with your “muffin top” — the unsightly bulge of excess belly fat along the waistline of your jeans. Likewise, saddle bags and sagging gluteals were just something women and men had to get used to. And then came liposuction, and everything changed.

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The first liposuction techniques developed in the 1970s involved “taking a cannula and putting it into the fat and sucking out fat,” explains Dr. Jason Pozner, a board certified plastic surgeon who uses a variety of liposuction techniques in his Boca Raton, Florida practice. Later, doctors began to insert tumescent anesthesia, which is a technique for delivery of local anesthesia that maximizes safety by using pharmacokinetic principles to achieve extensive regional anesthesia of skin and subcutaneous tissue. The use of tumescent anesthesia lead to less bleeding, bruising, and a much safer approach in general.

“As technology advanced, we moved to ultrasonic liposuction,” says Dr. Pozner. The techniqe used a cannula vibrating at a high frequency to cause fat cells to burst. However, this method also sometimes caused burns and seromas, and doctors soon abandoned the practice, Dr. Pozner explains.

The next generation was Vaser, a process that uses a pulsed ultrasonic technology. Vaser is especially useful for secondary liposuction and treating fibrous areas, such as enlarged male breasts (gynecomastia).

More recently, researchers have developed laser liposuction, which uses laser energy to liquefy fat and tighten the skin. This approach is especially useful for removing fat in small volumes, such as around the neck. It also works well with small pockets of revision liposuction and abdominal etching, which can create deeper cuts in the abdominal musculature.

The newest technique is radio frequency liposuction. This practice sends a bipolar radio frequency between the internal and external probe, which causes fat cells to be disrupted, or burst, due to a heat mechanism. This method also tightens the skin, similar to the laser liposuction technique.

The newest rage are some of the non-surgical fat removal technologies, such as Zeltiq. Although these won’t replace liposuction, Dr. Pozner says, they are a useful addition to cosmetic surgery practices.

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