Advances in liposuction made difference for today's patients

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E. Ronald Finger

My first liposuction procedure was in 1982. After reading an article about it by a plastic surgeon from New York, I was so impressed that I ordered the cannulas from Germany, since no one in the USA was yet making them.

The cannulas had a strange configuration compared to today's cannulas and were about a half-inch wide, which is very large by today's standards.

In the meantime, the only option was to literally cut the excess skin and fat from the thighs, when that was the problem. Patients were happy with the results at the time because it was the only procedure available for their much hated "saddle bag" lateral thighs.

The German cannulas were received. I studied the article, and proceeded to perform the procedure. Despite the lack of experience and the size of the cannulas, the results were more than satisfactory for many patients.

As liposuction became more popular, the amount of fat that could be removed was limited to around 2 liters. If more fat was removed, excessive bleeding would occur.

Jeffrey Klein, MD, a very bright dermatologist and pharmacist, came up with the idea of "tumescent infusion." This is fluid that contains an anesthetic agent as well as a vasoconstrictor. It was to be injected into the area to be liposuctioned, with the result of greatly diminishing any bleeding.

With this infusion, it was now possible to remove up to 5 to 6 liters of fat at one time with minimal bleeding.

Since 1982, cannulas have changed dramatically and are now much smaller, with varying ends and ports to suction the fat. Now there are liposuctions devices with ultrasound, lasers, vibrations, and so forth. However, only minor tightening can be achieved with traditional liposuction. If the fat is removed from the underside of the dermis itself, there is a little more skin contraction.

In order to achieve more skin tightening, new devices have recently come on the market that emit heat through radiofrequency (RF). One such device is Renuvion, which uses RF plus helium. This results in much more heat and some immediate shrinkage of the skin.

Even more tightening occurs with time. It's very effective for the neck, arms, breasts, abdomen, sides, back, thighs, and ankles with one treatment.

The combination of liposuction with Renuvion can achieve spectacular results in patients with moderate excess fat and skin laxity.

Now liposuction is safely performed virtually everywhere from the ankles to the face. The most common areas are the inner and outer thighs, knees, abdomen and back, "love handles," arms and neck. Liposuction is often added to tummy tucks for added contouring when needed. Liposuction is also used for male breast (gynecomastia) removal, usually accompanied by some excisional surgery.

So, liposuction has come a long way since 1982, and it is one of the most common and safest procedures that plastic surgeons perform. Additionally, the fat that is removed can now be transferred to other places, such as the buttocks, the breasts - and even the face - to add fullness, resulting in a more youthful-looking appearance.

E. Ronald Finger, MD, FACS is a board certified plastic surgeon with offices in Savannah and Bluffton. fingerandassociates.com

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