Liposuction is one of the most popular cosmetic surgical procedures performed in the United States and around the world. Liposuction has been around since the mid 1970’s. Over the years, it has continued advance and improve, with new techniques to make it safer and more effective than ever.

Obsolete Liposuction Techniques

Liposuction is a surgical procedure that was developed in 1975¹. Since that time, specific liposuction techniques have changed or fallen out of use, but the basics of the procedure have stayed the same. It requires the use of special, blunt metal tubes, called “cannulas”, to tunnel into and disrupt the fat under your skin. Cannulas come in different thicknesses and different types of openings near the tip. A suction device is connected to the cannula, and the disrupted fat is sucked out through the cannula opening and into a cannister that collects the fat.

Dry Technique

This was the technique used when liposuction was first developed. The surgeon would insert the cannula directly into the fat without injecting any fluid or local anesthetic to the area being worked on. The surgeon would manually move the cannula back-and-forth through the fat, which meant these procedures were time-consuming and tiring for the surgeons that performed them.

Wet Technique

With this technique, a small amount of saline solution and an enzyme called hyaluronidase would be injected into the fat to be suctioned out². Then, the cannula would be inserted and moved in the same way as with the dry technique. This is another technique that is no longer performed, since more advances in the procedure have been made.

Complications

Both of these early forms of liposuction were associated with major complications, which led to those techniques being abandoned.

Blood Loss

Significant bleeding would occur in the early days of liposuction. With both the dry and wet techniques, there was no way to protect the blood vessels in the target areas from the back-and-forth motion of the metal cannulas or from the suctioning. That resulted in damage to the blood vessels, and a lot of blood being sucked up along with fat. Patients undergoing these liposuction techniques frequently required blood transfusions after their procedures, and had lengthy recovery times.³

Fat Embolism

Because of the damage to the blood vessels caused by the cannulas, fat was able to enter the bloodstream. This could create a fat embolism if the fat formed a clot in the lungs or the brain.⁴

Uneven Contour

Another complication associated with early liposuction were grooves and depressions left under the skin. This was usually caused by uneven liposuctioning in some areas, suctioning too much fat too close to the skin’s surface, or suctioning too close to the incision sites where the cannula was inserted.⁵

Technological Advancements in Liposuction

As time went on, liposuction techniques continued to evolve. Each change to the process was done with the goal of improving liposuction results and minimizing complications.

Tumescent Technique

The tumescent technique was similar to the wet technique, but it required the use of much more fluid than was used in the wet technique. Developed in 1985 by Dr. Jeffrey Klein, this technique involves the injection of a large amount of “tumescent solution” into the area to be liposuctioned. Tumescent solution is made up of saline, lidocaine, and epinephrine⁶. The fluid fills up the spaces in the tissues, which creates more space for the surgeon’s cannulas to work, so there’s less chance of suctioning too close to skin and causing grooves and dimpling. The epinephrine also causes the blood vessels in the area to constrict, which keeps them protected and minimizes bleeding.

A Safer Technique

In the early 2000’s, as a response to the complications associated with other techniques, Dr. Simeon Wall Jr. developed SAFE Lipo⁷.

SAFE Lipo

This is a three-step technique that is less traumatic to your tissues, and, when used in conjunction with tumescent fluid, helps reduce the likelihood of serious complications. The steps are Separation, Aspiration, and Fat Equalization.

Step 1: Separation

After tumescent fluid has been injected into the target area, a cannula with a special wide tip is inserted under the skin. Without suctioning, the cannula is moved back-and-forth to gently separate fat beneath the skin without damaging blood vessels or supporting structures under the skin.

Step 2 Aspiration

This is the step where the fat is suctioned out. This process is made easier because of the tumescent fluid injected prior, and also because the fat has already been separated from other tissues. So the surgeon is able to suction quickly and easily, without taking out too much fat.

Step 3 Fat Equalization

At this point of the procedure, the surgeon uses a small fat equalization cannula to contour the remaining fat layer beneath the skin⁸. By shifting and smoothing out the fat that is left beneath the skin, your surgeon will minimize the appearance of bumps and grooves that may occur with liposuction.

We Know What We’re Talking About

Liposuction techniques continue to advance and improve, and they’re safer than ever. Schedule a consultation appointment to ask your plastic surgeon about SAFE Lipo, and if you’re a good candidate for the procedure.

1. Coleman III, W. P. (1999). The history of liposuction and fat transplantation in America. Dermatologic clinics, 17(4), 723-727.
2. Coleman III, W. P. (1999). The history of liposuction and fat transplantation in America. Dermatologic clinics, 17(4), 723-727.
3. Coleman III, W. P. (1999). The history of liposuction and fat transplantation in America. Dermatologic clinics, 17(4), 723-727.
4. El-Ali, K. M., & Gourlay, T. (2006). Assessment of the risk of systemic fat mobilization and fat embolism as a consequence of liposuction: ex vivo study. Plastic and reconstructive surgery, 117(7), 2269-2276.
5. Shiffman, M. A. (2006). Prevention and treatment of liposuction complications. In Liposuction (pp. 333-341). Springer, Berlin, Heidelberg.
6. Coleman III, W. P. (1999). The history of liposuction and fat transplantation in America. Dermatologic clinics, 17(4), 723-727.
7. “The SAFE Lipo Difference.” Body Contouring & Liposuction Surgery. https://www.safelipo.com/safelipo/difference.cfm (accessed September 21, 2018).
8. “The SAFE Lipo Difference.” Body Contouring & Liposuction Surgery. https://www.safelipo.com/safelipo/difference.cfm (accessed September 21, 2018).