For example, candidates for liposuction were restricted to generally younger individuals with good skin elasticity to avoid postoperative laxity. The volume that could be extracted was constrained by the considerable blood loss, and the large diameter of the cannulas restricted use of the technique in certain anatomic areas. Blood loss and lidocaine replacement. The issue of blood loss cannot be minimized, and the limitations it placed on liposuction led to an evolution of subcutaneous fluid instillation. It began with the movement from the dry technique (where no fluid was injected into the fatty tissues and blood loss was significant) to the wet technique, in which an adrenalin solution is injected into the tissues to be liposuctioned. This allowed surgeons to remove greater fat volumes with reduced (though still not negligible) blood loss. Subsequently, larger and larger volumes of dilute lidocaine and adrenalin were injected, with improved results.the contour somewhat at the. Other shaping procedures involved similar sorts of wide excisions from the upper inner aspect of the thigh. Shaping the knee was not realistically within the realm of possibility; therefore, liposuction in the thigh and knee areas created the opportunity to perform true sculpting of flesh in an effective and aesthetically pleasing fashion. Evolution of technical aspects, in the 18 years since Illouz's presentation, as liposuction has become a mainstay of the plastic surgeon's armamentarium, the technique has evolved considerably. When first described, the technique by its very nature had certain limitations.
More contemporary examples in garnier the literature included the work of Josef Schrudde in Cologne, germany who described fat curettage and suction of the hips, thighs, knees, and ankles in the early 1960s and presented his work at a meeting in 1972. Also in the early 1970s, kesselring of Switzerland and Fischer of Italy published similar suction fat curettage reports. These techniques failed to elicit significant interest among other plastic ogen surgeons either in Europe or the United States, as their results were inconsistent and complications common and significant. Other plastic surgeons took note only when Illouz developed his technique of suction-assisted lipolysis using blunt cannulas and high-vacuum suction and demonstrated both reproducible good results and low morbidity. Moreno-moraga et al concluded that laser-assisted lipolysis in knee remodeling is a safe and reproducible technique that reduces the amount of adipose deposits while providing concurrent skin contraction. 2, modern plastic surgery history, while taking into account the various early methods of shaping, sculpting, and removing fat, considers Illouz the father of modern liposuction. What courtiss in 1984 deemed controversial, citing that ".some authors tout its advantages; while others warn of potential dangers." is now the most common aesthetic surgical procedure performed in the United States. 3, board certified plastic surgeons performed over 478,000 liposuction procedures in 2004. Since many more nonplastic surgeons also now perform liposuction, the likely total number becomes even more astounding. Yet to reconfirm the old adage that the more things change, the more they stay the same, a 2000 article and survey cites an unacceptably high mortality rate of 1 in 5000 for liposuction surgery.
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Liposuction or sal first burst on the scene in a presentation by the French surgeon, Dr yves-Gerard Illouz, in 1982. His presentation was quickly followed by his professional publication in 1983, in which he described a 5-year, 3000-case experience with the technique of suction-assisted lipolysis (his term). 1, his method was quite straightforward and mask consisted of the following: Instill a hypotonic saline solution into areas of fat (theoretically to "rupture" the adipocytes). Insert blunt-tipped, hollow metal cannulas (of 5-, 8-, and 10-mm internal diameters with a lateral side opening) into these fatty deposits. Attach the cannulas via hose or tube to a high-power suction machine. Move these cannulas in and out of the fat in a fan-shaped pattern. This process aspirated the fat and allowed the operator to sculpt the fatty areas into a more pleasing shape. Almost immediately upon the release of Illouz's studies and the overwhelming interest they generated, surgeons worldwide and medical historians recalled earlier descriptions of concepts of surgical fat extraction and sculpting, dating back to the work of Dujarier in France during the 1920s. Unfortunately, his work resulted in disaster.
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