The Evolution of Liposuction, Part 2: The Mid-1980s to the Present
Roland Bleyer ran pioneering cosmetic surgery clinics in Australia and the United States, founded around the time when major advances in liposuction were being introduced. Following the development of the wet liposuction technique in the late 1970s, the next major advance in the field appeared in the mid-1980s. Dr. Jeffrey A. Klein, a California-based Dermatologist, developed what is now called tumescent liposuction. Dr. Klein challenged several traditional assumptions about medical practice that ended up being unfounded. He thought that a larger dose of local anesthesia diluted into a larger concentration of fluid would allow for liposuction to be performed under local anesthesia with less pain and fewer complications. Other physicians had previously assumed that the drug doses necessary for such a procedure would prove too dangerous. However, Dr. Klein determined that lidocaine, a commonly used local anesthetic, would likely be safe in larger doses if sufficiently diluted. The previous safety standards had been established in the 1940s with no scientific backing, and no studies existed to evaluate whether or not higher doses would be safe. Dr. Klein helped to establish those upper limits by modifying his tumescent liposuction technique over the course of a year. Since this advance, most liposuction procedures adopt a variation of the tumescent technique. More recent advances have focused on creating smaller and more precise equipment and on employing additional mechanisms to simplify the fat removal process. For instance, ultrasonic assisted liposuction (UAL) employs an ultrasound probe tuned specifically to the frequency necessary to disrupt fat cells. The cells are destroyed, leaving other tissues intact, and then vacuumed out. Laser liposuction works according to a similar principle. In addition, certain types of external liposuction have been developed, which break up fat from the exterior without the need to insert a cannula into the skin. The fat is then drained via a small incision.