Curette fat removal
Dujarrier removed fat from a ballerina's knees with a uterine curette. Injury to the femoral artery ended in amputation of her leg, and liposuction was abandoned until the 1960s.[1][2]
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History
From the first attempts in the 1920s to tumescent anesthesia and ultrasound: the steps that changed the operation.
Timeline
Dujarrier removed fat from a ballerina's knees with a uterine curette. Injury to the femoral artery ended in amputation of her leg, and liposuction was abandoned until the 1960s.[1][2]
Schrudde removed fat through small stab incisions with a sharp curette and suction. Seroma and skin necrosis were common. Sources date his work from the 1960s to a 1972 description.[1][2]
The Fischers, father and son, introduced a blunt hollow cannula attached to suction and passed it criss-cross through several incisions to treat outer thigh fat.[1][2]
Illouz extended the blunt cannula method to the whole body. He injected saline and hyaluronidase before suction, the wet technique.[1][2]
Illouz reported a five-year experience with more than 3,000 cases. The skin contracted evenly over many tunnels, with little undermining, no skin removal and small scars.[1]
Klein published the tumescent technique: large volumes of dilute lidocaine and epinephrine allowed liposuction without sedation or general anesthesia. His solution held 0.05% lidocaine and 1:1,000,000 epinephrine.[1][2]
Klein measured blood lidocaine for more than 24 hours. Levels peaked 12 to 14 hours after infiltration began, and he estimated a safe upper dose of 35 mg/kg.[1]
Zocchi introduced ultrasound-assisted liposuction in Italy. Laser lipolysis spread after studies by Apfelberg and colleagues the same year.[1]
A survey of 917 board-certified surgeons counted 95 deaths in 496,245 liposuctions from 1994 to mid-1998, or 19.1 per 100,000. Pulmonary embolism was the leading cause.[1]
FDA cleared the SmartLipo Nd:YAG laser through the 510(k) process on 31 October 2006, finding it substantially equivalent.[1]
Hoyos and Millard published VASER-assisted high-definition liposculpture in 306 patients. Superficial fat is thinned to show the muscles beneath.[1]
Paul and Mulholland described liposuction with bipolar radiofrequency energy that heats the fat and the underside of the skin.[1]
Pioneers
Their papers set the methods in use today.
Father and son who introduced the blunt hollow cannula attached to suction.[1][2]
Extended blunt cannula liposuction to the whole body, devised the wet technique and reported more than 3,000 cases.[1][2]
Used the dry technique first, moved to lidocaine infiltration and the tumescent technique, and taught liposuction internationally.[1][2]
Otolaryngologist who first used the term liposuction.[1]
Published the tumescent technique and estimated the safe lidocaine limit at 35 mg/kg.[1][2]
Used disposable syringes for suction, which measured the anesthetic injected and the fat removed.[1]
Described superficial subdermal liposuction for better skin retraction.[1]
Showed in controlled cases that fat grafted into a facial crease still held at six years.[1]
Published high-definition liposculpture and an 18-year review of 5,052 patients.[1][2]