Modern liposuction is considered extremely safe, but this wasn’t always the case. In the early days of liposuction as a fat-removal procedure, it was very much trial and error, with people’s lives and limbs hanging in the balance. Liposuction has a very mottled history.
Credit for the original concept of removing fat from certain parts of the body goes to Charles Dujarrier, who in 1921 attempted to remove a portion of fat from a ballerina’s calf and knee.
Dujarrier damaged a blood vessel, and as a result, the dancer’s leg had to be amputated. After this dramatic and tragic surgical error, interest in liposuction understandably waned for many decades.
Part of the problems was that liposuction tools were rather clunky. A lack of experience combined with no specialised tools meant the whole procedure was clumsy and fraught with difficulties.
That is no longer true because we started liposuction (albeit unpromisingly) in 1921, we’ve had a century to get it right.
We’ve learnt a lot.
While every surgery comes with risks, liposuction is no longer considered a danger to your life. Liposuction is now a safe, effective body contouring tool using specialised, precision equipment. Liposuction practitioners have extensive training that draws on the mistakes of the past to provide smooth results safely and consistently.
Most surgeons now use the tumescent liposuction technique, which reduces recovery times due to less tissue damage and bleeding.
Here’s some background about tumescent liposuction from its inventor and dermatologist, Dr Jeffery Klien.
Tumescent lidocaine anesthesia (TLA), which is now the worldwide standard of care for liposuction and many other plastic surgical procedures, was invented by Dr Jeffery Klien and was first described the tumescent technique for liposuction at a scientific meeting in 1986. He published his result in the Journal of the American Academy of Cosmetic Surgery in 1987.
Dr Klein’s innovative liposuction technique was the first of its kind, allowing surgeons to prevent significant surgical blood loss often associated with general anesthesia operations. Virtually every plastic surgeon and dermatology surgeon use the “Klein solution” for significant surgeries involving skin or subcutaneous fat.
Experience has shown that Dr Klein’s tumescent liposuction is safer than laser liposuction and ultrasound-assisted liposuction (UAL). Today tumescent liposuction continues to be the world’s safest and most comfortable form of liposuction with the quickest recovery and best cosmetic results.
Dr Michael Rich is trained by Dr Jeffery Klein and has been performing the tumescent liposuction technique for over 30 years.
Why the tumescent liposuction technique is so solid
Liposuction has always been more or less what it looks like now: a process of strategically suctioning fat away for cosmetic purposes. The essence of liposuction hasn’t changed.
The tumescent liposuction technique involves injecting a special fluid – tumescent fluid – into the treatment area to assist the doctor in getting smooth results with less bruising.
The word tumescent means ‘swollen or becoming swollen’, and outside of medicine tends to only appear in a saucy manner in romance novels or poetry. In liposuction, it refers to the special liquid we inject that makes the skin taut under its fullness.
Teeny tiny suction tubes reduce trauma
The suction tubes – microcannulas – are very thin, meaning the incisions in the skin are also very small. Microcannulas result in less trauma to the skin itself – a tiny cut and very minor, almost invisible scarring that fades well over time.
We make space under the skin for precision
The tension the tumescent fluid creates allows room for the tiny tube to fan out under the skin, where the fat is.
Fat softened before removal
The tumescent fluid also works to soften the fat, making it easier to remove.
Anaesthetic liquid numbs thoroughly
The tumescent fluid contains a few key ingredients, with the main actor being an anaesthetic liquid to numb the area. You won’t feel a thing.
Blood vessels constricted to reduce bleeding
The anaesthetic not only provides comprehensive numbing but also actively constricts the blood vessels feeding the treatment area. It’s this element of the tumescent fluid that is one of the most important.
The blood vessel constriction is important because blood vessels are easy to burst (think of a cut or bloody nose). Blood vessels threading their way through fat cells break easily during a liposuction treatment, causing bleeding. Bleeding is normal, based on the procedure, however with the tumescent fluid added, severely limited.
What would typically happen in older styles of liposuction is that these broken blood vessels would bleed into the treatment area like a regular cut might. This bleeding results in bruising, because bruising is simply trapped, old blood.
The body scavenges this old blood over time, which is the same process as when you see a bruise ( say on your knee) disappear over a week or so. The changing colours of a bruise are due to first the removal of oxygen (red to black-purple), then the removal of haemoglobin (black-purple to green-yellow) in the scavenging process.
The tumescent fluid constricts these broken blood vessels at the moment they are broken and thus heavily limits their ability to move blood into the area. As a result, you see much less bruising with tumescent liposuction than with older methods. It looks and feels better.
Why liposuction is safer than ever
In Australia, there are hefty regulations affecting surgeries, including liposuction. For example, a recent change to the regulations means that a liposuction doctor can remove no more than 200ml of fat in a procedure outside of a registered surgical clinic.
While ENRICH Clinic has only the highest of surgical standards, the law change means high standards for all liposuction practitioners and patients equal to those in a private hospital.
Additionally, there are limits on how much fat we can take out in one session no matter at which facilities we perform the surgery. Large-volume liposuction has long had limits enforced upon it since it is considered dangerous to the body to take too much fat at one time. The body can go into shock. The Australian standard for fat removal is a maximum of 5 litres per treatment.
With tumescent liposuction, a local anaesthetic is used, which means you are awake for the procedure. You receive a relaxant (surgery is always a bit nerve-wracking!) and made as comfortable as possible, but you will not have a general anaesthetic.
General anaesthetic has some inherent risks since it puts your body into a deeply unconscious state. A general anaesthetic is suitable for some liposuction procedures in some instances, but we do not use general anaesthetic at ENRICH Clinic.
Please feel free to ask any questions you have regarding your liposuction procedure, including the tumescent technique, local vs general anaesthetic, with our ENRICH team. Your comfort and safety is our top priority.
Risks of liposuction
There are always risks when undergoing any surgery, and liposuction is no different. It’s important to be informed of your risks before any surgery, not just because you should know what you are getting yourself in for, but because it helps you to be aware of what can go wrong post-surgery. Early intervention makes a big difference when things go awry as you are recovering from liposuction.
According to the Australian Society of Plastic Surgeons (ASPS), risks of liposuction include:
- The more areas treated in one session, the higher the risk
- The larger the treatment area, the higher the risk
- Tumescent fluid may have too much lignocaine in it and cause lignocaine toxicity
- Collection of fluid in the lungs if too much tumescent fluid is used
- Excessive fluid loss leading to shock
- Fluid accumulation
- Infection in fatty tissues (severe and difficult to treat)
- Delays in healing
- Damage to the skin or nerves
- Irregular, bumpy surface, uneven contours, rippling
- Asymmetric skin
- ‘Baggy’ skin
- Loss of skin sensation, numbness
- Skin discolouration or pigmentation changes
- Deep damage to nerves, blood vessels, muscles, lungs or abdominal organs
- Chronic pain
- Allergic reactions to drugs
- Blood clot or fat clot formation (may migrate to lungs)
- Deep vein thrombosis
- Heart/circulation complications
- Problems may require further surgeries
At ENRICH Clinic, we pride ourselves on our outstanding patient safety record. Dr Michael Rich performs all of our liposuction procedures, bringing over 35 years’ experience to your bodywork. You are in the best hands!
We are liposuction experts.
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