It has been said that history is an unending dialogue between the past and the present. We study history, it is said, in order to understand our present circumstances from the actions of people in the past and to anticipate the future.
However, historians, influenced by the social circumstances of their time, have sometimes passed on inaccurate information to later generations through subjective judgment rather than a factual account. If we understand these facts in the context of the circumstances of the time, I believe we can arrive at an accurate understanding of history and also apply it more accurately to the present.
A chapter that never fails to appear in liposuction textbooks is the history of liposuction. Because methods and theories that prove to be inaccurate are continually corrected by other medical researchers, I believe the history of medicine is meaningful as the foundation of surgical techniques and treatments, pointing the way for future research and the development of medicine.
From a physician's standpoint, therefore, studying the history of medicine carries an important meaning: it reduces trial and error in setting one's own research direction, eliminating unnecessary waste of time, and it helps identify the problems of present-day medicine so that the level of medicine can be improved and advanced.
From the standpoint of a patient who wants to understand information about liposuction, knowing the history of liposuction speeds up understanding of the methods currently in use and helps in grasping the overall picture of which information truly matters amid the confusing information generated by commercial advertising.
1. Liposuction began in the 1920s, when the French surgeon Charles Dujarrier removed subcutaneous fat using a curette (a scraping instrument) to slim the calves and knees of a ballerina; however, massive bleeding and vascular injury reportedly made it necessary to amputate the leg.
2. Modern liposuction began with the pioneers Arpad Fischer, who first started cosmetic surgery in Italy in 1956, and his son, the gynecologist Giorgio Fischer, who first performed liposuction in 1974. Their groundbreaking advance was the development of a blunt-tipped, hollow instrument called the 'cannula,' which made it possible to suction out the so-called adipose tissue . Today, all liposuction removes adipose tissue using this very cannula. The French physician Fournier refined this cannula technique, and then Illouz, a French gynecologist, developed a method of infiltrating hypotonic saline to swell the fat layer before suctioning in order to reduce bleeding, lessen trauma, and make suctioning easier. This is called the "Illouz Method" or wet liposuction, and it later evolved into tumescent liposuction.
3. This groundbreaking development in liposuction began to spread worldwide in the early 1980s. American physicians, who could be called the vanguard of world medicine, traveled to Europe to receive liposuction training from Illouz, Fournier, and Fisher. The physicians trained at that time were mainly dermatologists and plastic surgeons, who went on to lead the development of liposuction worldwide. The plastic surgeons Julius Newman and Richard Dolsky began the first lectures in the United States, and a live surgery workshop was held in 1983.
4. In the late 1980s, liposuction became established as part of the surgical curriculum in dermatology, and dermatologists such as Jeffrey Klein, Patrick Lillis, Rhoda Narins, William Coleman, and Timothy Flynn advanced the field. In 1987, the American dermatologist Klein introduced the 'tumescent technique.' In this method, a tumescent solution made by mixing a local anesthetic, a vasoconstrictor, and other agents into physiological saline is infiltrated into the fat layer, allowing liposuction to be performed under local anesthesia. Following the invention of the cannula by Giorgio Fischer, it was an outstanding, landmark invention in the field of liposuction, reducing bleeding and making liposuction a safe procedure that can be performed in an outpatient setting. In 1989, the American Academy of Dermatology issued the world's first guidelines for liposuction surgery.
Thus, the development of modern liposuction can be said to have begun in Europe in the 1980s and then advanced in the United States, and the key advances among these were the evolution of cannula design and the development of tumescent liposuction. In the case of the cannula, from the 6–10 mm bore of the early instruments developed in Europe, the bore became progressively finer in order to avoid damaging fibrous and vascular tissue, eventually leading to the development of microcannulas with an outer diameter as small as 20 gauge (0.9 mm). As for tumescent liposuction, its safety was demonstrated by a paper published by Housman in 2002, which reported a complication rate of about 0.68 per 100.
5. Later, in 1992, ultrasound-assisted liposuction (UAL) equipment was developed by Zocchi and was hastily adopted by the American Society of Plastic Surgeons. However, the risk of skin burns and seroma (an accumulation of plasma fluid) increased, and it was eventually withdrawn from the market; it later evolved into VASER, a third-generation ultrasound-assisted liposuction device.
6. In 2000, a new power-assisted liposuction (PAL) device was developed. The cannula is connected to a motor and moves back and forth by about 2–7 mm; this motion is used to make movement through the adipose tissue easier, reduce surgeon fatigue, and speed up the operation. It is still used effectively today in areas with abundant fibrous tissue, such as gynecomastia.
7. Laser-assisted liposuction (LAL) equipment was also developed in 2000, but to date no study has reported that laser liposuction provides any benefit in surgical outcomes.
This concludes a brief overview of the history of liposuction. In fact, modern liposuction can be considered only about 20 years old. The sources are listed below, and to maintain objectivity I have not included my personal opinions. For the latest developments in liposuction since then, there is a new post that you may find helpful to refer to.
Liposuction is estimated to have been introduced in Korea in the 1990s or later. Representative books on liposuction include Tumescent technique:, written solely by Klein ( Jeffery A Klein) and published in 2000; Safe Liposuction and Fat Transfer, published in 2003 by Narins (Rhodea S Narins) with 32 co-authors; and Liposuction, published in 2006 and co-authored by Shiffman (Melvin A Shffman, Alberto Di Giuseppe). I believe it was through these excellent books that liposuction techniques in Korea became academically established.
Dr. Klein is an American dermatologist, Narins is also a dermatologist, and Shiffman, the author of Liposuction, who honored us with a visit to Venus Clinic in 2010, is a general surgeon. Looking at the history of liposuction, therefore, it is no exaggeration to say that liposuction was developed by Giorgio Fischer of Italy and perfected by surgical physicians, including dermatologists. Today, liposuction worldwide is performed mainly by dermatologists and surgical physicians, and plastic surgeons, who mainly used general anesthesia and the wet technique, are increasingly switching to tumescent liposuction under local anesthesia.
Giorgio Fischer
Founder of the International Academy of Cosmetic Surgery, Honorary President of the International Society of Cosmetic Surgery
When choosing a liposuction clinic, I believe one should choose an experienced physician who has studied liposuction academically and mastered a variety of techniques, and in conclusion, the choice of a clinic in the field of liposuction should be judged by genuine patient satisfaction that has not been falsely manufactured.
Sources)
History of liposuction. Flynn TC, Coleman WP 2nd, Field LM, Klein JA, Hanke CW. Dermatol Surg. 2000 Jun;26(6):515-20.
Flynn TC. The history of liposuction. In Shiffman MA, Giuseppe AD, eds. Liposuction principles and practice. Berin Heidelberg New York: Springer, 2006:3-6.
Wikipedia http://en.wikipedia.org/wiki/Liposuction
