Reviewing the History of Liposuction and Cosmetic Fat Removal

Early Developments: When Was Liposuction Invented?

Liposuction's origin can be traced back to the 1920s when French surgeon Charles Dujarier devised the concept of fat removal and body sculpting. His first attempt at contouring a patient's body in 1921 did not go so well when he tried improving the lower body of a dancer through means of skin and tissue excision. This resulted in significant tissue death, ultimately necessitating amputation. Ensuing experimental procedures to remove skin and fat proved somewhat more successful yet still resulted in severe side effects.

Several decades later, in the 1970s, doctors Arpad and Giorgio Fischer innovated upon the many cosmetic fat removal attempts by developing a blunt tunneling technique that ultimately became liposuction. Using rotating scalpels called a cannula to break up and suction out fat, the father-son duo's method allowed for better results and fewer side effects. It should be noted that these early liposuction procedures were only performed on the thighs. 

Laying the Foundation of Modern-Day Liposuction 

Research based upon this new technique from Arpad and Giorgio Fischer continued throughout the following years as surgeons improved the blunt tunneling design. The main goal was to reduce the blood loss and nerve damage that occurred as a result, and finally, in the late 1970s, Dr. Yves-Gerard Illouz and Dr. Pierre Fournier developed a procedure using a blunt-tipped cannula. This device helped lessen side effect severity and deliver better results with shorter downtime.

Dr. Fournier was the first surgeon to implement the local anesthetic lidocaine to reduce pain during liposuction, also called the wet technique. Building upon this method in the 1980s, California dermatologist Dr. Jeffrey A. Klein fine-tuned the idea behind tumescent liposuction. This procedure involves injecting a tumescent solution containing saline, lidocaine, and epinephrine into the treatment area to make the fat more easily removable. 

The Modern Technique is Developed

Further innovations in the 1990s included introducing compression garments to make patients more comfortable during recovery and improve results. Furthermore, Dr. Michele Zocchi of Italy developed the practice of using ultrasound energy to soften fat even more than tumescent solutions could before removal. Other concepts like laser and power-assisted liposuction were introduced in the 1990s and 2000s. Laser energy helps surgeons liquefy fat in a manner distinct from ultrasound energy while also helping provide some skin tightening effect. In contrast, power-assisted liposuction involves a cannula that moves in pulses to break up fatty tissue.

Noninvasive Methods Appear

During the 2000s, several liposuction alternatives surfaced to meet the demand of patients seeking less invasive ways to remove fat. Using a variety of different methods, such as laser heat, freezing temperatures, ultrasound waves, radiofrequency waves, and more, these noninvasive treatments aim to shrink fat cells by delivering energy to the skin. Although they may sound more appealing initially, we can easily see why these methods are unsuccessful now that we understand the finite number of fat cells in the body. 

To begin, shrinking fat cells by causing them to empty their contents requires a vast amount of time. Patients who underwent these nonsurgical procedures typically need multiple sessions and have to wait months and months for their bodies to process out the water released by the targeted fat. Furthermore, these cells can expand and shrink quickly, so results from such noninvasive treatments tend to be short-lived. Contrasted with treatments that directly remove fat, like liposuction and newer, more innovative procedures, results from nonsurgical methods are subject to change dramatically over time.  

AirSculpt®: The Most Innovative Approach Yet 

Whereas traditional liposuction uses manual syringes and a cheese-greater-like scraping motion to remove fat, AirSculpt® uses a more delicate and automated technique. The patented AirSculpt® cannula developed by Dr. Rollins spins rapidly, controlled by the surgeon via a power-automated foot pedal. These elements provide practitioners with unparalleled precision and finesse, enabling them to pluck fat cells one by one. 

Other key differentiating factors between traditional liposuction and this newer method include patients staying awake the whole time. Using local rather than general anesthesia dramatically reduces patient risk and enables surgeons to maneuver and talk with their patients during treatment to ensure exactly desired results are achieved. Furthermore, AirSculpt® does not require scalpels or large incisions characteristic of liposuction. Instead, procedures are performed through a two-millimeter wide, perfectly symmetrical entryway that heals without stitches. If scarring does occur, it ends up looking like a mere freckle! Patients recover considerably more quickly than traditional liposuction and often return to work the next day.

The innovative AirSculpt® fat removal and transfer technique changed the body contouring industry for good. Patented in 2012 by Dr. Aaron Rollins, this procedure is far less harsh than liposuction and takes an extensively more detailed approach. Though it requires more skill and artistry, AirSculpt®'s results are so impressive that they seem unfair. Nowadays, getting a fat removal procedure under general anesthesia is considered antiquated and unnecessary thanks to the industry-wide advances this technology inspired. 

A History of Fat Transfers 

We've reviewed the history of various attempts at removing fat cosmetically – now, let's take a deeper look at fat transfer procedures. Also known as fat grafting, this technique allows patients to enhance areas like their buttocks or breasts using their tissue instead of implants. Not only does this provide a more natural look, but it also is safer than using silicone or saline-filled implants, which the body could ultimately reject.

The history behind fat transfers in medical literature can be traced back to 1893 when German surgeon Gustav Neuber first outlined successful outcomes after transplanting fat beneath atrophic scars. Despite the positive results he reported initially, he ran into a problem that has influenced considerable amounts of innovation – fat reabsorption. One key difference between his approach and modern techniques was the fact that Neuber did not attempt to treat or change the fat's structure before transferring. In the following decades, doctors tried other early forms of fat transfer for procedures like breast and facial reconstruction to improve one's mobility. The main struggle continued to be the unpredictable nature of fat reabsorption and retention of the initially grafted material. 

With the advent of liposuction, as we reviewed in the last section, surgeons discovered how suitable this type of grafted fat tissue is for transplant procedures. Fournier first reported attempting these types of treatments as early as 1983 using unpurified fat. Later, doctors would experiment with and finally introduce standard methods of processing the lipoaspirate and then placing it back into the body to maximize retention rates. S.R. Coleman is credited with introducing the free fat transfer technique, which involves grafting free fat cells instead of intact tissue. 

The essential characteristic of this method was the dramatic reduction of damage done to the fat cells during extraction, largely thanks to innovation in fat removal technologies. Furthermore, Coleman's approach also popularized using centrifuges to purify the fat before reinjection, done in a way that separates higher-quality fat likely to survive from blood and lower-quality material.  

Even by the early 2000s, however, surgeons still experienced wide ranges of reabsorption despite Coleman's innovations. The last several years have featured vast amounts of research and new techniques optimized at improving fat viability through enhanced purification techniques and becoming even more gentle with the fat during extraction and transfer steps.

AirSculpt® Fat Transfers 

AirSculpt® fat transfers incorporate the most recent cutting-edge research combined with our patented devices to ensure optimal results. We use a closed-loop technique that employs gravitational energy to separate high-quality fat from the rest of the material. Next, we carefully prepare the fat and filter out the low-quality contents, and then that's it. As our founder Dr. Rollins likes to say, the more one tinkers with fat before grafting it, the greater the chances of decreasing its viability in a way that could affect one's results or even harm a patient.