Tuesday, February 12, 2013

Laser Liposuction History

Birth of liposuction

Liposuction is still a relatively young procedure. The concept has been developed in 1974 by a an Italian gynecologist Dr Giorgio Fischer and his father Dr Arpad Fischer. Their first publication was in 1976:"Fischer A, Fischer GM. First surgical treatment for modeling body's cellulite with three 5-mm incisions." Bull Int Acad Cosmet Surg. 1976;3:35. It was the beginning but the key concepts were there: cannula, suction, sculpting, tunnels. They have invented liposuction.

It was revolutionary but not perfect. The major problem was a very significant blood loss that sometimes would lead to fatalities. From 1977, French surgeons Dr Pierre Fournier and Dr Yves Illouz refined the technique making the liposuction less aggressive. They became very popular among their peers. In the early 1980's surgeons from all over the world came to Paris to learn this revolutionary new technique. In 1989 Dr Fournier published his book " Liposculpture ma technique. Paris, Arnette, 1989." In this book liposuction pioneers including Dr Fischer himself relate the birth and development of the procedure.

The second liposuction revolution

A major improvement was introduced in 1985 by an American dermatologist Dr Jeffrey Klein. Dr Klein invented the tumescent technique. This was a revolution because it became possible to perform a liposuction with a totally local anesthesia. Moreover, the blood loss was reduced to a minimal. The toxicity of the drugs was under control. The risks of a general anesthesia were eliminated. Patients were back to their normal life very quickly. Cosmetic results were greatly enhanced by the use of smaller cannulas. He made liposuction a reliable, safe and effective cosmetic procedure. It is still a gold standard today. Dr Klein has described his concepts and findings in his book "Tumescent Technique: tumescent anesthesia and microcannular liposuction. St Louis. Mosby. 2000."

From liposuction to laser liposuction

Always in search of technological advances, practitioners became interested in the use of lasers to treat fat deposits as an alternative to liposuction. In 1992 Dr Apfelberg made the first description of a Yag laser effect on the fat tissue. Despite encouraging results, the laser did not demonstrated a significant advantage and was not developed. But at the beginning of the 21st century doctors from South America (Goldman, Schavelzon, Blugerman) started to publish studies demonstrating the effect of the laser on fat and on the skin. Dr Katz and Dr McBean from New York have related this in their very interesting 2011 article laser lipolysis: an update. Soon, an Italian company would get the FDA approval for a laser device, the world famous "Smartlipo®".

Smartlipo was introduced in the UK in 2006. At this time, practitioners were taught to use the laser alone, without additional suction. Whilst the laser beneficial effects on speed recovery and skin tightening were obvious, it was not so good for body sculpting. Very logically, a lot of practitioners started to combine the laser and the suction giving birth to the laser liposuction.

Today, laser liposuction combines the benefits of the liposuction under local anesthesia (as described by Dr Klein 27 years ago) with the specific thermal effect of the laser on the dermis and blood vessels. Lasers have also improved in speed, power, safety. The first Smartlipo has now been replaced by a second generation of laser lipo.This combination of old and new techniques allows these clinical results in a day procedure without all the risks of the traditional liposuction with general anesthesia.

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