Although there were efforts toward removing fat in the early 1900s, the modern liposuction techniques upon which we base modern practices was started by Dr. Illouz from France in the early 1980s.

I read my first article on liposuction in 1982, and purchased my first cannulas from a company in Germany. For the suction device, we used standard “wall suction.”

My first case was liposuction of the outer thighs, often called “riding breeches.” The case was very successful. Prior to liposuction, the fat had to be excised with overlying skin, leaving a long scar. Liposuction was a monumental advancement in fat removal with minimal scarring.

One of the biggest advancements in liposuction has been in the anesthesia, called tumescent anesthesia. This allows removal of much more fat and with minimal blood loss and discomfort. 

Improvement has also been in the size and design of the cannulas, which are much smaller in diameter and with multiple designs in the holes. These are energy-based liposuction cannulas, such as lasers and ultrasound, which, in my opinion, have added more complication risks without benefit.

The Tickle liposuction or Micro-Aire cannulas enable the plastic surgeon to perform the procedure with less effort and fatigue, and appear to make refinement of the results easier to achieve. Post-operative dressings have been improved as well leading to better results.

There are numerous areas of the body that can be liposuctioned. These include neck, arms, breasts, back, waist, “love handles,” “muffin tops,” abdomen, thighs, ankles, and anywhere there is excess fat. The fat can be used to inject in areas such as the buttocks if desired; this procedure is sometimes called “Brazilian Butt Lift.”

Like every procedure, the plastic surgeon’s technique, experience, and skill are at the top of the list for safety and a smooth, shapely result. In the hands of a true professional, it is among the safest of all procedures.

It is important to understand that liposuction removes only fat. Liposuction can tighten skin only slightly, providing the patient has skin without stretch marks or excess sun damage.

For more skin tightening, technology such as the Renuvion, ThermiTight, etc. can be used. These instruments tighten the skin with radiofrequency heat, creating renewed collagen and elastin, which tightens the skin. 

One treatment should be performed simultaneously with liposuction. The alternative procedure for loose skin is surgical excision, as in a tummy tuck.

Some patients wonder if fat that is removed can “grow back.” When a person gains weight, fat cells increase fat content. They do not grow more fat cells. So, if weight is gained, the remaining fat cells can still increase in size.

If one does not watch their diet by eating healthy and controlling portions and doing some form of exercise, they can enlarge in the areas that have been liposuctioned and other areas of the body as well. 

E. Ronald Finger, MD, FACS is a board certified plastic surgeon with offices in Savannah and Bluffton.