Liposuction: Myths, Magic & Marketing

Patient received Liposuction at Bortnick Plastic Surgery

1. MYTH: Liposuction is a relatively new procedure

REALITY: Historically speaking liposuction is an older procedure. The roots of liposuction can be traced to a french plastic surgeon, Charles Dujarier, in 1926. As with many early surgeries, this ran afoul. After performing liposuction on the leg of a beautiful french model, she subsequently developed gangrene and had the leg amputated. Forty years later, another French plastic surgeon, Dr. Illouz, is credited as the modern father of liposuction. During the 1980’s, refinements in the technique and technology laid the ground work for modern liposuction.

2. MYTH: Tumescent liposuction is the best type of liposuction

REALITY: Tumescent  liposuction is not a type but a technique of liposuction. During the 1980’s, Dr. Klein, a dermatologist, refined the technique of Dr. Illouz, by increasing the amount of saline solutions instilled into the body during surgery. Tumescent technique has largely become a relic of the past. Like some other techniques, tumescence lead to problems with fluid overload for the patient and pulmonary complications. Modern techniques still utilize saline solutions but at a much smaller volume called wet and superwet techniques. These are now inherently safe procedures.

3. MYTH: Only real plastic surgeons can perform any type of liposuction or cosmetic procedures.

REALITY: It may be hard to believe, but anyone with a valid medical license can call themselves a plastic surgeon. The consumer must investigate carefully before he or she goes to see a physician. Liposuction is currently being performed all over The United States and in Kansas City, by dentists, ob-gyn, nurse practitioners, general practitioners, medi-spas and others.

4. MYTH: Laser Assisted Liposuction (LAL) offers advantages compared to other techniques.

REALITY:  Laser assisted liposuction (LAL),marketed under the names of smart lipo or slim lipo, was a marketing success. However, a review of the literature from plastic surgery journals, has not to date shown any large series studies demonstrating any superiority of the procedure. In fact, a 2010 survey of plastic surgeons, published in the Journal of Aesthetic Surgery, showed that among the approximately 500 ASAPS responding members only 13% perform LAL. Further, 60% of those that perform LAL cited their main reason for using the technique was marketing.While claims of skin tightening and quicker recovery have not been substantiated in the literature, it is documented that there is a higher associated rate of contour irregularity requiring revisions. Similarly UAL ( ultra sound assisted liposuction) has been in steady decline since its early introduction. The current gold standard remains SAL or PAL, suction and power assisted liposuction, respectively.

5. MYTH: Liposuction can be best performed under local anesthesia in the office setting.

REALITY:  Again while liposuction could be performed with any technique in the office setting, it is extremely limited in its application. Like all procedures patient selection remains of paramount importance. Those patients requiring very small treatments, or minor revisionary liposuction procedures may be done in the office while the patient is awake. However, it is generally agreed that general anesthesia administered in an accredited surgery facility is the right decision.  This will determine not only your outcome, but your safety as well. Marketing of early tumescent technique was directed at the office setting, as is LAL today. The amount of fat removal that can be accomplished safely, efficiently and comfortably is considerably reduced in the awake patient. Further any cost reduction is offset by increases in time spent performing the surgery.