The most important cosmetic surgical development in the past 25 years has been liposculpture. Introduced in the 1970s by Giorgio Fischer and further developed by Yves Gerard Illouz and Pierre Fournier, the technique has been improved and has totally changed the way cosmetic surgery is practiced today. There are two types of fat removal with aspiration. One is liposuction, which is the removal of fat through aspiration of localized deposits of subcutaneous fat. The other is actual body contouring or liposculpturing using both removal of the deep localized areas of fat and liposuction of the superficial layer for better draping of the skin to utilize contracture for a more aesthetic result. The original concept of liposuction had substantial limitations related primarily to excess skin, loss of elasticity and surface irregularities. The field of liposuction surgery is indebted to Marco Gasparotti who in 1989 introduced his technique of superficial liposculpture. It always seems that the job of the cosmetic surgeon is to sculpture the patient.
Twenty years of experience performing liposuction has convinced me that I need to be able to work superficially as well as in the deeper plane if I am to obtain optimum results. As I start this discussion it is extremely important that one understand the distinction between sculpturing in the superficial layer and damaging or injuring the dermis. Fournier, one of the fathers of liposuction and mentor of many liposuction surgeons practicing today, states, “What you take is not as important as what you leave.” Gasparotti’s technique involves deep removal of fat and subdermal removal of fat. His theory is that the subdermal removal of fat increases the postsurgical contracture of the skin to produce a smoother result. In areas such as the abdomen this approach has allowed substitution of liposuction for formal abdominoplasty or panniculectomy. Unfortunately, in the hands of unskilled cosmetic surgeons total removal of the fat between the dermis and the underlying muscle and fascia can result in significant deformities and irregularities. As I teach the art of liposuction I instruct my students that defects on the operating table will be defects forever. The superficial layer of fat is a distinct layer approximately 1–2 cm beneath the skin.
There is a definite learning curve in liposuction surgery and to find this layer takes some practice. If one suctions too close to the dermis permanent defects will occur. If large areas are removed in the deep layer only, significant contour irregularities will result. The advent of the tumescent technique of liposuction has further enhanced our ability to safely contour the body and protect the dermis while still being able to carry out superficial liposculpture. The safety of liposuction as we know it today has occurred owing to Jeffrey Klein and his contribution of the tumescent technique. My personal technique of the use of tumescent infiltration will be presented later in this article. Gasparotti in his original theory felt that by properly thinning the superficial subcutaneous tissue one could use the properties of retraction or contracture and support of the skin to function in a dynamic way to obtain the desired contour. Initially this technique was proposed for flaccid skin. Through the years, the technique has been utilized in all facets of body contouring. Contracture has given us the ability to hold and improve the sculptured results. Contrary to the original concept of liposuction in which we were taught to stay deep, the superficial technique of liposuction revolutionized our ability to create a new body form. As Gasparotti noted in his text of superficial liposculpture, the skin is an active structural dynamic contributor to the body contouring procedure, not just a passive element in the operation. Though the technique I use may differ in method, the goals of the procedure are similar to those of others who subscribe to the use of superficial liposuction.
My personal technique of liposuction is constantly evolving as new modalities emerge that allow me to improve my results and enhance patient safety. The term “the art of medicine” is nowhere more evident than the field of cosmetic surgery. Liposuction is definitely based on scientific medically sound principles but the optimal results depend on the eye to visualize and the skill to artistically create the desired symmetry and contour. In liposuction surgery personal preference may be a combination of one’s artistic style in combination with technical changes. In the process of our learning curve we will incorporate the methods of other colleagues and also develop our own individual skills.
Our website is not responsible for the information contained by this article. Articleinput.com is a free articles resource thus practically any visitor can submit an article. However if you notice any copyrighted material, please contact us and we will remove the article(s) in discussion right away.
Note: This article was sent to us by: Carl D. Sorginson at 01292010
1. What you should consider when choosig your cosmetic surgeon
All articles are property of their respective authors. Please read our Privacy Policy!
© 2009 ArticleInput.com.