Thirtyfour years of liposuction: past, present and future.

Initial, variably successful at- tempts of fat sculpting date back to the begin- ning of the 20th Century, but Gerard Illouz was the first to introduce the modern, safe, wide- spread method of liposuction. Preoperative in- jection of local anaesthesia, saline, distilled wa- ter, adrenaline and hyaluronidase, defined wet technique, established as a safe and effective adjunct to lipoaspiration. This procedure was initially based on an automatic pump system, but then the accuracy of syringe aspiration was popularized by Toledo in the eighties. Liposuc- tion in the subcutaneous tissue, just 3-4 mm deep to dermis, also called superficial liposuc- tion, is a modern effective evolution of the tech- nique, but requires a good mastery in order to avoid disfiguring outcomes. Ultrasound and laser lipoplasty methods have provided further advancement in the range of technical choices offered to the plastic surgeon. Liposuction is a purely surgical procedure, and as such, carries risks of minor and major complications. In the nineties, an interplay between abdominoplasty and abdominal liposuction as simultaneous pro- cedures, also called lipoabdominoplasty, has be- come more and more popular. Reinjection of the harvested fat with the purpose of liposculpture for both reconstructive and cosmetic indications is a relatively recent development which has es- tablished as a successful, world-wide accepted procedure. Adipose stem cells, extracted from the unlimited source represented by human adi- pose tissue, are a great promise for future tis- sue-engineering. Liposuction has nowadays be- come a safe, effective, popular procedure for contouring adipose tissue and human body in general, in many reconstructive and cosmetic in- dications.