The invention of the tumescent technique of liposuction in 1985 by Dr. Jeffrey Klein revolutionised the industry
For the first time, with the use of smaller cannulas and local anaesthetic, the risks of excessive bleeding and skin inconsistencies were dramatically reduced.
Doctors were able to reassure their patients that the uncertainties associated with conventional methods of liposuction were minimal.
The first tumescent liposuction surgery was carried out on April 5, 1985, by Dr. Klein.
The patient had localised accumulation of fat on her lower abdomen and a hysterectomy scar. Dr. Klein used undiluted concentrations of local anaesthesia (500mg of lidocaine and 1mg of epinephrine in 50ml) to remove just under 100ml of fat.
The patient said they experienced almost no pain during the treatment and suffered no surgical bleeding, and this was accredited to the epinephrine causing capillary vasoconstriction — the constriction of blood vessels.
The high concentration of epinephrine did reportedly cause a stinging sensation during administration and a rapid increase in heart rate, also known as tachycardia.
As Dr. Klein further developed the technique, he increased dilution levels of the anaesthetic solution for subsequent patients. The level of dilution allowed smoother flow and larger quantities of anaesthesia into the cannulas that spread more widely and affected a larger area in the body.
Although the micro cannula removes less fat per minute compared to traditional cannulas, these small-diameter cannulas allow for removal of a greater total volume of fat and produce a much smoother, cleaner end result.
He noticed that as dilution increased (with no change in anaesthesia concentration), both the stinging sensation previously felt by patients and the tachycardia were dramatically reduced. He also noticed that a greater area of subcutaneous fat was reached.
By the end of 1985, Dr. Klein had perfected this technique and found an optimum level of anaesthesia:
500–1250mg of lidocaine and 0.5–1.0mg of epinephrine per litre of solution.
The tumescent liposuction technique was shared publicly for the first time by Dr. Klein in Philadelphia in June 1986 at a lecture.,
In January 1987, The American Journal of Cosmetic Surgery published the first-ever article detailing the technique:
Klein JA, The Tumescent technique for liposuction surgery. American Journal of Cosmetic Surgery, 1987, volume 4, pages 263–267.
