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Summary: Now​ the number one cosmetic surgery procedure in the United States, liposuction has a history of over 30 years as a cosmetic procedure. Liposuction veteran Dr. Elliot Jacobs took a moment to share his personal perspective. Smiling Woman With Digital Tablet Q: How did you first ​get interested in liposuction?

Dr. Jacobs: I attended an ASAPS conference in Hawaii in 1982 where the French plastic surgeon Dr. Yves-Gerard Illousz presented his safe and efficient technique for removing subcutaneous body fat.  This was a tremendous improvement over earlier attempts.  I thought at the time, “This could really turn into something!”

Q: What was ​innovative about Dr. Illousz’s method?

Dr. Jacobs: He used blunt cannulas and high volume suction to remove fat cells—not sharp instruments.  In prior years, surgeons had tried simply cutting fat away.  That didn’t work very well and in fact lead to some disasters.  Dr. Illousz described over 3,000 procedures with no complications.

Q: Did you go back to New York and get started immediately?

Dr. Jacobs: No, liposuction was so new that patient safety and good results demanded a strategy beyond just “trying it out.”  Instead, I was fortunate to have the opportunity to work firsthand with Dr. Illousz.  Along with another plastic surgeon, we opened a private clinic in the Bahamas, each of us flying in to perform cosmetic surgery including liposuction.  During that time I began perfecting my own approach. In the meantime, a blue ribbon committee of plastic surgeons traveled to view Dr. Illousz’s work in Paris and came back to the U.S. with glowing reports.  Eventually, the concept of tumescent infiltration (fluid infusion) prior to liposuction contributed to the overall increase in safety and in refinements for the procedure.

Q: How did you conduct​ the procedure?

Dr. Jacobs: I erred on the side of being conservative in removing fat, paying careful attention to creating natural looking and very smooth contours rather than removing high volumes.  I also began to expand the areas where I would apply liposuction techniques, no longer using it on just on thighs and abdomens.

Q: How did liposuction advance after this?

Dr. Jacobs: It was obvious to many surgeons that liposuction could deliver benefits beyond its use as a standalone procedure.  They began using it to compliment abdominoplasty, facelifts, breast reductions and other cosmetic surgeries.

Q: How do you feel about PAL and UAL?

Dr. Jacobs: Power-assisted and ultrasonic-assisted liposuction are variations on the basic tumescent technique.  These methods can make it less strenuous for the surgeon to maneuver through fat tissue, but they have not been shown to produce superior results.  Most plastic surgeons suggest that patients should choose an experienced liposuction surgeon who consistently produces great results and leave the selection of methods and instruments to the doctor.

Q: What do you find exciting about performing liposuction today?

Dr. Jacobs: One thing that’s new and promising is our ability to transfer fat from one part of the body to another.  As plastic surgeons understand more about when and how this works, there will be more ways to use fat that’s not needed in one area of the body to create more generous curves and youthful contours in other areas.

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