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In the October 1997 issue of the ARCHIVES, Shiffman¹ cites an article by us² and states that "Attempts by Goodstein and Hoefflin to use a cannula with a sharp trailing edge acting as a curette in the subdermal tissues resulted in lymphorrhea (severe edema and fluid) as well as occasional skin necrosis." Our article is related to liposuction of the trunk and extremities, and the complications of lymphorrhea and skin necrosis occurred in several patients from whom large volumes (>4000 mL) of fat were removed.

Using a blunt-tipped cannula with a beveled aperture must be distinguished from using a sharp instrument for liposuction. Mottura³ and others³ have demonstrated that mechanical dislodgement (avulsion) of fat at the edge of the cannula's aperture (curette effect) is the primary mechanism by which liposuction occurs and beveled aperture cannulas are widely used for liposuction procedures. In fact, they are thought to be indispensible by . . . [Full Text of this Article]

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