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Tumescent Liposuction

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Tumescent liposuction, also referred to as liposculpture, is now recognized world wide as the technique permitting the greatest safety, the most rapid recovery, the least pain and the best aesthetic results.   It is considered by most cosmetic surgeons to be the safest and most effective form of liposuction surgery. Tumescent liposuction has gained a tremendous amount of popularity in recent years. Tumescent liposuction is also the only technique that, in the hands of an expert surgeon, permits liposuction totally by local anesthesia, avoiding the dangers of general anesthesia, IV sedation and narcotic analgesics.

There are surgeons who prefer to simultaneously use general anesthesia and tumescent liposuction. Some surgeons rely on general anesthesia because they do not have the skill to achieve complete anesthesia with tumescent liposuction. Others recommend general anesthesia just because they prefer patients to be unconscious. Still others use general anesthesia because it permits liposuction to be completed more rapidly, avoiding the dangers of general anesthesia, IV sedation and narcotic analgesics.

Development of Tumescent Liposuction

Although liposuction is a relatively new form of cosmetic surgery, there have been several recent improvements in the technique. One of the most significant improvements has been the introduction of tumescent liposuction, developed by Jeffrey A. Klein, M.D. in 1985. It permits liposuction totally by local anesthesia instead of general anesthesia. This technique is now considered the safest form of liposuction for removing very large amounts of fat because there is virtually no blood loss. Not only has tumescent liposuction proven to be safer than the standard technique using general anesthesia but it also has proven to be less painful, has minimized post operative recovery time, and has produced optimal cosmetic results.

Tumescent liposuction was first presented by Dr. Klein in 1986 at the Second World Congress of Liposuction Surgery in Philadelphia. His article that first described the technique appeared in the American Journal of Cosmetic Surgery in 1987.

The word tumescent means swollen and firm. Tumescent liposuction uses large volumes of a dilute solution of lidocaine, a local anesthetic, in combination with the vasoconstrictive drug epinephrine, which temporarily shrinks capillaries.

Local anesthesia used in tumescent liposuction for liposuction is so effective that patients no longer need intravenous sedatives, narcotic analgesics, or general anesthesia. Over the years, numerous patients who previously had liposuction with general anesthesia have had second treatments with tumescent liposuction. Virtually every one of these patients has found tumescent liposuction to be less painful, to provide better results and to result in more rapid healing and recovery. During this technique, the surgeon will inject a solution into your fatty areas before the fat is removed. It is made up of a saline solution, a mild painkiller and epinephrine, a drug that contracts your blood vessels. The solution not only helps the surgeon remove the fat more easily but it helps reduce blood loss and provides pain relief during and after surgery.

Virtually No Blood Loss

As a result of the widespread capillary constriction caused by the epinephrine in the anesthetic solution, there is minimal bleeding during and after surgery. This is a major improvement in the liposuction technique compared to older methods that simply use general anesthesia.

Dr. Klein recently completed a study of large volume liposuction of 112 patients, each of whom had between 1,500 ml to 3,400ml (1.5 quarts to nearly 1 gallon) of fat removed using tumescent liposuction. None of these patients required a blood transfusion. In fact, the average patient lost approximately three teaspoons (15 ml) of blood. Tumescent liposuction is so effective at minimizing blood loss that the majority of patients with large volume liposuction lose less blood during the surgery than they do at the time of their routine pre-operative laboratory studies.

Tumescent Liposuction Variations

Wet Technique
Wet liposuction simply refers to the use of fluid injection prior to liposuction treatment. To prepare for wet liposuction, the surgeon administers approximately 100 milliliters of local anesthesia containing epinephrine directly into the tissue. This results in less blood loss during the procedure and reduces patient discomfort after surgery.

Super Wet Technique
The super wet technique is similar to tumescent liposuction, except that it uses a solution containing less of the anesthetics lidocaine and epinephrine. In their place, intravenous sedation or general anesthetic is used (because the area being treated does not become fully anesthetized by the solution alone). Not using an injected local anesthetic means that the doctor does not have to wait for any swelling to go down. The surgery usually takes no longer than two hours, and the patient can opt to have other procedures performed while the general anesthetic is in effect.

Anesthetic Injections
In the first step of tumescent liposuction, a large dose of liquid (composed primarily of lidocaine, a local anesthetic, and epinephrine, which helps to shrink blood vessels) is injected into the part of the body being treated. The added fluid forces the compartments of fat to swell and firm up, which lets the doctor extract the unwanted fat more smoothly and with minimal bleeding.

Tumescent liposuction and the “wet” and “super-wet” techniques are now used by surgeons in place of the dry technique, which fell from favor due to the excessive blood loss that resulted, as well as the fact that the procedure required hospitalization. The super-wet technique is currently used more often than the wet technique, and tumescent liposuction continues to be a popular choice. Whether you chose wet, super-wet, or tumescent liposuction will depend on a number of factors, including how many areas you wish to have treated.

Tumescent Liposuction Benefits - Reduced Bruising, Swelling, and Pain

Tumescent liposuction can significantly reduce some of the unpleasant side effects of other techniques. Because the anesthetic solution temporarily reduces the size of the capillaries, it can significantly reduce blood loss during surgery and the pain, bruising, and swelling that occurs afterward. And because tumescent liposuction provides local anesthesia, patients can avoid the side effects of general anesthesia, such as vomiting and nausea.

Tumescent Liposuction Risks

As with any form of liposuction, complications can occur during tumescent liposuction. Two risks that are unique to tumescent liposuction are lidocaine toxicity and fluid accumulation. Lidocaine toxicity occurs when the amount of lidocaine in the tumescent solution is too high, making it difficult for the body to adequately metabolize the drug. When too much solution is injected into the treatment area, it is possible for fluid to accumulate in the lungs.

Find a Tumescent Liposuction Surgeon

Tumescent liposuction must be performed by a qualified surgeon. Searh our directory of cosmetic surgeons to find a doctor in your area.

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