What is liposuction?
Liposuction is defined as the removal of fat from deposits beneath the skin using a hollow stainless steel tube-called a cannula-with the assistance of suction, or a powerful vacuum.
What is tumescent liposuction?
Tumescent liposuction refers to a technique that uses large volumes of tumescent solution that is injected into the fat causing the targeted areas to be come tumescent, or swollen and firm. The tumescent solution is comprised of a local anesthetic, epinephrine (to decrease blood loss), and normal saline. Local anesthesia is widely regarded as the safest form of anesthesia, there is no need to be “put under.” Because local anesthesia persists for many hours there is no need for narcotic pain medications after surgery.
What are the benefits of tumescent liposuction over more traditional liposcution?
The tumescent technique offers patients a better safety profile than traditional liposuction. Risks are greatly reduced because the surgery is performed under local anesthetic thus negating the need for general anesthetic and its associated risks and complications. The epinephrine contained in the tumescent solution allows for greater control over bleeding preventing the need for blood transfusions. The use of smaller cannulas results in less scarring and damage to the underlying tissue.
Smoother Cosmetic Results
The tumescent technique permits the use of microcannulas which in turn yields smoother cosmetic results. Traditional liposuction cannulas (stainless steel tubes) have a relatively large diameter and remove fat rather quickly. However, with the use of large cannulas (diameter greater than 3 millimeters) there is an increased risk of irregularities and depressions in the skin. Microcannulas with a diameter less than 3 millimeters, allow fat to be removed in a smoother and more uniform fashion. Some surgeons prefer larger cannulas because it allows liposuction to be done more quickly. In addition, while the surgery is being performed, the patient remains awake and coherent enough to respond to prompts from the surgeon. In some cases, the surgeon may ask the patient to stand to get a better perspective and see if the surgical result is symmetrical and smooth.
After tumescent liposuction, there is a certain amount of blood-tinged local anesthetic solution that remains under the skin. This solution also contains a drug called epinephrine. Epinephrine causes the blood vessels to constrict resulting in less bleeding, bruising, and swelling thereby allowing the body to heal more quickly. This excess fluid is either slowly absorbed over several weeks into the blood stream, or it can be rapidly removed by drainage through skin incisions and absorbed by special absorptive pads.
Rapid drainage of blood-tinged anesthetic solution out of incision sites, accelerates the rate of healing, and reduces post-operative pain swelling, and bruising. Post-liposuction drainage of blood-tinged anesthetic solution can be maximized by 1) leaving incision sites open and not closed with sutures, 2) placing several adits (1.5 mm tiny round holes) in the skin to encourage drainage, 3) placing absorbtive pads on the skin to absorb the drainage, and 4) wearing spandex compression garments to encourage drainage.
Am I a candidate for tumescent liposuction?
The ideal candidate is someone who is in good health, actively exercises, and is of normal body weight but has localized fat deposits that have been resistant to exercise and diet. However, even those who are mildly to moderately overweight may be good candidates. The ideal candidate also has realistic expectations, is in overall good health, and is a non-smoker.