Tumescent Liposuction - Fat Removal Surgery

Tumescent Liposuction

 

The tumescent technique is a form of liposuction that has vastly improved the safety and effectiveness of fat removal surgery. In fact, for most areas of the body in which is feasible, it is superior to other liposuction approaches, such as dry liposuction.

 

The tumescent liposuction technique simply involves infusing a large quantity of anesthetic, blood vessel constrictor, and saline into the area from which fat is going to be removed. This fluid fills the spaces between the skin and the deeper structures and essentially expands the fatty layer. Since the skin is raised by fluid, the chance of damaging the important structures under the skin is reduced. Also, since the area is filled with saline—which is mostly water—any heat generated by the liposuction probe is quickly dissipated. In other words as the fat is being liquefied, the chance for burns is greatly reduced because the saline absorbs much of the heat that is generated.

 

 

The local anesthetic, usually lidocaine or similar drug, is placed under the skin as well to completely block nerve signals. These nerve signals are what usually sends information about pain to the brain. Another component of the infusate used in tumescent liposuction is an agent that constricts blood vessels, usually epinephrine. Epinephrine, also called adrenaline, is the same substance that is released into the bloodstream by the adrenal glands during a frightening or stressful experience. When epinephrine is placed under the skin, it causes the blood vessels to shrink.

 

Having constricted blood vessel in the area that is undergoing tumescent liposuction serves a few important functions. First, constricted blood vessels do not leak much blood, even if they are damaged by the ultrasound probe. This means that bleeding and bruising is less in the tumescent liposuction compared to other approaches. Second, small balls of fat, called fat emboli, can be very damaging to the body if they enter the blood. Epinephrine infused during tumescent liposuction virtually prevents fat emboli from entering the bloodstream. Finally, if the blood vessels in the area are constricted, the local anesthetic is less likely to enter the blood stream. While lidocaine placed under the skin is a great way to deaden pain signals, lidocaine in the blood can dramatically affect the heart, which is a bad thing to happen in a simple tumescent liposuction.

 

Tumescent liposuction appears to be very safe. When the tumescent technique was studied in over 15,000 patients there were no deaths nor were there any serious complications. The complications that did arise from tumescent liposuction were infection, skin irregularity, bruising with blood collection under the skin, scarring and damage to the nerves in the area. Tumescent liposuction is significantly safer than dry, wet, and superwet liposuction approaches. In fact, most plastic surgeons have adopted the tumescent technique in their liposuction practices more or less exclusively. For certain areas of the body, like the chin and face, there is really no reason to use any of the other liposuction techniques. The one exception to this rule is laser liposuction (which is not technically liposuction). Even in laser liposuction, some surgeons are experimenting with the use of the tumescent approach.

 

Given the many advantages of tumescent liposuction, it is important to discuss the possibility of using this approach if you are considering liposuction.