Tumescent liposuction involves the surgical removal of excess body fat using a combination of traditional liposuction techniques and tumescent anesthesia. The procedure is relatively new to the cosmetic surgery scene, having come into widespread use in the 1990’s. Tumescent liposuction offers significant benefits over traditional liposuction techniques for its ability to minimize post-operative discomfort, curtail surgical bleeding, and reduce bruising and swelling during the recovery period.
Tumescent liposuction is unique in that it uses large volumes of a dilute solution of lidocaine, paired with the drug epinephrine. The lidocaine serves as a local anesthetic, eliminating the need for patients to go under general anesthesia. The epinephrine serves to temporarily restrict capillaries, thereby reducing bleeding during the surgery. This combination allows surgeons to perform liposuction using minimal amounts of sedatives. The lidocaine is retained in the body for several hours after the procedure, giving the patient up to 12 to18+ hours of pain-free recovery. The use of tumescent anesthetic also eliminates the drunken feeling felt by many patients after going under general anesthesia, as well as the nausea felt by traditional liposuction patients.
At the start of the procedure, the surgeon anesthetizes the skin at select locations using tiny needles. Once the skin has been numbed, longer needles are used to anesthetize the subcutaneous fat with large quantities of the dilute lidocaine and epinephrine solution. Patients are frequently given a mild sedative, such as Valium to help relax them during the procedure. Once the areas to be treated are completely numb, the doctor begins the liposuction. Small holes, called adits, are made in the skin using round skin biopsy punches to form access sites for the liposuction microcannulas. A microcannula is a very small stainless steel tube, ranging from 1mm to 3mm in diameter, designed to effectively remove small amounts of fat. Fat is suctioned out of the body in small tunnels through the microcannula, leaving the fibrous strands attached to the skin and muscles intact. Once the desired fat has been suctioned out, the microcannulas are removed. Since the adits are such small holes, there is no need for sutures using this method. This actually serves to speed up the healing process since drainage can occur via the adits, greatly reducing the amount of swelling and bruising of the treated areas.
Tumescent liposuction, as with any other type of surgical procedure, does carry some risks. Patients should expect some side-effects from the procedure such as bruising, swelling, and temporary numbness of the treated areas. Significant drainage will occur in areas where adits were formed. Some skin irregularities may result from the procedure, though this side-effect is greatly reduced with the use of both the tumescent anesthesia and microcannulas. Other, more serious side-effects can include blood clots, infection, and allergic reactions to the anesthesia.