Tumescent liposuction is a relatively simple, yet elegant procedure. The procedure is performed in the operating room in order to keep the instruments and operating area sterile. Sedation is commonly used, but for small areas, it can be performed completely awake or with general anesthesia. Small incisions, generally less than 5 mm in length, are created near the area of fat to be removed. The tumescent solution, which is comprised of saline (saltwater), epinephrine, and lidocaine, is injected into the fat.
This tumescent solution is the magic ingredient that makes liposuction possible by constricting blood vessels and numbing the area. Once the area is numb, liposuction is performed using small cannulas (hollow tubes with small holes on the end). These cannulas are attached to suction, which draws out the fat.
Length of Procedure
The procedure length can be quite variable. For small areas, such as bulges on the thighs, it may take less than 45 minutes. For larger areas or full body liposuction, however, it may take several hours. As the liposuction progresses, less and less fat can be removed with each passing of the cannula. This phenomenon leads to longer operating room time when aggressive liposuction is being performed.
End Results and Recovery
Removal of fat is the end game for tumescent liposuction. This allows contouring of the body to give a more pleasing body shape. Recovery time really depends on the area. For small areas, people will be back to their normal routines in 1-2 days. For larger areas, such as the abdomen, love handles, and back, it may take up to a week before returning to normal activities. According to a rough estimate, every 500 cubic centimeters of fat removed adds one day in recovery. Liposuction is permanent with a healthy lifestyle and weight management. Once the fat cells are removed, they do not return unless the patient gains weight.
Goals for Tumescent Liposuction
Most people are trying to reshape troubled areas of the body. Some of the most popular areas are the love handles, saddle bags, muffin top, male breasts, neck (double chin), and thighs. Most patients are looking to sculpt their body into a more attractive figure.
Often times, people will consider a tummy tuck to tighten the skin and muscles around the abdomen. Laser and radio frequency skin tightening is very popular to help the skin contract over the areas of liposuction. Brazilian butt lifts are in high demand right now. This procedure takes the fat from tumescent liposuction and injects it into the buttock to increase volume and improve shape.
Risks are generally minor. The most common risks are fluid collections that may develop and require removal, irregularities in the contours that may require revision, temporary numbness, pain, lidocaine toxicity, and infection. There are other, less common risks that you should review with your physician before undergoing any liposuction procedure.
Tumescent vs. Traditional Liposuction
The procedures in and of themselves are actual very similar. In both traditional and tumescent liposuction, the same solution is used to prepare the area of fat to be removed. Tumescent liposuction involves a greater amount of the tumescent fluid being used than in traditional procedures. To be considered tumescent liposuction, roughly four times the amount of tumescent fluid needs to be used in comparison to how much fat is being removed. For example, if 500 cubic centimeters of fat is anticipated to be removed, a total of two liters of tumescent solution needs to be infiltrated. The removal is also similar, as the same cannulas can be used. Tumescent liposuction allows larger areas to be removed comfortably with minimal anesthesia. It also reduces the amount of bruising.
What goes in, must come out. So, when doing tumescent liposuction, it is important to consider how the extra fluid is being removed. We prefer to use a drain that contains and removes the fluid. Some recommend leaving the incisions open to allow the fluid simply to drain out naturally. Although effective, this method is somewhat messy.
Be sure to find a reputable surgeon. Seek out a Board Certified Plastic surgeon who is a member of the American Society of Plastic Surgeons. These practitioners have strict rules on patient safety. Tumescent liposuction and traditional liposuction can be performed by anyone. The cavalier use of tumescent liposuction can lead to problems with patient safety by using excessive amounts of tumescent fluid or removing dangerous amounts of fat.
Generally speaking, the amount of fat removed in an outpatient setting should not be more than five liters. If more is planning to be removed, it is recommended that patients spend the night in the hospital in order to be properly monitored.
For additional questions, contact your physician or our plastic surgery office.