Liposuction Tumescent Technique

Tumescent liposuction. What does that mean?

Tumescent is the fluid we inject into the skin before we remove the fat. It is not a new technique. Almost all doctors use tumescent. Why would we do that? The fluid has two things in it:

1. numbing medication and
2. epinephrine.

The epinephrine is the most important factor, as it causes the small blood vessels to constrict so you don’t lose as much blood. The numbing medication can allow you to do liposuction without general anesthesia, though unless for a small area, I think for optimal shaping, fat removal, and safety general anesthesia is better.

All doctors doing liposuction use this tumescent. Ultrasonic, Vaser, UAL, Slim lipo, smart lipo, traditional liposuction- these are what you do after you have blown up the tissue with the tumescent fluid. (Lauren Greenberg, MD, Palo Alto Plastic Surgeon)

Most plastic surgeons these days utilize the tumescent technique. Fluid is infused to expand the area where the fat is, numb the area being treated with an anesthetic, and reduce bleeding with epinephrine, all mixed together in the solution.

We combine power assisted tumescent liposuction with laser liposuction. We do all under local anesthesia, outpatient. Results are excellent. (Edmond A. Zingaro, MD, San Francisco Plastic Surgeon)

We always use tumescence for Liposuction

There are many liposuction techniques, but one thing they all have in common is that some “tumescent” fluid is instilled prior to the procedure. This minimizes blood loss, decreases postop pain, and allows the canula to move through the fat more easily. (Jeffrey Horowitz, MD, Bel Air Plastic Surgeon)

Modern Liposuction uses Tumescent Technique

There is lots of advertising directed at the public nowadays. Some folks are trying to say they use the “new” tumescent technique. This technique has been around for years Every Board Certified Plastic Surgeon I know uses tumescent technique for his/her liposuction.

In the O. R., one makes a small incision and then places a thin cannula into the area where you want to remove the fat. Tumescent fluid is placed via this cannula. The fluid consists of normal saline, (the same fluid they put in your I.V.), lidocaine, (to decrease pain), and epinephrine (to decrease bleeding and bruising).

Once the fluid is in, it is then removed along with the fat via the liposuction cannula. The tumescent technique allows plastic surgeons to do the operation with much less pain and bruising then in the “old days.”

Remember, when it comes to liposuction, seek out a Board Certified Plastic Surgeon. Discuss your goals with him/her, and together make the best decision for you. (Jeffrey J. Roth, MD, FACS, Las Vegas Plastic Surgeon)

Tumescent liposuction vs. “wet” technique

Most docs perform versions of the “wet” technique which is quite similar to tumescent liposuction. It is always best to ask your prospective surgeon what he or she actually does however. Best. (John P. Di Saia, MD, Orange Plastic Surgeon)

Difference between tumescent liposuction and liposuction

Tumescent liposuction refers to the technique of injecting a very dilute solution containing Normal Saline (0.9%) of Lactated Ringer’s solution and adding lidocaine and epinephrine (usually one vial of 50cc of 1% Lidocaine with 1/100000 epinehrine). The purpose of using this solution is to help anesthetize the area with the lidocaine and to diminish the amount of bleeding by constricting the small blood vessels with the epinephrine.

Tumescent refers to the local anesthetic method and is not referring to the technique of liposuction itself. Liposuction is performed after the anesthetic liquid has had time to work and can be done with small diameter cannulas, power assisted cannulas, ultrasonic assisted liposuction and more recently laser assisted liposuction such as Smart Lipo or Slim Lipo.

My preference is Slim Lipo because the laser fibre is flexible and the wavelength at 924nm. specifically melts the fat. Laser assisted liposuction has the advantage of causing the skin to tighten after the procedure a decided advantage over tranditional liposuction. (Joel B. Singer, MD, New York Plastic Surgeon)

Almost all liposuction is tumescent liposuction

Liposuction is the removal of fat from the body through the use of suction. In order to perform liposuction safely and comfortably, surgeons will inject a solution into the fit. This solution usually contains a local anesthetic and epinephrine.

The local anesthetic will numb the area so that the liposuction itself is less painful. The epinephrine will cause the blood vessels in the area to contract, leading to less bleeding. A decreased amount of bleeding means less bruising.

The word tumesecent comes from the latin “tumescere” which means to swell up. So, basically, surgeons will use a tumescent solution, containing the anesthetic and epinephrine, to swell up the area that will be suctioned.

By introducing a tumescent solution, the surgeon numbs up the area and decreases the blood loss. So, almost all liposuction is tumesecent liposuction. Now, there is a caveat to this, of course. If you want to be very particular about your language, tumescent lipousction can refer to a particular technique.

In the previous paragraphs, I never mentioned how much fluid was injected into the area to be liposuctioned. In very strict terms, tumescent liposuction refers to a technique in which about 3ml of tumescent solution is injected for every 1ml of fat liposuctioned out.

There are also other techniques like the superwet, wet, and dry techniques that use different amounts of tumescent solution. (Edward S. Lee, MD, Englewood Plastic Surgeon)