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Liposuction Using Tumescent Method

Tumescent solution lipoplasty: saline, lidocaine, epinephrine
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Tumescent Method of Lipoplasty

Liposuction using the tumescent method describes a type of liposculpture during which the cosmetic surgeon first infiltrates a large quantity of medical fluid into the subcutaneous fatty tissue to be suctioned. The liquid contains saline, dilute lidocaine (a local anesthetic) and epinephrine (a vasoconstrictor that shrinks capillaries in order to inhibit blood leakage). Typically, up to three times more solution is injected, than body fat removed. Tumescent liposculpture was developed by the dermatologist Dr. Jeffrey A. Klein, M.D.,in 1985.

Meaning of Tumescent and Tumescence

Tumescent means "swollen and firm", which is exactly how the area of fatty tissue becomes after fluid-injection. The aim of the is to numb the fatty tissue that needs removing, (tumescent is the only type of liposuction that can be performed using only local anesthesia) reduce blood loss, inhibit bruising and permit fat removal with minimal damage to tissue. In addition, the long-lasting effects of the anesthetic solution provide increased pain relief after the lipoplasty procedure and reduce the need for specific post-operative pain medication.

Tumescent Liposuction - Procedure

After the infiltration of the local anesthetic and vasoconstrictor, there is a 30-45 minute pause in the procedure, while the fat tissue settles and becomes less swollen. Then one or more surgical incisions are made through which the adipose tissue is pumped out. The plastic surgeon may make several incisions to increase the amount of cross-suctioning and thereby optimize skin smoothness and body contouring effect.

Use of Microcannulas

A liposuction cannula is the stainless steel tube which the cosmetic surgeon inserts into the subcutaneous fat needing removal through a small incision in the skin. During tumescent lipoplasty, very small cannulas (microcannulas) are used. This facilitates a more delicate and approach to the cross-suctioning of the fatty tissue. For example, micro cannulas require much less manual pressure to push them into the fatty tissue, and the cosmetic surgeon can change the direction and angle of the cannula with greater precision. Result? There is less risk of approaching too close to the undersurface of the skin thus causing irregularities in the skin contour.

Superwet vs. Tumescent Liposuction

Drawbacks of the tumescent method include: length of operation - superwet liposuction typically takes less time. Also, with superwet there is less likelihood of too much fluid being injected (less risk of lidocaine toxicity). Finally, according to some experts, the tumescent method requires a higher degree of skill by the cosmetic surgeon since the areas being treated remain swollen during the procedure thus obscuring their 'sculpted' shape.

Tumescent Liposculpture - Advantages

Clinical evidence indicates that tumescent lipoplasty has a number of specific benefits and advantages over other types and techniques of liposuction, including:

- Less need for general anesthesia
- Less post-operative pain
- Less need for pain-killers, analgesics
- Less blood loss
- Smaller incisions
- Less bruising
- Less post-operative infection
- Smoother skin and body contours

Most lipoplasty experts consider tumescent liposuction to be the safest method.

Other Liposuction Techniques:
Dry Method
Wet Method
Superwet Method
Ultrasonic Method

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