What is Tumescent Liposuction?
Tumescent liposuction describes a form of liposuction done under local anesthesia and mild sedation. Recently, tumescent liposuction has been grouped with other procedures as Drive-Thru Cosmetic Surgery. Tumescent liposuction offers several advantages:
- Tumescent liposuction is safer than techniques that require general anesthesia.
- Tumescent liposuction results are similar to or better than general anesthesia techniques.
- Tumescent liposuction allows the patient to return home the day of the procedure.
- Tumescent liposuction lowers the cost of liposuction procedures by allowing them to be done in the doctor’s office. There is no additional charge for a surgicenter, hospital or anesthesiologist.
Tumescent liposuction gets its name from how the anesthesia is achieved. A special fluid is pumped into the surgical area until the area becomes firm or swollen. The Latin work tumescens means swollen and gives the procedure its name.
Who is a Good Candidate for Tumescent Liposuction?
Just about anyone who would consider standard liposuction is a good candidate for tumescent liposuction. Liposuction is the procedure of choice for anyone who wants to permanently remove a localized area of fat. Popular areas include:
- Abdomen central and lateral (love handles).
- Inner thighs. Outer thighs (saddlebags). Knees.
- Back of bra-line area
- Male breast
It is important to remember that liposuction is not a weight-loss procedure. Although your body will resist putting fat back on the in the liposuctioned areas, you will not lose weight because you had liposuction.
Where is Tumescent Liposuction Performed?
We do tumescent liposuction in our office in Dallas and Fort Worth. The procedure is performed in a room designed for tumescent liposuction. This provides a safe and comfortable environment for the procedure. Typically, patients have their follow-up visits at the office where their procedure was performed. Arrangements can be made for follow-up visits at one of the other offices if you prefer.
How is Tumescent Liposuction Done?
We begin by discussing the patient’s goals and marking the area(s). Next photographs and measurements are taken of the areas to be treated. Patients are given some sedative and pain control drugs at around the time of your pictures. After pictures, the patient is taken to the procedure room. The areas to be treated are prepared and the patient is placed on a monitor. Now we are ready to begin.
Procedure Steps of Tumescent Liposuction
First, the patient is positioned. Next, the first incision point is anesthetized using a local anesthetic and the incision is made. The tumescent fluid is pumped in through the incision using tools designed for tumescent liposuction. The fluid contains several critical ingredients:
- Saline water with salt. We use normal saline which has the same amount of salt as our blood. Most of the fluid used is from normal saline. Normal saline allows us to numb large areas safely.
- Lidocaine a commonly used local anesthetic. Lidocaine makes the tissue go numb, reducing or eliminating any pain from the procedure.
- Epinephrine or adrenalin a vasoconstrictor (temporarily reduces the size of blood vessels). Epinephrine greatly reduces bleeding and bruising. It also enhances the numbing effect of lidocaine.
- Sodium bicarbonate an acid-neutralizing agent. Sodium bicarbonate reduces the discomfort from pumping in the lidocaine. It also greatly enhances the safety of the lidocaine and allows large areas to done safely.
Secondly, after the area is numbed, we use specific tools of Tumescent Liposuction to tighten skin, treat fat and remove fat. The tools we commonly use are:
Thirdly, once the fat is removed, the areas are cleaned and bandaged. Once the patient is awake enough, they can go home. We always require a driver, we don’t want patients driving after sedatives even though they are awake.
How Long Does Tumescent Liposuction Take?
The length of time that a Tumescent Liposuction procedure takes depends on the type and number of areas involved. In general, we consider one area to take about 45-60 minutes from start to finish. Examples of one area are:
- Upper abdomen
- Lower abdomen
- BOTH love handles
- BOTH inner thighs
- BOTH outer thighs
- BOTH arms.
Some area combinations are a little faster. For example, upper and lower abdomen with love handles can typically be done in about 90 minutes. However, we usually use one hour per hour in helping our patients plan their day.
What Should I Expect for Recovery after Tumescent Liposuction?
Most patients are drowsy and want to sleep the evening after the procedure. The night after the procedure, we encourage patients to:
- Eat a meal.
- Hydrate aggressively. Tumescent Liposuction is a very dehydrating procedure. We like to see most patients drink 2-4 quarts of a sports drink like Gatorade® the evening of the procedure.
- Take the prescription pain medication at bedtime. We prefer the patient to take the pain med at bedtime to avoid pain awakening them overnight. After this dose, pain medication should be taken only as needed.
- Move around their home environment for a few minutes 2-3 times. The first 1-2 days after the procedure you may be sore and swollen. Typically, the second day after the procedure is the worst. Typical post-procedure side effects area:
- Swelling in the area of the procedure. Occasionally swelling may extend outside the procedure area. Typically swelling goes down to gravity.
- Bruising is fairly common. Inner thighs bruise almost every time. Necks bruise only rarely. Other areas vary in the amount of bruising.
- Discomfort usually soreness. Some patients have ongoing numbness that can last for several days or a week or two. Severe pain is uncommon. We do give you pain medications to take as needed. Tylenol or ibuprofen (available over the counter) is more often all that is necessary.
It is a good idea to move around some in the early days after the procedure. Moving around helps to reduce soreness. We recommend that you wear a special compression garment after the procedure. The garment is fit at our office immediately following the procedure. We also prefer if you avoid formal exercise routines for two weeks following the procedure. Occasionally, Dr. Johnson will extend the exercise ban for an additional week at your first return visit. Most people are able to return to work in 1-2 days. Swelling typically lasts about 3-4 weeks, but in some patients can last for several months.
Our typical return visits are at one week, three months and six months. Occasionally, we may ask you to come back more frequently. The final results are not seen for 6-12 months. The earliest that a touch-up procedure can be considered is 6 months. Touch-ups are additional procedures in the same are to improve or enhance the results. National studies show touch-ups occur in around 20% of cases. Innovations Medical does touch ups on around 8% of cases.