What is Tumescent Liposuction?
- The word tumescent refers to anything that is swollen and firm. With tumescent liposuction, a large volume of very dilute solution of local anesthesia (lidocaine, bicarbonate and epinephrine) is injected into the fat beneath the skin, causing the targeted area to become swollen and firm. The local anesthetic lidocaine in the solution used for tumescent liposuction reduces the pain that one would experience after liposuction. The drug epinephrine (adrenalin) provides profound localized vasoconstriction that it reduces surgical bleeding during tumescent liposuction.
- Tumescent liposuction can be combined with other forms of liposuction such as in VASER liposuction. In fact, the tumescent technique liposuction is essential for VASER liposuction to work since ultrasonic energy used in the VASER liposuction needs "water" to emulsify or liquefy the fat. The fluid in the tumescent solution also prevents "skin burn injuries" from VASER liposuction.
Benefits of Tumescent Liposuction
Less blood is lost.
Intravenous fluid replacement is not necessary.
Bacteriostatic lidocaine may decrease the risk of infections.
Tumescence magnifies defects; therefore, the likelihood of needing a secondary procedure may be less.
Lipid-soluble lidocaine is somewhat suctioned out with the aspirated fat.
Vasoconstriction minimizes absorption.
The epinephrine may increase the cardiac output, which, in turn, hastens the hepatic metabolism of the lidocaine.
The duration of anesthetic effect may last as long as 24 hours.
The lidocaine may be given safely up to 45 mg/kg and even higher in certain conditions.
- It is standard of care to employ the tumescent liposuction technique in most liposuction methods, including the VASER liposelection/liposculpture.
- Infilitrating the area of fat with tumescent solution reduces the risk of burn injuries that may occur in VASER liposuction or Laser-assisted liposuction.
Emmanuel De La Cruz MD, PLLC
Plastic & Reconstructive Surgeon