UW Medical Center's Cosmetic Surgery Center is the region's leader in cosmetic surgery procedures.
What is tumescent liposuction?
What can liposuction achieve?
What are the limitations of liposuction?
What is the recovery like?
What is tumescent liposuction?
Tumescent liposuction (tumescent technique) refers to the performance of liposuction using large volumes of a dilute solution of lidocaine, a local anesthetic, in combination with the drug epinephrine which temporarily shrinks capillaries. This is comfortably performed with minimal sedation required.
Since the fat is removed by suctioning small "tunnels" through the fat, the skin remains intimately connected to the underlying muscles by multiple fibrous attachments. As healing occurs after surgery, these fibrous strands contract and pull the skin into close proximity with the muscles. It is this process that helps the skin redrape to the new contour after liposuction. The tumescent technique permits accurate removal of fat, with greater assurance that the liposuction cannula will not inadvertently be allowed to approach too near the undersurface of the skin which would cause irregularities. Thus the tumescent technique helps to minimize the risk of post-surgical irregularities or rippling of the skin.
The fat cells that are removed by liposuction do not grow back. The patient's new, more pleasing silhouette is permanent. If the patient gains or loses weight, the change tends to be distributed proportionately over the entire body. The change of silhouette produced by liposuction is equivalent to being able to focus the effects of dieting to specific areas of the body.
Although the results of liposuction are often quite spectacular, it is not realistic to expect perfection. Liposuction of the thighs, while improving the silhouette, does not usually eliminate the subtle "puckering" of the skin often called "cellulite." Cellulite results from the pull of fibrous tissue that connects skin to underlying muscle. Liposuction with the tumescent technique may or may not reduce the degree of cellulite and is unlikely to eliminate it.
Your surgery will be performed either at the Dermatologic Surgery Center, 4225 Roosevelt Way N.E. or next door at the Cosmetic Surgery Center (4245 Roosevelt Way N.E.). Shortly after your arrival, you will change into an operating gown and the areas on your body that are to be treated with liposuction will be marked with a felt-tipped pen. It usually takes about an hour to get set-up before the surgery actually begins. A blood pressure cuff will be placed on one arm, and depending on the area to be treated, an intravenous line (IV) established in the other arm. A small instrument will be placed on one of your fingers to monitor the oxygen levels in your blood. Next, using very small needles, the doctor or nurse will anesthetize the skin at sites where the longer needles will be inserted to anesthetize the subcutaneous fat. The actual injection of the anesthetic solution is almost painless. Patients usually experience a slight pricking sensation under the skin as the area becomes numb.
Once an area has been well infiltrated with a large volume of dilute anesthetic solution, it is usually completely numb. You will be checked for any incompletely anesthetized area which will then be completely anesthetized by infusing more anesthetic solution through the small cannula exactly where it is needed. After completing the infiltration of the local anesthetic but before your doctor actually begins removing the fat by liposuction, you will be escorted to the bathroom to empty your bladder.
Only mild sedation is required when using the tumescent technique for liposuction. Our usual sedation consists of 10 mg of Valium or a similar medication.
After completing liposuction, an antibiotic ointment is applied to the tiny incision sites. The incision sites are so small that stitches are not generally used. Elastic garments will be placed and you are ready to get up and go home. Because of residual local anesthetic, it is several hours after completing the liposuction before any significant soreness begins. Although you will feel well enough after surgery to drive yourself home, you should not do so because large amounts of local anesthetic and the Valium may cause some drowsiness.
The tumescent technique minimizes post-operative discomfort. Because the residual local anesthesia lasts for 12 to 18 hours or more, plain Tylenol is sufficient to treat post-operative discomfort, although you will be provided with stronger medication if needed. With this technique, there is no post-surgical nausea, nor the unpleasant feeling of "hang-over" usually associated with general anesthesia.
This technique dramatically reduces both the bleeding during surgery and post-operative bruising and swelling as compared to liposuction done purely by general anesthesia. Minimal bleeding reduces post-operative recovery time. Most patients can return to work within three to four days after surgery. An elastic support garment is worn for a few weeks following surgery.
About 90 percent of patients can actually see at least some improvement in their silhouette by one week after surgery. However, because of the slow resolution of post-surgical swelling, the FINAL results following liposuction cannot be assessed until 6 months after surgery.
As with any surgical procedure, liposuction is associated with certain expected side-effects such as bruising, swelling, and temporary numbness. Although irregularities of the skin are possible following liposuction, this side-effect is minimized by the tumescent technique, especially when performed with small cannulas. Touch-up procedures may be required to achieve the best result and should not be considered as a complication. As judged by current world-wide experience, tumescent liposuction is very safe. Serious complications such as blood clots, infection and allergic reactions are extremely rare. Detailed information about risks of surgery and expected results are provided at your consultation.
If you’d like to work with the most talented cosmetic surgeons to ensure that your outcomes are the best that they can be, UW Medical Center provides exceptional healthcare, including cosmetic surgery! Call 206-598-8111 for an evaluation.