|The Tumescent Technique, which permits the local anesthesia of large areas of subcutaneous fat, was developed by a California dermatologic surgeon Jeffrey Klein, M.D., in 1985. Klein first presented his findings in 1986 at the Second World Congress of Liposuction Surgery in Philadelphia.
The Tumescent Technique utilizes large volumes of saline solution, containing dilute local anesthetic and adrenaline, which is injected into the fatty tissue. The injected area then becomes locally anesthetized – “numbed”. There may be some discomfort during the initial process of injection. With the tumescent technique, liposuction patients usually need no general anesthesia, as compared with the traditional standard liposuction methods. However, patient may require intravenous sedation or narcotics. In fact, many receive only minor sedation to help them relax, and are completely conscious and comfortable during suctioning portion of tumescent liposuction surgery. After surgery, most patients may get up and walk out of the office without assistance. Patients are usually back to their regular routine in a couple of days. With the Tumescent Technique, postoperative discomfort is significantly reduced, since the local anesthesia remains in the treated tissue for 16 hours after surgery.The Klein formula tumescent solution is injected into the fatty tissue through small, “numbed” slit incisions in the skin. These slit incisions are made, when possible, in inconspicuous places. The tumescent fluid is injected under pressure which causes the target fatty tissue to become firm and inflated. This allows the surgeon to later extract the fat in a more accurate and uniform fashion, thereby producing smoother results. The anesthetic and other agents in the tumescent solution should be allowed sufficient time to diffuse (percolate) and take full effect throughout the fatty tissue. The solution will numb the areas as well as reduce bleeding by temporarily closing down capillaries. Constricting the capillaries is important to reduce bleeding during and after surgery. Less bleeding means less bruising. Not only does this make the surgery safer, it also speeds up postoperative recovery. As a result, most patients can return to work or their regular routines in a couple of days.
|Advantages of Tumescent Liposuction
- Tumescent liposuction is a dermatologic surgical procedure that can be done safely and less expensively in the office surgical suite.
- Relatively large liposuction cases can be done safely in an office surgical setting, affordably, using the tumescent method.
- The risks of general anesthesia are eliminated with tumescent liposuction (e.g.: risks of endotracheal intubation, risks of significant blood loss, risks of hypoxemia (low blood oxygen), and risks of side effects from general anesthesia).
- The desired fat compartments can be anesthetized (numbed) individually with tumescent liposuction.
- Intraoperative blood loss has been greatly reduced with tumescent liposuction. Usually, only 12cc of blood is lost for each liter of fat that is removed with tumescent liposuction. More blood than this (about 24cc) is required for a routine preoperative blood test!
- Blood transfusions and intraoperative intravenous fluid replacement are rarely necessary with tumescent liposuction.
- Sensations felt during the suctioning portion of tumescent liposuction are usually minimal. Patients rarely have intraoperative discomfort. However, some patients with a history of pain sensitivity may benefit from having an anesthesiologist “stand-by” or administer some “light sedation”. Patients who have never had surgery may wish this option as well if large or many areas are planned for liposuction.
- Post-operative recovery is faster following tumescent liposuction as, opposed to traditional/standard liposuction.
- The post-operative recovery period at home is usually 1-2 days. Many patients desire to have their liposuction performed on Thursday or Friday to take advantage of weekend (non-work) days.
- Post-operative discomfort is typically minimal. Significant numbing usually lasts for 18 hours in the suctioned areas. This is yet another major advantage that tumescent liposuction has over the other methods.
- Patients usually dress without assistance following tumescent liposuction and may walk out without assistance. In comparison, patients are customarily very bruised, very sore, and may be incapacitated for weeks following standard liposuction under general anesthesia.
- Post-operative pain medicines are rarely needed with tumescent liposuction.
- There is usually much less bruising and swelling with tumescent liposuction compared with standard liposuction under general anesthesia.
- Medical journal studies confirm that the aesthetic results of tumescent liposuction are superior.