Tumescent Liposuction: Cheaper, Safer and Less Invasive

Tumescent Liposuction is really a hybrid term consisting of two items. The first is tumescent which is a technique of local anesthesia and the second being liposuction which is the method of removing subcutaneous fat from a person.[1] The process tumescent process was discovered in 1985 by Dr. Jeffery Klein a clinical professor of dermatology at the University of California, Irvine. He published a professional article on the procedure in 1987 for the first time in the January issue of American Journal of Cosmetic Surgery. The goal of the procedure was to increase the safety of surgeries and reduce fatalities and complications.

The procedure is less painful, produces minimal bruising, and costs much less. The reason it cost so much less is because the patient is not put under general anesthesia but only local anesthesia and is awake during the procedure. The process involved a large amount of fluid (mostly lidocaine, a numbing agent, and epinephrine used to constrict the blood vessels) pumped by the liter into the area to be liposuctioned. [2] The cannulas used to suction out the fat are much thinner than those used during traditional liposuction at only 2-4 mm. The procedure is easier for surgeons to perform and there is less scar tissue formed due to the thinner cannulas.

The procedure is most easily performed on the abdomen, thighs, buttocks, and the male breast. It can also be performed on the arms, medial side of the thigh, and female breast but this requires more experienced surgeons.[3] The procedure is not recommended for those with cardiovascular disease, severe coagulation disorders including thromophilia or for pregnant women. Other risk factors include a family history of thrombophlebitis, pulmonary emboli, or multiple miscarriages.

Tumescent anesthesia is currently employed to perform the following surgeries: varicose vein stripping, removal of skin cancer lesions, skin grafting, hair transplantation, forehead, face, and neck lefts, laser resurfacing, abdominoplasty, and breast augmentation.[4] A doctor should have completed his or her residency training and be board certified in a specialty (such as dermatology) to complete this procedure. Additionally, they should have evidence of liposuction surgery training during his or her residency training or a certificate of attendance at an appropriate liposuction training course.

In 1988, fifty-five dermatologists employing the tumescent procedure in their practice were surveyed and of the 9, 478 liposuction cases the risk of developing systemic complications was only found to be 0.07% (Coldiron, et al. 2006) of these roughly 9,500 cases only five patients had "excessive" intra or post operative blood loss and two had infections. The most common complications included: Contour irregularities (2.1%), hematoma (0.46%), and persistent postoperative edema (0.46%). After the procedure was more widely embraced in 2002 66,000 cases were performed and there were found to be absolutely no deaths reported of these. The rate of serious side effects was only 0.68 per 1,000 cases (2006).

[1] Coldiron, B., Coleman III, W.P., et al. (May 2006). ASDS Guidelines of Care for Tumescent Liposuction. Dermatologic Surgery. Vol. 32, Issue 5, p. 709-716, 8p.

[2] Buckley, Cara. February 2, 2002. "Promises less pain, Minimal Bruising," The Miami Herald.

[3] Venkataram, M. (2008) Tumescent Liposuction: Standard Guidelines of Care. Indian J. Dermatol Venereal Leprol. 74:554-560.

[4] Palkhivala, Alison. (2005). Cosmetic Surgery Times: April 2005. Vol. 8, Issue 3, p 14.