Awake Tumescent Liposuction

Tucson Cosmetics is one of the first to offer true awake tumescent liposuction under local anesthesia as a safer alternative to using General Anesthesia.

Liposuction is has become the most commonly performed cosmetic procedure in the United States. Since it was first introduced in the United States in the early 1980s, many refinements have been made. The most significant improvement was the use of a diluted local anesthetic instead of general anesthesia. This improvement is referred to as the tumescent technique and was developed by dermato-surgeon Jeffrey Klein, M.D.

The tumescent technique utilizes a natural saline solution containing a precise amount of very local anesthetic (lidocaine) which is injected into the fatty tissue. The injected area then becomes anesthetized. With the tumescent technique, liposuction patients need no general anesthesia, as contrasted with the traditional/standard liposuction methods which do require general anesthesia with intubation, or deep intravenous sedation. The word “tumescent” means swollen and firm. By injecting a large volume of very dilute lidocaine (local anesthetic) and epinephrine (capillary constrictor) into subcutaneous fat, the targeted tissue becomes swollen and firm, or tumescent and anesthetized. The tumescent technique is a method that provides local anesthesia to large volumes of subcutaneous fat and thus permits liposuction totally by local anesthesia. The tumescent technique eliminates both the need for general anesthesia and the need for IV narcotics and sedatives. The tumescent technique for liposuction 1) provides local anesthesia, 2) constricts capillaries and prevents surgical blood loss 3) provides fluid to the body by subcutaneous injection so that no IV fluids are needed 4) has the best post-op pain control.

However, our patients may choose to be awake during the procedure or under twilight anesthesia (MAC anesthesia, conscious sedation). Many patients receive only minor sedation to help them relax, like Ativan, and then they remain completely conscious and comfortable during the suctioning portion of tumescent liposuction surgery. After surgery, most patients may get up and walk out of the office without assistance. Patients return to their routine in a couple of days. With the tumescent technique, postoperative discomfort is significantly reduced since the local anesthesia remains in the treated tissue usually causing numbness and pain reduction for 16 hours or more after surgery. Patients frequently require only Extra Strength Tylenol to control the relatively minor discomfort that may occur after liposuction surgery that is performed using the tumescent technique.

At Tucson Cosmetics:

• Tumescent liposuction can reshape any part of the body by removing unwanted fat deposits.
• Liposuction cases can be handled safely and affordably using the tumescent method.
• The risks of general anesthesia are eliminated with tumescent liposuction (e.g., risks associated with endotracheal intubation, significant blood loss, hypoxemia, and side effects from general anesthesia). The targeted fat compartments can be anesthetized individually with tumescent liposuction providing the most optimal postoperative pain control than standard liposuction.
• Vasoconstriction Prevents Blood Loss
• Profound vasoconstriction (shrinkage of capillary blood vessels) results from the tumescent infiltration of a large volume of dilute epinephrine into subcutaneous fat. Tumescent vasoconstriction is so complete that liposuction can be done with virtually no blood loss. In contrast, the older forms of liposuction used before the invention of the tumescent technique were associated with so much surgical blood loss that autologous blood transfusions were often routine.

Smoother Liposuction Results with Microcannulas

A liposuction cannula is a stainless steel tube that is inserted into the subcutaneous fat through a small opening or incision in the skin. A microcannula has an outside diameter of fewer than 3 millimeters (mm). The diameter of microcannulas ranges from 1 mm to 3 mm. With special designs, microcannulas can remove fat very efficiently. The use of larger cannulas, for example, those having an outside diameter ranging from 3 mm to 6 mm require larger incisions which usually leave visible scars and more textural deformities. Smoother liposuction results can be achieved by using microcannulas which allow a more gradual and controlled removal of fat. This improves the ability of the surgeon to achieve smoother results. Larger cannulas are associated with an increased risk of liposuction-producing skin depressions and irregularities. Larger cannulas may remove fat so quickly that there is a risk of removing too much fat. It is also more difficult to precisely control the direction of a large cannula. We get superior results with the microcannula.

Adits for Microcannulas

Adits are small holes in the skin made with round, skin-biopsy punches. Adits are used as access sites, in which the liposuction cannula is passed in and out of during the liposuction process. Adits also facilitate the drainage of the blood-tinged anesthetic solution after liposuction. Because of the skin’s ability to stretch, microcannulas can usually fit through a 1.0 mm, 1.5 mm, or 2 mm round hole made in the skin with a skin biopsy punch. Such tiny holes usually disappear without scars after liposuction. Adits are so small that it is not necessary to close them with sutures. Because adits are not closed with sutures, they promote copious postoperative drainage of blood-tinged tumescent anesthesia, which in turn reduces post-operative bruising, tenderness, and swelling. Larger cannulas require larger incisions. When larger incisions are closed with sutures, there is delayed drainage, and prolonged swelling, bruising, and pain after liposuction.

Other Advantages of Tumescent Anesthesia

Because tumescent local anesthesia lasts so long, tumescent liposuction is less painful and more pleasant than liposuction under general anesthesia or IV sedation. With tumescent local anesthesia, patients can avoid postoperative nausea and vomiting associated with general anesthesia. Tumescent anesthesia is so efficient at providing fluid to the body that it is unnecessary to use IV fluids. There is a risk of dangerous fluid overload if excessive IV fluids are given to a tumescent liposuction patient.

When you arrive at Tucson Cosmetics Aesthetics and Surgery you will be provided with a comprehensive consultation addressing all your questions regarding the procedure. You will be given a pre/post-operative folder with instructions for optimal surgical results. You will need clearance from your medical physician to assure that you are healthy enough to undergo the procedure. We recommend Dr. Randy Kiewe, who is one of the best Medical Physicians on Long Island. Then, you will be all set for the surgery. Just remember to avoid aspirin, vitamin e, herbal supplements, Advil, ibuprofen, or other medications that the surgeon may limit, at least 2 weeks before surgery. You should expect to swell for a few days after the procedure. Most people return to their daily routine within a few days with tumescent liposuction. Also, expect to have some bruising after the procedure which can last for up to 1-2 weeks post-surgery. We recommend arnica Montana a herbal medication that decreases bruising and swelling 60% faster than a placebo.

You may not be a candidate for liposuction if you have significant other medical problems, or are on medications like coumadin that may cause excessive bleeding. Our medical Physician and our Surgeon will best be able to recommend treatment during a consultation.

If you are concerned about loose skin after liposuction, we can do combination therapy with Thermage skin tightening to help tone the skin if there is some residual skin laxity post-procedure.

LIPO AFTERCARE

Aftercare for lipo can involve multiple modalities including physiomed lymphatic massage and PEMF treatment. TeslaWave technology replicates the effect of exercise by contracting and flexing the muscles of the treatment area. TeslaWave can help you achieve your desired body shape with a series of 30-minute treatments. TeslaWave incorporates Pulsed Electromagnetic Field (PEMF), a therapy that generates pulsating magnetic fields.

The PEMF generated by TeslaWave can be used on most of the body, helping promote several regenerative factors:

► Build and define muscle

► Promote healing and reduce pain post-surgery or post-injury

► Enhance collagen production

► Improve cellular repair

► Increase nitric oxide production

► Increase blood oxygen

► Reduce inflammation

► Improve vascular function

► Accelerate detoxification

We offer the following procedures:

• Facial liposuction of the cheeks, jowl, and chin
• Liposuction of any body area
• Fat transfer to parts of the body by liposuction in certain fatty areas.
• Fat transfer to the face. Fat transfer to the buttocks.