Tumescent Liposuction

Liposuction is the removal of excess fat. Tumescent liposuction is performed in patients who only require local anaesthesia. The procedure takes longer than traditional liposuction, but no more than 3 hours. Because the fluid that is used in such procedures contains, in addition to a normal saline solution and adrenaline (that causes blood vessels to contract), a certain amount of an anaesthetic substance (usually lidocaine), no further anaesthesia is required.

Pre-op Assessment

In a healthy patient, this surgery does not require any special preparation. A blood clotting disorder must be ruled out by an examination during the consultation process and by a laboratory test. Patients are recommended to refrain from using medication containing acetylsalicylic acid (e.g., aspirin, anopyrin) for two weeks before surgery. The suitability of this procedure must be considered carefully in patients who use medication that reduces blood clotting. It is also less suitable to perform this surgery three days prior and during a woman’s menstruation period. Although this surgery is performed throughout the year, cooler months are more suitable given that compression underwear must be worn after such procedures.

Procedure

Besides an anaesthetic effect, the anaesthetic substance contained in the infiltration solution also has a lipophilic effect which means that it induces – without any side effects – surface destruction of fat cells which can then be freely suctioned using thin, 2 mm cannulas. Fluid amounting to two to three times the volume of the fat being removed is usually used in this technique. This results in a swelling (also referred to as ‘tumescence’) of the subcutaneous tissue, which is naturally only temporary. This makes it possible to use thin, oblong cannulas. If we worked with non-infiltrated tissue, the diameter of the cannulas would have to be much larger. It is necessary to wait, sometimes for as long as 40 minutes before the anaesthetic starts to take effect and before the fat can be removed using liposuction cannulas. The advantages of tumescent liposuction are that it is performed under local anaesthesia, making use of the lipophilic effect of lidocaine and that it is possible to manipulate with the patient during the procedure. The procedure takes longer than classic liposuction and removal of several large areas of fat from the entire body is not recommended in one sitting.

Recovery

Liposuction compression underwear must be worn all the time, especially during the first days, with only minimal breaks for showering and using the toilet. The time recommended for wearing such underwear depends on the particular case and ranges from 3 to 7 weeks.
In the first days after surgery, the result of the procedure is covered by post-surgery swelling to such an extent that the areas treated may be even larger than before surgery. Bruising is normal. Pain is not too intense. Fever of up to 38 °C is not exceptional. It is recommended that the patient rests during the first 14 days, avoiding greater strain and exercise.

First Visible Effects

The removal of fat can become visible after three weeks, but the final effect can only be assessed after three months. After a liposuction, the patient’s body will not deposit as much fat in the treated areas as before, but principles of a healthy lifestyle must be adhered to.