Everything Patients Need to Know About Tumescent Lipo
Liposuction is a cosmetic surgical procedure that removes unwanted body fat to create a more contoured shape. While effective at eliminating excess fat that doesn’t go away after changes in diet and exercise, liposuction is not intended as a weight loss treatment.
There are different types of liposuction procedures, some of which require the patient to be unconscious under general anesthesia, others allow patients to stay awake during the procedure with local anesthesia. Tumescent liposuction is one of these types — the most popular and common type of liposuction. In this guide, we’ll take a close look at tumescent liposuction, how it works, and the benefits of choosing it over traditional procedures.
A Brief History of Tumescent Liposuction
While liposuction itself was first developed in 1974, tumescent liposuction is a slightly more recent development. In the early 1980s, liposuction was only offered under general anesthesia, which puts the patient into a sleep-like state.
What Is Tumescent Liposuction?
This changed in 1985 when Dr. Jeffrey A. Klein, a dermatologist from California, began performing liposuction using a new approach where —after administering a simple shot of lidocaine in the skin, he made a small opening and infused the tumescent numbing fluid into the treatment area — patients could stay awake, alert, and comfortable while undergoing the fat removal treatment[98].
In 1986, Dr. Klein began teaching the “tumescent technique” to other doctors and plastic surgeons at the 2nd American Academy of Cosmetic Surgery (AACS) World Congress on Liposuction. Since being introduced, tumescent liposuction has remained a popular cosmetic procedure with a proven track record of high patient safety.
Tumescent liposuction can remove fat from many areas of the body, including:
- Abdomen / 360
- Arms
- Bra area
- Chin
- Male chests
- Flanks
- Inner Thighs
- Outer Thighs
Benefits of Tumescent Liposuction vs Traditional Liposuction
There are many benefits of choosing tumescent liposuction over traditional liposuction procedures. Potential patients can expect:
Reduced Bleeding and Bruising
The tumescent liquid contains epinephrine, a drug that significantly reduces bleeding and bruising[99]. Microcannulas are also used during tumescent liposuction which helps to further reduce blood loss and bruising caused by tissue trauma.
Enhanced Precision and Safety
Because patients are awake during tumescent liposuction, it’s safer than traditional liposuction. Surgical misadventures are less likely because the doctor can see how the patient responds during treatment. Tumescent or local anesthesia puts less stress on the body than general anesthesia, this allows for a quicker recovery and reduced risk of complications.
Shorter Recovery Times
Compared to traditional liposuction procedures where general anesthesia is administered and can cause grogginess for up to 2 weeks post-procedure, tumescent liposuction patients typically experience a much shorter recovery time. Since tumescent anesthesia uses high volumes of lidocaine you will remain numb for hours post procedure reducing the immediate need for pain medications. The length of recovery will vary from person to person, but the recovery is far less following a tumescent liposuction procedure than traditional. However, the length of recovery varies from patient to patient.
In addition, the use of microcannulas require a much smaller opening/incision be made in the skin versus traditional liposuction that uses much larger diameter cannulas and require a longer, line cut be placed in the skin. Often the tiny opening made for tumescent liposuction will not even require sutures leaving a barely visible scar.
Ideal Candidates for Tumescent Liposuction
Tumescent liposuction is a great procedure for those who want to remove stubborn fat deposits that won’t go away with diet and exercise. To qualify for the procedure, potential patients must be committed to living a healthy lifestyle before and after liposuction, including eating a healthy diet and exercising regularly.
In addition, ideal candidates must:
- Typically be within 20 pounds of their ideal body weight
- Be willing to do this procedure while awake, but numb with local anesthesia
- Stop smoking 6 weeks before the procedure (failure to do so can result in delayed healing post-procedure)
- Not be taking blood thinning medications
- Not have major medical conditions
- Not have Cardiac arrhythmias
Potential candidates should also keep in mind that tumescent liposuction is not a weight loss procedure, and age plays a part in healing and results. Our doctor at WIFH is honest and straightforward with patients, providing a realistic expectation as to the results they will see post-procedure.
Getting Tumescent Liposuction, Step-by-Step
Interested in getting tumescent liposuction at WIFH? Read below to discover our step-by-step process for tumescent liposuction patients, from initial consultation to recovery:
Initial Surgical Consultation & Scheduling
If someone is considering tumescent liposuction, it’s essential that they personally meet with the doctor who is going to be performing the procedure. At WIFH, Dr. Cox meets with each potential patient to determine whether they are a good candidate for tumescent liposuction. These consultations can be done in-person at our office in Atlanta, or can be conducted virtually online.
During the consultation, he will talk to the patient about:
- Their complete medical history and lifestyle
- The areas the patient is concerned about
- Their desired outcome and expectations
- Whether the procedure is a good fit for them
If the surgeon determines the patient is a good candidate, they will schedule the procedure.
Pre-Procedure Preparations
Preparing for tumescent liposuction begins far before the day of surgery. We recommend that all patients:
- 6-8 Weeks Before: Eat healthy, stay hydrated, and prepare for new lifestyle changes. Approved patients who are smokers should try to stop at least 6 weeks before the procedure.
- 1 Week Before: Limit sun exposure and discontinue taking any fish oils, daily supplements, blood thinners, NSAIDs (Ibuprofen, Aspirin, etc.), and herbal medications. Patients review with their surgeon all of the medications and supplements they are taking to determine if any will need to be discontinued prior to surgery.
- 2-3 Days Before: Avoid consuming any alcohol in the days before the procedure.
The Day of Your Procedure
On the day of your actual procedure, patients should eat a light meal prior to arriving at our office.
Upon Arrival
First, the patient will change into a robe. Weight and measurements will be taken. Then, the doctor will mark and photograph the treatment areas. Photos are critical in order to monitor your progress post procedure.
In addition to the local anesthesia, some patients may choose to have a mild oral sedative to help ease anxiety, which the doctor will prescribe and administer. Patients who received an oral sedative during the procedure will need someone to drive them home.
Preparing the Tumescent Fluid
Next, the liquid anesthetic is measured and mixed by one of our medical professionals — being either a licensed nurse or physician assistant — following specific safety guidelines. We use a very conservative calculation based on the patient’s medical history, medications, and weight to determine the amount of lidocaine needed to safely numb the area.
What’s In the Tumescent Fluid?
The tumescent fluid contains:
- Lidocaine (an anesthetic)
- Epinephrine (a medication that prevents bleeding and bruising)
- Saline (a mixture of salt and water)
Administering the Anesthetic
The tumescent fluid is slowly injected into the treated area. In a matter of minutes, the fluid completely numbs the entire area and elevates the fat off of the muscle tissue. The numbing effect feels very similar to receiving a shot before a dental procedure. Lidocaine also has antibacterial properties, which help prevent infection.
Incisions & Fat Removal
After the fluid is injected and the patient is numb, the surgeon will make small incisions (about ⅛”) into the treatment area. These incisions allow a tiny hollow, blunt tip needle called a microcannula to access under the skin to suck the fat and tumescent fluid out of the treated area. At WIFH, we conduct laser-assisted tumescent liposuction to aid in the fat removal process. The heat from the laser helps quickly liquify the fat, while safely delivering enough thermal energy to provide additional tightening of the skin.
When compared to traditional liposuction, the incisions are much larger at approximately ½” each. By nature of their size, the larger cannulas inherently cause more tissue damage, which leads to more bruising and recovery time, and requires that the patient is asleep for the duration of the procedure.
The tumescent procedure typically takes between 30 minutes and 2 hours, depending on the area(s) being treated. During this process, the patient will only feel slight pressure and movement. Some patients choose to listen to music or scroll on their phones to distract themselves during the procedure.
Tumescent Liposuction Aftercare & Recovery Considerations
Recovery from tumescent liposuction is generally a smooth process. Here are a few key notes for aftercare and considerations for recovery.
Wear Your Compression Garment
For a smooth and effective recovery, WIFH recommends that patients wear a compression garment under their clothes for approximately 4-6 weeks post-procedure[100]. The garment helps alleviate swelling and ensures the treated areas heal properly for optimal results.
Lumps Are Normal
During recovery, it’s common for patients to experience firm, lumpy areas of swelling in the area that was treated 4-6 weeks after treatment. Over time, these will dissipate.
Avoid Submerging Incisions
Patients can shower immediately after their procedure. We recommend using mildly warm water, not hot water as it can lower your blood pressure. We also ask that you refrain from taking baths or immersing the incisions in water until they have completely closed and healed. This typically happens within 3-5 days after the procedure.
Take It Easy & Expect Drainage
Patients should expect significant drainage after the procedure, but this typically subsides after 2-3 days. After 24-48 hours, patients can resume non-strenuous activities, but we recommend that most patients wait 1-3 weeks before exercising or resuming high-impact exercises like running. Remember, it’s important to listen to your body. If it doesn’t feel comfortable, don’t do it!.
Risks, Side Effects
As with any surgical procedure, cosmetic or not, there are risks every potential patient should consider. While infections from tumescent liposuction very rarely happen, there is always a slight risk.
Infection
In general, the infection rate for tumescent liposuction is estimated to be around 1 in 2000. To date, WIFH has had 15,000+ patients receive tumescent liposuction, and we have only had one patient get an infection, which was quickly resolved with oral antibiotics.
Swelling, Bruising & Pain
Patients should also be aware that this procedure still involves a risk of bruising, swelling, and pain. However, these side effects are generally much less severe than those associated with other types of liposuction.
To further minimize your risks, always choose a reputable surgeon who has a successful track record of performing tumescent liposuction. In addition, follow pre- and post-care instructions to avoid infection and ensure the best results.
Tumescent Liposuction vs Other Liposuction Techniques
As mentioned earlier, tumescent liposuction is just one of many liposuction techniques. Knowing the differences between each type will give you a better idea of what treatment is best for you.
Tumescent vs. Traditional Liposuction
The biggest difference between tumescent and traditional liposuction is the type of anesthesia used. With tumescent liposuction, patients are given local anesthesia and stay awake during the procedure. Traditional liposuction requires general anesthesia, so patients are unconscious during the procedure.
In addition, tumescent liposuction typically uses smaller cannulas than traditional liposuction, which creates smaller incisions and can lead to less bruising, bleeding, swelling and scarring in patients.
Tumescent vs. Ultrasound-Assisted Liposuction (UAL)
With ultrasound-assisted liposuction, ultrasonic waves are used to disrupt fat that’s then sucked out using a cannula. However, with tumescent liposuction, a fluid is injected into the patient, then a microcannula sucks out the fluid and fat. Ultrasound-assisted liposuction can be performed while the patient is unconscious or awake. However, tumescent is only done while the patient is awake.
Tumescent vs. Laser-Assisted Liposuction (LAL)
A laser-assisted liposuction procedure can also be a tumescent procedure. For example, Smartlipo follows the same anesthetic protocols as tumescent liposuction. But instead of the normal microcannula, Smartlipo uses a microcannula with an encased laser fiber, which is then inserted underneath the skin. The addition of the laser can help tighten the skin, increase collagen production, and further reduce bleeding and bruising.
Read More
Tumescent Liposuction FAQs
Is tumescent liposuction safe?
If you are a good candidate for tumescent liposuction, yes, it’s one of the safest office-based procedures that you can do for cosmetic surgery. With tumescent, patients don’t have to worry about the risks associated with general anesthesia.
Is tumescent liposuction painful?
While patients may feel some pressure and movement, it’s considered less painful than traditional liposuction procedures. Patients may experience some mild pain in the days following the procedure, but your doctor can prescribe medications to help keep you comfortable during recovery.
Does tumescent liposuction tighten skin?
Tumescent liposuction removes fat deposits from the body. While it can tighten the skin, laser liposuction procedures, like Smartlipo, can help deliver even better tightening results with the use of a laser during tumescent liposuction.
Real Patient Stories and Outcomes
Image: Before and after photo of Smartlipo on the abdomen
Visit our Smartlipo gallery for more before and after photos.
Book a Consultation for Tumescent Liposuction in Atlanta
Tumescent liposuction is one of the safest office-based procedures that anyone can get for cosmetic surgery. Those who are good candidates for the procedure often see really gratifying, long-lasting results with the adoption of good nutrition and exercise.
To decrease your potential risks, consult a credible doctor with a proven track record, like Dr. Cox at WIFH. Dr. Cox has performed thousands of tumescent liposuction procedures without complications and was one of the first physicians trained in Smartlipo in 2007. He is available for complimentary consultations in-person or virtually online.
If you have any questions about tumescent liposuction or want to learn if it’s a good option for you, please contact us to schedule a complimentary consultation with Dr. Cox.
