Tumescent Liposuction by Dr. Bermant

The tumescent technique can reduce bruising, pain and swelling after surgery. Blood loss is minimized and there is a lower chance to need a blood transfusion after surgery. Anesthesia solution is injected into the planned regions for fat sculpting.

This fluid consists of a mixture of saline (intravenous salt solution), lidocaine (a local anesthetic), and epinephrine (adrenaline which constricts blood vessels). The numbing medication can provide anesthesia during surgery and lessen after surgery pain. Blood vessel constriction lessens blood loss during surgery and bruising after the operation.

Large amounts of fluid used inflate or "tumesce" the fat compartments making them swollen and firm. The expanded compartments permit the liposuction cannula to pass under the skin smoothly as fat is removed.

Injected amounts vary depending on what needs to be done. Sometimes the injected amount is as much as three times the amount of fat to be removed. Tumescent liposuction is typically performed on patients who need only a local anesthetic. This surgery can take significantly longer than traditional liposuction (and sometimes as long as several hours). Since the fluid injected contains adequate anesthetic, additional anesthesia may not be necessary.

The superwet technique is similar to the tumescent technique, except that smaller volumes of fluid are injected. Usually the amount of fluid injected is equal to the amount of fat removed. The super wet technique often requires IV sedation or general anesthesia. Depending on what needs to be done, this method takes 1 to 2 hours of surgery time.

After the patient relieves intravenous sedation medication, the incision sites are injected with a thin needle. A scalpel then makes a tiny hole. A larger injection cannula then is used to introduce the anesthetic solution into the entire region to be sculpted.

Fluid is injected using the various incisions for the liposuction. The injections continue until the tissues are expanded with the fluid (or tumescent). Learn more about Dr. Bermant's Anesthesia.

Extra Complications with these methods
The tumescent and superwet techniques can result in lidocaine toxicity (too much of the anesthetic material in the body). Because the lidocaine generally binds to the local tissue at the injection site, such problems are rare. Fluid can collect in the lungs (pulmonary edema) if too much is injected.

After your surgery
Since all fluid injected is removed, your weight after surgery may be the same or higher. As the extra fluid and tissue swelling are managed by your body, the weight should normalize.

Drainage from the incisions is common. Occasionally a small rubber drainage tube will be inserted beneath the skin for one to three days to prevent fluid build up. You may need antibiotics while these drains are in place. Until the major drainage has stopped, you may need additional gauze pads to keep your clothing from getting too wet (again depending on technique).

Liposuction Surgery