Tumescent Liposuction involves a dilute solution of local anesthesia that is injected into the fat beneath the skin. This area becomes swollen and firm, or tumescent. The two main components of the tumescent solution are epinephrine and lidocaine.Liposuction Epinephrine causes contraction of the muscular walls in blood vessels, leading to a narrowing of the blood vessels. This effect of the drug almost eliminates all surgical bleeding during liposuction. The other component, lidocaine, provides strong local anesthesia and eliminates the need for IV sedation or general anesthesia. This method eliminates the risks associated with general anesthesia and excessive surgical bleeding. The tumescent technique solves the concerns and dangers associated with the early form of liposuction.

Before the tumescent liposuction technique was created by Dr. Jeffrey Klein, a dermatologic surgeon, liposuction required blood transfusions because blood loss was so high. Some doctors would require their patients to donate their own blood several weeks before surgery, to later be transfused during surgery. Patients who receive liposuction with the tumescent technique lose approximately 15 to 30 ml of blood. Routine laboratory studies require the same amount of blood to be taken. Today, blood transfusions are no longer a necessity in liposuction surgery.

The excessive bruising associated with liposuction is considerably reduced with the tumescent technique. This is because of the minimal amount of blood loss linked with the tumescent technique and because of the amount of drainage of blood after the operation. The small incisions do not require stitches and are left open to allow the remaining mixture of blood and anesthetic to drain.
The advantages of the tumescent technique include the following:

• Minimal blood loss
• Lidocaine can be used safely up to 45 mg/kg
• Lidocaine is suctioned out with the fat
• The effects of the anesthetic may last as long as 24-36 hours
• The swelling can highlight defects that need to be removed
• Blood transfusions are not required
• Lidocaine may decrease the risk of infections
• Post-operative bruising is reduced

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