Liposuction is one commonly undertaken procedure and with the different techniques available plastic surgeons have resulted to the safest. What’s the safest technique? A question I believe is not just in the minds of the surgeons but also their patients. Tumescent liposuction technique has proved since its invention and development in 1985 to be the safest procedure. This technique involves injecting dilute local anesthesia and adrenaline into the subcutaneous fat causing it to become firm and swollen before its removal. Adrenaline is a potent vasoconstrictor causing local vasoconstriction which prevents surgical bleeding during the procedure. The local anesthetic that’s most preferred is lidocaine. This procedure is opted for if the patient takes a well-balanced diet and maintains good physical health but still can’t reduce localized fat deposits.
Tumescent liposuction benefits
Use of local anesthesia eliminates the need to use IV sedation, narcotic analgesics or a general anesthesia. Adrenaline present in the tumescent anesthetic solution causes capillary constriction preventing bleeding. The large amounts of the diluted solution delivered subcutaneously provide the body with fluids thus no IV fluids required. Capillary constriction by adrenaline also causes reduced absorption of lidocaine thus lowering its blood concentration and by extension its potential toxicity. The prolonged anesthetic effect makes the tumescent liposuction procedure less painful and pleasant unlike liposuction done under general anesthetics. As a result there’s avoidance of the unwanted effects of general anesthesia such as post op nausea and vomiting. Lidocaine is bacteriostatic thus reducing infection risk. In addition due to lidocaine’s lipophilic nature some of it is suctioned out with fat. Epinephrine on the other hand speeds up the metabolism of lidocaine in the liver through increase in cardiac output.
Liposuction cannulas are steel tubes that are stainless used during tumescent liposuction procedure. They are inserted into the fat beneath the skin via small incisions or openings in the skin to suction the fat. The cannulas measure 1-3 mm in diameter and are able to efficiently remove fat. They come in different types as follows: the one whole standard cannula, the spatula, pyramid liposuction cannula, double Mercedes liposuction cannula, 12 hole harvest cannula and blunt open end cannula among others. The one hole standard cannula is used in soft fatty tissue. Pyramid liposuction cannula is popular efficient and versatile making its use common among surgeons. Spatula liposuction cannula is preferred for liposuction around the face and neck. 12 hole harvest cannulas are available as raised slightly or smooth.
Tumescent liposuction technique is performed for localized fat deposit reduction associated with genetic susceptibility. Others include removal of a lipoma, hematoma evacuations, axillary hyperhidrosis, madelung disease, pseudogynecomastia, axillary bromhidrosis, and though controversial the liposuction is also done for obese persons.
Areas of the body where performed
It is performed in the neck, arms and back, upper and lower abdomen, flanks, the outer and inner thighs, inner knees, the calves, ankles, and though controversially its ben used as an alternative to breast reduction surgery for breast reduction.
Tumescent liposuction has over the years proved safe and non-fatal thus should be most preferred and commonly performed procedure in cosmetic surgery.