When many people hear the word liposuction, they picture a major procedure performed under general anesthesia. For select patients, small-area liposuction can be performed comfortably in the office using local numbing alone. In this blog, Dr. Lisa Ishii will discuss how tumescent liposuction works, who may be a candidate, and why it remains one of the most effective options for treating stubborn pockets of fat.
What Is Tumescent Liposuction?
Tumescent liposuction refers to the liposuction technique in which local infiltration of anesthetic is used as opposed to using general anesthesia. This tumescent technique was first devised and perfected by dermatologist Dr. Jeffrey Klein in 1985. It involves utilizing a diluted, epinephrine-containing anesthetic solution infiltrated into the target tissue. This allows for anesthesia of the tissue so that the patient can comfortably undergo the procedure while remaining awake. The addition of epinephrine aids in vasoconstriction of the vessels in the treatment zone for enhanced hemostasis.
Tumescent liposuction is also unique in that smaller gauge cannulas are utilized. This aids in the comfort and safety of the procedure. Smaller cannulas in combination with local anesthesia minimizes more risk compared to traditional liposuction. As a tradeoff, only smaller areas or single body areas can be targeted as opposed to a “360 lipo” approach.
Long-term satisfaction of tumescent liposuction is high, with over 85% of surveyed patients recommending this procedure to friends and family at their long term follow up (mean of 8.9 years).
The Best Candidates for Small-Area Liposuction
Much like traditional liposuction, tumescent liposuction candidates are healthy patients who are close to their ideal weight with stubborn pockets of fat unresponsive to diet and exercise. This is not a weight loss procedure and should not be sought after if you are undergoing active weight fluctuations.
If you have moderate to severe skin laxity, most comprehensive results may require skin removal (ex. Abdominoplasty) and would best be served by referral to one of our trusted plastic surgery colleagues.
Areas We Treat:
- Submentum, jowls/jawline
- “Buffalo hump” area
- Upper and lower abdomen; flanks
- Back and bra-line
What Does Awake Liposuction Feel Like?
Awake liposuction is a well tolerated and comfortable procedure. The procedure begins with the numbing process, in which the tumescent lidocaine solution is infiltrated into the treatment area. This portion is typically the most uncomfortable portion as the treatment area is not yet numb. Despite this, lidocaine works quickly and the numbing process itself gets increasingly more comfortable after the first few minutes.
After the area is numbed, you will feel a “tugging and pulling” sensation during the fat removal process. If any discomfort is not tolerable, more lidocaine can be added to make the procedure more comfortable. During the procedure, you will be asked to shift positions so that I can target the unwanted fatty tissue from multiple angles.
FAQs: Recovery + Downtime
Right after the procedure, my team will place absorptive pads and a medical-grade compression garment over the treatment area. It is normal for some of the numbing fluid to expel over the next 24-48 hours. The following day after your procedure, a fresh set of absorptive pads will be placed in the office so that the garment remains dry.
It is normal for the treatment area to be swollen, sore, and bruised. Depending on the location of the procedure, swelling and bruising may sink into the gravity-dependent areas even if this is outside of the treatment area.
The medical-grade garment must remain on for 7 days even while sleeping. After 7 days, you will transition to an “at-home” compression garment such as Spanx or other non-medical shapewear during waking-hours only. Soreness will fade with time, and patients are encouraged to go on leisurely walks starting at the 48 hour mark to help with drainage and swelling. Patients are encouraged to slowly start introducing their regular activities within 2-3 weeks as tolerated.
Most patients will look “worse” in terms of swelling and bruising for the first 1-2 weeks. Swelling can persist even through the 1-month follow up appointment, although most patients appreciate a notable result even at the 1-month mark. The adit sites are the openings made on the surface of the skin from which the fatty tissue is removed—these will initial heal as small pink or red marks that slowly fade into slightly hypo- or hyper-pigmented small scars. By 3 months, you will have event-ready results, but final results are typically appreciable at 6 months.
The Bottom Line
Liposuction is much less intimidating than patients may think. With tumescent liposuction, patients can comfortably undergo treatment without general anesthesia.
For patients bothered by persistent fullness in areas such as the lower abdomen, liposuction remains one of the most effective and predictable body contouring options available. To start your body contouring journey in the Raleigh, Durham, Chapel Hill area, contact our team for more information.
