There have been some recent improvements in the liposuction technique, the most significant being the tumescent anesthetic technique, developed by Dr. Jeffrey A. Klein. The tumescent technique involves liposuction procedures done with a local anesthetic injection rather than general anesthesia.
“Tumescent” translates to “swollen and firm”. The procedure uses large volumes of a diluted solution of lidocaine (a local anesthetic), and epinephrine that temporarily shrinks capillaries, reducing bleeding and bruising. Patients undergoing tumescent liposuction generally do not require additional IV sedatives, general anesthesia, or narcotics. This eliminates many risks of surgery that can come with general anesthesia.
The tumescent solution consists of a diluted solution of lidocaine, a local anesthetic, epinephrine, which is a vasoconstrictor that shrinks capillaries, and saline. During the procedure, the solution is injected into the fatty target areas, which then become swollen and firm.
The tumescent technique is remarkably safe. There have been no reported deaths associated with this technique. Serious complications are usually related with excessive liposuction procedures, or having multiple simultaneous unrelated surgeries being performed. Additional complications have arisen when general anesthesia or narcotics are used.
While lidocaine can be toxic in concentrated form, the tumescent liposuction procedure uses a highly diluted solution. Therefore, it is important for patient safety that the surgeon understands the safest amount of lidocaine to use in relation to the body weight of the patient. Interestingly, after lidocaine is injected, its concentration level in the blood increases, reaches peak levels, and then decreases. Additionally, one of the main reasons tumescent anesthesia is so safe is this very slow rate of lidocaine absorption.
Tumescent liposuction procedures have a very low risk of infections. There is strong evidence that shows that the tumescent local anesthetic prevents the growth of bacteria, along with killing bacteria.
While it appears that tumescent liposuction techniques are very safe, common sense and skill by the surgeon and patient are required. Too many treatment areas should not be done during a single procedure, and patients should be healthy.
Dr. Wright and his staff at Laser Lipo and Vein are happy to discuss all the details about tumescent liposuction, including any questions you may have about the use of local anesthetics during the procedure.