Tumescent Anaesthesia

Liposuction is a surgical technique that involves removing excess fat deposits located between the skin and muscle and thereby improving the contour of the body. Tumescent Liposuction involves the infusion of a local anaesthetic solution and the use of a small blunt stainless steel tube, called a cannula. The liposuction cannula is inserted into the fat through small incisions in the skin, and fat is removed by suction created by a suction pump, as the cannula creates tiny tunnels through the fat. During the healing process after liposuction, these tiny tunnels shrink and disappear, resulting in an improved body contour.

What is tumescent anaesthesia?

The tumescent technique for local anesthesia has revolutionised liposuction by eliminating both the risks of general anaesthesia and the bleeding once associated with liposuction.It was first described by Dr Jeffrey Klein in 1987. The tumescent technique involves the infusion of large volumes of very diluted lignocaine (local anaesthetic) and adrenaline (for vasoconstriction) into subcutaneous fat, through tiny incisions made in the skin. The word tumescent means swollen and firm. With the tumescent technique, the volume of dilute lignocaine that is infused into fat is so large that the treatment area literally becomes tumescent (swollen and firm). The tumescent technique produces profound and long-lasting local anaesthesia of the skin and subcutaneous fat.

What are the benefits of tumescent liposuction?

Local anaesthesia used in the tumescent technique is so highly effective that patients no longer need intravenous sedatives, narcotic analgesics, or general anaesthesia. Because of the widespread vasoconstriction caused by the adrenalin in the tumescent solution, there is minimal bleeding during and after surgery. This major improvement in liposuction technique eliminated the bleeding present with the older methods that used general anaesthesia.

History of Liposuction

Liposuction was first invented by Dr Giorgio Fischer in Italy in 1977, and was then popularised by French surgeons Dr llouz and Dr Pierre Fournier. It was introduced into the United States in 1982. The tumescent technique was developed by Dr Jeffrey Klein in the latter half of the eighties, through his methodical research. It proved to be safer than the older techniques that required general anaesthesia, it also proved to be less painful during and after the operation, minimised post-operative recovery time, and produced optimal cosmetic results.

Dr Leung was fortunate enough to have been tutored by Dr Giorgio Fischer and Dr Pierre Fournier in the art and techniques of tumescent liposuction.

What is the difference between Tumescent Liposuction and VASER Liposuction?

Tumescent liposuction is the medical procedure of removing fat under local anaesthesia. VASER liposuction is the use of a VASER (ultrasound assisted liposuction) device manufactured by Sound Technology, which aids in the removal of fat under tumescent anaesthesia. The device is used as part of the tumescent technique, not in lieu of it.

Are some localised areas of fat resistant to diet and exercise?

Yes. Fat deposits in the abdomen, hips, and under the chin are often resistant to diet or exercise. Similarly, after pregnancy, the fat on the abdomen and hips may persist despite concerted efforts at dieting and exercising. Some of these localised accumulations of fat are inherited and frequently impossible to eliminate by exercise or dieting. After the age of 30, an individual often gains fat according to a genetically predetermined pattern. For these people, liposuction is literally a dream come true. Liposuction is the only realistic means of significantly changing the body’s silhouette. In effect, liposuction is equivalent to being able to focus the effects of dieting to specific areas of the body.

Am I a good candidate for liposuction?Site Images / 20111115 Female Naked Back shutterstock_3692131 (small)

The best candidates for liposuction are at or near their ideal body weight, are in good health and have realistic expectations. Liposuction can provide a good candidate with a significant improvement, but it is difficult to achieve perfection. There is no definite age or weight limit for patients. Many liposuction patients are of average size but are concerned about localised accumulations of fat.

Who is not a good candidate for liposuction?

A person who expects absolute perfection is not a good candidate for liposuction. Patients who are significantly overweight, and who are not willing to undergo lifestyle changes, are usually not good candidates for liposuction. A person who has a serious or poorly controlled medical problem is not a good candidate for liposuction.

Is liposuction a good treatment for obesity?

Liposuction is a poor treatment for obesity. Liposuction is not effective, even as a last resort, for people who are unable to lose weight by dieting and exercise. Obese patients usually regain the weight that is removed by liposuction unless they undergo dramatic lifestyle changes by changing the way they eat and increasing their exercise level. Whenever large-volume liposuction has been used in an attempt to treat obesity by surgery, there has been a significant increase in the incidence of serious surgical complications. It is not safe to remove huge amounts of fat by liposuction.

However, an overweight person whose weight has been stable for many years and has certain problem-areas of fat may be a good candidate for liposuction. Liposuction in a large patient is reasonable when the goal is to improve a troublesome body contour area.

What is a successful liposuction surgery?

Optimal aesthetic result is more important than maximising the amount of fat removed. One of the most common causes for disappointment in the results of liposuction surgery is the removal of too much fat, which produces an abnormal or unusual appearance. According to Dr Fournier: “What is left behind is more important than what is taken out”. For example, even a small amount of fat removed from the saddlebag area can produce a dramatic change in the patient’s silhouette.

Does liposuction always remove cellulite?

‘Cellulite’ is a term commonly used to refer to unevenness of the skin that is often present on the thighs and buttocks of women. Whilst liposuction improves the silhouette of the body, it does not usually eliminate cellulite. Liposuction does reduce the degree of cellulite to a minor degree but it is unlikely to produce a significant improvement or completely eliminate cellulite.

Does liposuction produce permanent results?

The new silhouette generated by liposuction is more or less permanent. If you gain a moderate amount of weight after liposuction, then the figure will simply be a fuller version of the new body shape. Fat cells removed by liposuction do not grow back. As long as you do not gain excessive amounts of weight, the new, more pleasing silhouette is permanent. Of course after liposuction, the clock keeps ticking, and advancing age will produce the usual changes in the shape of the body associated with the aging process. If you gain weight after liposuction, you will not accumulate as much fat in the treated areas as would have happened if liposuction had not been done.

Does the fat come back in other areas after liposuction?

If you do not gain weight after liposuction, then fat does not accumulate in other areas of the body. However, if you gain a significant amount of weight after liposuction, then the fat must go somewhere. In fact, the fat accumulates in every area of the body in proportion to the amount of fat cells in each area. Areas where fat cells have been removed by liposuction will accumulate relatively little fat, while areas not treated by liposuction will collect relatively more fat. For example, if a woman gains weight after liposuction of her hips, outer thighs, and abdomen, then most of the fat will be deposited elsewhere such as the woman’s breasts, face, back and legs.

Does liposuction cause unevenness or indentations in the skin?

Unevenness and indentations in the skin is a known risk of liposuction. However, skin irregularities are very unusual in the hands of a skilled surgeon using the tumescent technique with microcannulas. The use of large diameter cannulas tends to increase the risk of irregularities, while the use of microcannulas (less than 3 mm in outside diameter) reduces this risk. When large cannulas are used, any inadvertent passage of the cannula too close to the skin may leave a depression or furrow, this does not happen when using microcannulas.

Is there significant blood loss during tumescent liposuction?

The tumescent technique is so effective at minimising blood loss such that average blood loss is only approximately 15 to 30 ml (1 to 2 tablespoons) per litre of aspirate during the liposuction procedure. This is only slightly more than the blood taken for the average blood test. In the days before the advent of the tumescent technique, the biggest risk of liposuction was excessive loss of blood during surgery.

How does the tumescent technique reduce bruising after liposuction?

There are two reasons for this significant decrease in bruising. First, because there is so little blood loss with the tumescent technique, therefore very little blood remains beneath the skin to cause bruising after surgery. The second reason for decreased bruising is that with the tumescent technique there is a considerable amount of post-operative drainage of the blood tinged residual tumescent solution. By allowing the lower incisions to remain open for several days after the surgery, most of the residual blood-tinged tumescent solution drains out. This minimizes bruising and swelling and accelerates the rate of healing.

How much weight can I lose by liposuction?

You should not expect to lose a dramatic amount of weight with liposuction. However, because fat is removed from cosmetically important areas, liposuction should produce significant improvements in aesthetic appearance, as if you lost a significant amount of weight.

What can I expect if I get pregnant after liposuction?

Pregnancy does not permanently alter the results of liposuction. If a woman has liposuction and subsequently becomes pregnant, gains weight, gives birth and finally loses the excess weight of pregnancy, then her original liposuction improvements will return, just as if she had never been pregnant.

Will liposuction improve the stomach I acquired after my last baby ‘mummy tummy’?

Liposuction typically provides excellent improvement of the abdomen after pregnancy. In fact, for the vast majority of patients, liposuction provides a better and more natural appearance than a tummy tuck (abdominoplasty).Site Images / Body Image Two (medium)

How long will it be until I see results?

The final result is not seen immediately, as it depends on the healing process known as skin retraction. Most patients will see 90% of their ultimate liposuction results within four to six months after surgery. For the first few weeks after surgery there is postoperative swelling. The rate at which this swelling subsides varies from patient to patient. Proper postoperative drainage and lymphatic massage for a few weeks after liposuction seems to decrease the amount of postoperative swelling.

What are the risks of Liposuction?

There is a large body of data worldwide to confirm that liposuction is extremely safe. Rare problems that can potentially occur with any surgical procedure include infections, skin ulcerations, and nerve injury. The tumescent technique minimises these risks. As with any surgical procedure, liposuction is associated with certain common side effects such as bruising, swelling and temporary numbness. Although irregularities of the skin are possible following liposuction, this side effect is minimised by tumescent liposuction using microcannulas and the skill of an experienced surgeon.

How long does it take to complete a typical liposuction procedure?

The average patient will spend 3 to 4 1/2 hours at Facial Artistry. However, the actual procedure may only require 2 to 3 hours. The length of time it takes to perform a liposuction depends on the size of the area treated, the number of areas being treated, and the type of anaesthesia being used. Because it takes a certain amount of time to infuse tumescent anaesthesia, it usually takes longer to do liposuction using tumescent anaesthesia than it does using general anaesthesia.

Is the procedure painful?

Getting the procedure is similar to getting dental work done. The only part that is uncomfortable is having the initial part of the tumescent infusion. At Facial Artistry, we usually use mild sedative to make you feel comfortable during the numbing process. Patients are awake enough to get up for a bathroom break but sedated enough to fall asleep through the procedure. Some patients prefer to chat throughout the procedure. Once the area being treated is numbed, there is only a sensation that something is being done without any discomfort.  

How much does it cost for Tumescent Liposuction?

We understand you are curious to know how much the procedure you are thinking of having might cost.

The truth is that the cost of many procedures vary considerably depending on different factors, such as age, sex, skin tone, body fat content etc. We therefore believe it is unethical to give a cost estimate without gaining a proper understanding of your needs. Your body, your skin and your expectations are different to anybody else’s. We want to plan treatments based on your needs.

Our philosophy is simple. We want you to be fully informed, we want you to understand all your options and have one accurate price quoted once. Our experience tells us  that this is what most of our clients want too.

To request an appointment with Dr Bernard Leung to discuss your suitability for VASER Liposuction to treat man boobs please email us or call us on 02 6255 8988.