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Leonard Grossman, MD
Plastic Surgeon
New York Center for Plastic Surgery
New York, NY
212-585-2133
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Steven Margolis, MD
Cosmetic Surgeon
The New England Vein and Lipo Center
Concord, MA
(978) 369-6762
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David Amron, MD
Cosmetic Surgeon
Spalding Drive Cosmetic Surgery and Dermatology
Beverly Hills, CA
(310) 275-2467
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Mark Taylor, MD
Cosmetic Surgeon
Gateway Laser Center
Salt Lake City, UT
(801) 364-6604
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Richard Edison, MD
Cosmetic Surgeon
Ft. Lauderdale, FL
(954) 981-3223
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John Sherman, MD
Plastic Surgeon
New York, NY
(212) 535-2300
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Brian Joseph, MD
Plastic Surgeon
Winter Park, FL
(407) 673-3223
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Susan Lim, M.D.
Cosmetic Surgeon
Singapore
(65) 6475-7133
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- Click the links below for additional information
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Liposuction.Com (All About Liposuction)
TUMESCENT LIPOSUCTION INFORMATION
Thank you for your interest in tumescent liposuction. The goals of this website (Liposuction.Com) is to provide answers to the most common questions about tumescent liposuction, and to provide the technical information needed to make a well informed decision about having liposuction.
ABOUT LIPOSUCTION.COM
Liposuction.Com contains the world's largest and most authoritative source of information available on-line. Carefully reading the various chapters within this website, and other sources of written information, is typically the first step in learning about liposuction and making a decision about having liposuction.
PHOTO GALLERY
The photo gallery for this website provides a large collection of 'before & after' photographs. Among these photographs you will probably find before photos that look just like you.
AREAS TREATED BY LIPOSUCTION.
The most frequently treated areas for women are listed below. For each body area, you can click on the 'Text' link in order to find detailed written information about liposuction in that area or click on the 'Photo' link to find a wide range of photos the demonstrate the results of liposuction.
Abdomen (Text or Photo)
Breasts (Text or Photo)
Hips (Text or Photo)
Waist (Text or Photo)
Back (Text or Photo)
Thighs (Text or Photo)
Knees (Text or Photo)
Face, Chin & Neck (Text or Photo)
Arms (Text or Photo)
Buttocks (Text or Photo)
Calves & Ankles (Text or Photo)
In men, who comprise about 15% to 20% of patients, the most commonly treated areas include the
Face, Chin & Neck (Text or Photo)
Abdomen (Text or Photo)
Breasts (Text or Photo)
Flanks (Love-Handles) (Text or Photo)
TECHNICAL ASPECTS.
This website also contains in-depth discussions about scientific and technical aspects of liposuction, including pharmacology of tumescent local anesthesia, surgical techniques using liposuction microcannulas, and potential liposuction complications.
SAFETY.
Because liposuction surgery is elective surgery, it is important that patients have the benefit of the safest surgical and anesthetic techniques. The safest form of liposuction is the tumescent technique which virtually eliminates the risks of surgical
bleeding and permits liposuction totally by local anesthesia.
TUMESCENT LIPOSUCTION WITH GENERAL ANESTHESIA.
can be done safely provided 1) an Board Certified Anesthesiologist or Certified Registered Nurse Anesthetist (CRNA) is present to administer the anesthetic and monitor the patient, 2) the surgeon does not attempt to remove too much fat, nor attempt to treat too many areas on the same day, and 3) the surgeon does not do other surgeries unrelated to liposuction on the same day. The last statement is controversial. Many surgeons who do liposuction under general anesthesia probably believe that it is safe enough to perform unrelated surgical procedures on the same day as liposuction. A similar number of surgeons believe that excessive surgical trauma on the same day is dangerous and unnecessary for elective procedures.
LIPOSUCTION CONSULTATION.
A consultation with a liposuction surgeon is typically the second step in your careful deliberations about having liposuction. You can locate and contact a liposuction surgeon near you and make arrangements for a consultation by using the Surgeon Locator directory on Liposuction.Com. You should expect your liposuction surgeon and surgical staff to be dedicated to helping you achieve your goals of self-improvement. Your consultations should be personal and private. Usually you may bring your spouse, relative, or special friend with you to the consultation. Your consultation with a liposuction surgeon is your opportunity to get answers to all your questions about liposuction. You should not feel compelled to make any decision about having liposuction at the time of your initial consultation. The consultation is your opportunity to acquire detailed information about liposuction and about what liposuction can do for you. Your goal should be to appraise the personality, knowledge, experience, skill, friendliness, and professionalism of the surgeon and staff. At the same time the surgeon and staff will want to make sure that you are a good candidate for liposuction.
HOW TO CHOOSE A SURGEON
Before your liposuction consultation you should prepare a list of questions that you would like to have answered. You can find some suggested questions for your surgeon at How to Choose a Surgeon section in this website. You should feel free to ask the surgeon and the surgeon's staff, any questions that this site does not answer. Take notes or highlight areas of concern as you read through Liposuction.Com's many informational pages so that you can ask for further clarification and more detailed information.
WHAT IS THE TUMESCENT TECHNIQUE?
The tumescent technique for local anesthesia involves the injection of large volumes of very dilute lidocaine (local anesthetic) and epinephrine (vasoconstrictor that shrinks capillaries) into subcutaneous fat. The word tumescent means swollen and firm. With the tumescent technique, the volume of dilute lidocaine that is injected into fat is so large that the targeted areas literally become tumescent (swollen and firm). The tumescent technique produces profound and long-lasting local anesthesia of the skin and subcutaneous fat. Tumescent liposuction designates a form of liposuction that uses tumescent local anesthesia.
WHAT IS THE SUPERWET TECHNIQUE?
Surgeons who do liposuction under general anesthesia or heavy IV sedation typically use less than the optimal concentration and volume of tumescent local anesthesia. These surgeons often refer to their technique as the superwet technique rather
than the tumescent technique.
DIFFERENCE BETWEEN TUMESCENT TECHNIQUE AND SUPERWET TECHNIQUE.
Surgeons who use the tumescent technique for local anesthesia to do liposuction totally by local anesthesia typically wait for 30 to 60 minutes after completing the infiltration of tumescent fluid in order to allow some detumescence to occur before starting to do liposuction. The volume of tumescent anesthetic solution that must be infiltrated into an area is so large that the tissue become swollen and firm. This degree of tumescent swelling makes it difficult to do liposuction immediately completing the infiltration. It is much easier to do liposuction after sufficient time has passed to allow a degree of detumescence (decreased swelling and firmness) to occur; this usually takes about 30 to 45 minutes. Detumescence does not diminish the profound tumescent local anesthesia and intense vasoconstriction, both of which persist for more than 12 hours after the tumescent infiltration is completed.
In contrast, surgeons who use the superwet technique do liposuction under general anesthesia. It is regarded as expensive an inefficient to occupy a surgery centers operating room and pay an anesthesiologist for 30 to 60 minutes while merely waiting for detumescence to occur. As a consequence, surgeons who us the superwet technique with general anesthesia typically infiltrate 50% or less tumescent fluid compared to surgeons who do liposuction totally by local anesthesia. By using less tumescent fluid, liposuction can be started sooner.
LIPOSUCTION, BODY SCULPTURE, LIPOPLASTY, ETC.
The terms liposuction, liposuccion, lipoplasty, lipoplastie and body sculpture are synonyms. Body sculpture or liposuction or lipoplasty can literally be a dream come true. Localized accumulations of fat, which are often inherited and frequently impossible to eliminate by exercise or dieting, can now be removed permanently by liposuction surgery.
ABOUT FAT
Body fat on an adult tends to increase gradually over the years. After the age of 30, an individual often gains fat according to a genetically predetermined pattern. For example, the abdomen, hips, and the area under the chin are areas where fat begins to accumulate in adults. Fat in these areas is often resistant to diet or exercise. After pregnancy, the fat on the abdomen and hips may persist despite concerted efforts at dieting and exercising. For many people who have an inherited tendency to accumulate localized deposits of fat, liposuction is the only realist 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.
WHAT IS LIPOSUCTION?
The concept of liposuction is surprisingly simple. Liposuction is a surgical technique that improves the body's contour by removing excess fat from deposits located between the skin and muscle. Liposuction involves the use of a small stainless steel tube, called a cannula (from the Latin word for reed, tube, cane). The cannula is connected to a powerful suction pump and inserted into the fat through small incisions in the skin. Fat removal is accomplished as the suction cannula creates tiny tunnels through the fatty layers. After surgery, these tiny tunnels collapse and thus result in an improved body contour.
PERMANENCE OF RESULTS
Fat cells that are removed by liposuction do not grow back. As long as the patient does 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 subtle changes in the shape of the body. But overall, the new body shape after liposuction suction is more or less permanent. If a woman has a tendency to accumulate fat on the thighs and knees when she gains weight, then after liposuction these areas do not accumulate as much fat as other areas that have not been treated.
WHAT HAPPENS IF THERE IS A SMALL WEIGHT GAIN AFTER LIPOSUCTION?
If the patient does gain a moderate amount of weight after liposuction, then her figure will simply be a larger version of her new body shape. For example, suppose a woman who weighs 60 kg (132 pounds) has liposuction of her hips thighs and abdomen which removes 3 kilograms (6 pounds), and six months later the patient again weighs 6 kilograms. In essence, the woman has gained 3 kilograms and the fat cells in all areas of the body will be proportionately larger. The areas treated by liposuction are still smaller because of the liposuction, but those areas are larger than they would have been if she weighed 57 kg and had not regained the 3 kilograms. Areas that were not treated by liposuction typically get bigger with increasing weight. For example, this women described above can be expected to have relatively bigger arms and breasts compared to her size before liposuction.
WHAT HAPPENS IF THERE IS A LARGE WEIGHT GAIN AFTER LIPOSUCTION?
If a patient a gains a significant amount of weight after liposuction, then new fat cells are formed everywhere on the body, including areas that were previously treated by liposuction. If the weight gain is greater than 15 percent, for example if a 60 kilogram woman becomes a 69 kilograms woman, then all areas of the body will acquire new fat cells, and the benefits of liposuction will be much less apparent.
PREGNANCY AFTER LIPOSUCTION
usually does not 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.
WHO IS A GOOD CANDIDATE FOR LIPOSUCTION?
The best candidates for liposuction are in good health and have realistic expectations of liposuction. There is no definite age limit, or weight limit for patients who are good candidates for liposuction. Many liposuction patients are of average size but are concerned about localized accumulations of fat. However, some of the happiest patients have been individuals who are somewhat obese. It is important to emphasize that liposuction is not a treatment for general obesity. Liposuction is not effective as a last resort for people who are unable to maintain reasonable weight by dieting. However, an overweight person whose weight has been stable for years and has certain problem-areas of fat may be an excellent candidate for liposuction of localized areas of fat.
WHAT IS A SUCCESSFUL LIPOSUCTION SURGERY?
A liposuction surgery is a success when the patient is happy with the results. A liposuction is unsuccessful if the patient is unhappy with the results, even though the surgeon believes results of a liposuction are excellent.
MAXIMIZING VOLUME OF FAT REMOVAL MAY BE A MISTAKE.
Maximizing the volume of fat removal should not be a goal for liposuction. The
surgeon's goal must be to obtain the best aesthetic result rather than to maximize 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 a disfigured or abnormal appearance. The cosmetic success of a liposuction surgery is often the result of removing an amount of fat equivalent to a half-pound of butter from a woman's saddlebag area or from a man's love handle area. While this amount of fat is relatively small compared to a person?fs total body weight, it does produce a dramatic change in the patient's silhouette.
EARLY HISTORY OF LIPOSUCTION
Liposuction was initially developed in 1978-1982 in Italy by Gorgio Fischer and in France by Yvez Illouz and Pierre Fournier. Liposuction was introduced into the United States in 1982. At that time liposuction could only be performed under general anesthesia. In those days, liposuction was associated with so much blood loss that patients frequently required hospitalization and blood transfusions.
DEVELOPMENT OF THE TUMESCENT TECHNIQUE
In 1985 Dr. Jeffrey A. Klein, M.D., a dermatologist in California, revolutionized liposuction surgery when he developed the Tumescent Technique which permits liposuction totally by local anesthesia and virtually eliminates surgical blood loss. Because the Tumescent Technique is by far the safest form of liposuction, it has become the world wide standard of care. Not only has the Tumescent Technique proven to be safer than the older techniques that required general anesthesia, but it has also proven to be less painful, has minimized post-operative recovery time, and has produced optimal cosmetic results.
LIPOSUCTION TOTALLY BY LOCAL ANESTHESIA
The word 'tumescent' means swollen and firm. The Tumescent Technique uses large volumes of a dilute solution of lidocaine, a local anesthetic, in combination with the vasoconstrictive drug epinephrine, which temporarily shrinks capillaries. Local anesthesia used in the Tumescent Technique for liposuction is so effective that patients no longer need intravenous sedatives, narcotic analgesics, or general anesthesia.
VIRTUALLY NO BLOOD LOSS
As a result of the capillary constriction caused by the epinephrine in the tumescent anesthetic solution, there is minimal bleeding during and after surgery. This is a major improvement in the liposuction technique compared to the older methods that used general anesthesia and often required blood transfusions.
In one scientific study, published in the journal Plastic and reconstructive Surgery, 112 liposuction patients each had between 1,500 ml to 3,400 ml (between 1.5 quarts to 1 gallon) of fat removed using the Tumescent Technique. None of these patients required a blood transfusion. In fact, the average patient lost approximately one tablespoon (15 ml) of blood. The Tumescent Technique is so effective at minimizing blood loss that the majority of patients with large volume liposuction lose less blood during surgery than they do at the time of their routine pre-operative laboratory studies.
In the days before the advent of the Tumescent Technique the biggest risk of liposuction was excessive loss of blood during surgery. In fact many surgeons required their patients to donate their own blood several weeks before surgery. Then during surgery the patient's blood would be returned to the patient by transfusion. With the tumescent technique blood transfusions are no longer a part of liposuction surgery.
SAFETY FIRST
Ideally, liposuction surgeons and the surgeons' nursing assistants should all be well trained in Advanced Cardiac Life Support (ACLS). They should be equipped and able to diagnose and treat all true emergencies immediately. Surgical complications in liposuction are quite rare. Among the risks of any surgery under general anesthesia is respiratory arrest as a result of either an allergic reaction, or mechanical malfunction or human error associated with general anesthesia. Thus, from the perspective of safety, being able to take care of a medical emergency, such as a cardio-pulmonary arrest, is of primary importance.
SAFETY & SURGICAL FACILITY
Liposuction surgeries can be performed very safely in an office surgical setting, especially if the procedure is performed entirely under local anesthesia, without IV sedation of general anesthesia. An office surgical facility that has been accredited by a national organization is preferable when liposuction is performed under general anesthesia or IV sedation. In the United States, the American Association of Ambulatory Health Care (AAAHC) HYPERLINK "http://www.aaahc.org" www.aaahc.org and the American Association for Accreditation for Ambulatory Surgery Facilities (AAAASF) HYPERLINK "http://www.aaaasf.org" www.aaaasf.org are two such organizations. Many other nations have similar organizations. Accreditation of a surgeon's office documents that the facility has passed an inspection and has strict policies and procedures for patient safety. Accreditation demonstrates an extra effort to optimize patient safety.
RISKS OF ANY SURGERY
As judged by current worldwide experience, liposuction is amazingly safe. Rare problems that can potentially occur with any surgical procedure include infections, bleeding and nerve injury. The tumescent technique minimizes these risks. The type of anesthesia determines the risks of surgery. For example, dentists prefer local anesthesia rather than general aesthesia simply because it is sufficient and safer. To the best of our knowledge, there have been no reported deaths using the tumescent technique for liposuction totally by local anesthesia.
SKIN IRREGULARITIES FOLLOWING LIPOSUCTION
As with any surgical procedure, liposuction is associated with certain common side-effects such as some degree of bruising, swelling and temporary numbness. Irregularities of the skin are possible following liposuction. Most patients have some skin irregularities before liposuction. In most cases, any skin irregularities resulting from liposuction are minimal and appear within the limits of normal skin. Skin irregularities following liposuction can be minimized by choosing a skillful surgeon who uses smaller cannulas. The size (outside diameter) of the liposuction cannula (stainless steel tube that is inserted beneath the skin to suction fat) is a factor that determines the risk of liposuction irregularities. The use of larger cannulas (outside diameter > 3 mm) increases the risk of liposuction resulting in irregularities of the skin. When microcannulas (outside diameter < 3 mm) are used, noticeable irregularities are less common. Larger diameter cannulas are sometimes preferred because they facilitate more rapid removal of fat. Microcannulas remove fat somewhat more slowly but are less likely to create an irregularity by inadvertently removing too much fat from a localized area.
TUMESCENCE GIVES SMOOTHER LIPOSUCTION RESULTS
The large volumes of dilute local anesthetics infiltrated into the fatty tissue causes
the tissue to become swollen and firm, or tumescent. The Tumescent Technique magnifies the fatty area that is to be treated by liposuction. If there is an area that has not been completely treated, this is more easily detected because the area is swollen and enlarged. Thus the risk of post-surgical irregularities and unevenness is reduced.
MICROCANNULAS GIVE SMOOTHER LIPOSUCTION RESULTS
With the Tumescent Technique very small cannulas (microcannulas) are used. This permits a more delicate and gentle approach to liposuction. The liposuction cannulas which have been specifically designed for the Tumescent Technique are less than or equal to 2.8 mm in diameter. These micro cannulas require a minimal amount of force in order to advance them into the fatty tissue. As a result, this surgery is much gentler and the surgeon can control the direction and position of the cannula with much more accuracy. The ultimate result is a greatly reduced risk of inadvertently approaching too close to the undersurface of the skin and unintentionally causing irregularities.
CRISSCROSSING GIVES SMOOTHER LIPOSUCTION RESULTS
The risk of liposuction irregularities is increased when liposuction is attempted using only one incision. When only one incision is used for liposuction, the resulting tunnels tend to create parallel furrows that are more likely to leave visible as a liposuction irregularity. The addition of one or more incision allows the surgeon to approach the target fat from different directions, creating a crisscrossing pattern of liposuction tunnels within the fat. Crisscrossing tunnels allow a more uniform removal of fat and produces smoother results.
WHAT IS AN ADIT?
An adit is a technical term used by mining engineers to designate a horizontal opening by which a mine is entered, or drained. An adit is an access or entrance into a tunnel. In liposuction an adit is a small opening in the skin that permits drainage of fluids after a surgical procedure. In tumescent liposuction, 1.5 mm or 2.0 mm skin biopsy punches are used in order to create small cutaneous openings that allow access for the liposuction microcannula, and allow an efficient route of egress for any residual blood-tinged tumescent anesthetic solution. An adit typically heals without a clinically apparent scar.
OPTIMAL POST-LIPOSUCTION CARE
New techniques for post-liposuction care allow more rapid recovery, less bruising, less swelling and less prolonged tenderness. This is achieved by encouraging rapid 'open-drainage' of residual blood-tinged solution of tumescent local anesthesia. In addition to the usual skin incisions required for liposuction, the surgeon can also make several additional tiny round holes in the skin called 'adits' (made with 1.5 mm skin biopsy punch) which facilitate open-drainage. Drainage can be optimized by allowing the tiny adits to remain open (not closed by stitches) and by using special super-absorptive pads (HK Pads(TM)) together with post-operative elastic compression garments. With open drainage, patients can usually see dramatic improvements within two weeks after surgery, and they can expect to see 90 percent of the final result within 4 weeks. With older techniques that closed incisions with sutures, the ultimate results following liposuction usually require 12 to 16 weeks to become fully apparent.
DOES LIPOSUCTION REMOVE CELLULITE?
Although the results of liposuction are often quite spectacular, it is not realistic to
expect perfection. Liposuction of the thighs, while improving the silhouette, does not necessarily eliminate the subtle "puckering" of the skin that is often referred to as "cellulite." Liposuction with the Tumescent Technique often reduces the degree of cellulite but it is unlikely to eliminate it.
DECREASED RISKS OF INFECTION WITH TUMESCENT TECHNIQUE
Liposuction infections are extremely rare. Although there have been reports in the medical literature of patients who have had serious infections following liposuction surgery, to the best of our knowledge, the risk infection following liposuction is reduced by using the tumescent technique. Lidocaine, the local anesthetic that is used for the Tumescent Technique kills bacteria.
LIPOSUCTION SCARS
The visibility of surgical scars after liposuction depends on 1) the size of the liposuction surgical incision 2) the number of liposuction surgical incisions, 3) the location of the liposuction surgical incision and 4) the degree of natural pigmentation in a patient's skin.
Size of Liposuction Incisions: Larger surgical incisions leave scars that are usually more visible than smaller incisions. Larger diameter liposuction cannulas require larger surgical incisions in order to allow the larger cannula to pass through the skin incision and into the fat immediately beneath the skin. Microcannulas require smaller incisions and thus the scars tend to be less visible. Adits are so small (typically 1.5 mm to 2 mm diameter) that they often become invisible in patients who have light colored pigmentation.
Number of Liposuction Incisions: The number of incisions required to adequately perform liposuction can vary depending on the size and location of the area being treated, and size of liposuction cannulas that the liposuction surgeon uses. Multiple incisions or adits permit a crisscrossing pattern of liposuction tunnels, which in turn tends to permit smoother results.
Location of Liposuction Incisions: The locations of liposuction adits or incisions are typically placed in areas of the body where they will be minimally visible. This is especially important when large incisions are required in order to accommodate larger diameter cannulas. The tiny incisions and adits used with microcannulas are so small that they eventually become invisible, especially in patients with light pigmentation. In lightly pigmented patients, adits can be placed almost anywhere with little risk that the scars will still be visible 12 months after liposuction surgery.
Degree of Pigmentation in Patient's Skin: The term post-inflammatory hyperpigmentation describes darkened scar that typically occurs in human skin after an injury. The increased pigmentation results after inflammation or trauma causes the rupture of pigment-containing skin cells. The ruptured cells release pigment into the surrounding tissue where it is gobbled up by scavenger cells in the skin which causes the affected skin too appear darker. The darker a person's natural pigmentation, the longer this hyperpigmentation persists. This process of post-inflammatory hyperpigmentation normal and every patient must be expected it in some degree. With careful attention to minimizing trauma to the skin during liposuction, a surgeon can reduce the risk of prolonged scar pigmentation.
HOW DOES LIPOSUCTION AFFECT SKIN?
The degree of skin change after liposuction is the same as one would expect if it were possible to lose an equal amount of fat in these localized areas simply by dieting. Because a liposuction cannula simply makes small tunnels through the fat, there remain multiple connections between the skin and the underlying tissue. These fibrous connections contract with the healing process and maintain the skin in its
natural position. After tumescent liposuction, one does not generally have to worry about excessive folds of skin in the areas treated by liposuction. Skin contraction after tumescent liposuction of the abdomen is so dramatic that for most patients liposuction provides better results than a surgical excision of skin by tummy-tuck surgery.
DECREASED BRUISING
There is dramatically less bruising using tumescent local anesthesia for liposuction as compared to general anesthesia. There are two reasons for this significant decrease in bruising.
First, the profound vasoconstriction produced by the tumescent technique prevents bleeding to such a degree that bleeding and thus bruising after surgery is minimal.
Second, open-drainage technique for post-operative care maximizes drainage after liposuction of blood-tinged tumescent solution. This further minimizes bruising and swelling, and accelerates the rate of healing.
RECOVERY IMMEDIATELY AFTER LIPOSUCTION
Immediately after liposuction patients must be observed until it is determined that there is no impairment of breathing, the blood pressure is stable and any post-operative nausea and vomiting associated with general anesthesia has resolved. After liposuction totally by local anesthesia, there is virtually no blood loss and with local anesthesia the incidence of nausea is small. Patients are typically discharged home about 30 minutes after completion of liposuction totally by local anesthesia. After liposuction by general anesthesia patients are typically observed for about one hour. With the tumescent technique, the tumescent solution contains local anesthetic lidocaine. The effects of the local anesthetic persist for many hours after surgery so that there is minimal pain at the treated areas. If the superwet technique employs injected solution containing relatively little lidocaine there is little postoperative local anesthesia of the treated areas and patients may require the use of some narcotic analgesics.
ACCELERATED POST-OP HEALING
As a result of open drainage (not using stitches to close adits or incision sites) the rate of healing is accelerated. Open incision and open adits permit drainage of the slightly blood-tinged anesthetic solution. Blood trapped in subcutaneous tissue, even very dilute blood found in the blood-tinged tumescent drainage fluid, causes a significant degree of inflammation. Because the open-drainage encourages the rapid drainage of residual blood-tinged anesthetic solution, there is less inflammation and the healing process is significantly accelerated. Because of the significant decrease in swelling and decrease in inflammation and pain after the surgery, patients are able to return to normal physical activities very soon after surgery. There is no limitation to physical activity other than what common sense would dictate. Some patients are able to return to jogging, golf, light aerobic exercise within a day or two after surgery. Some patients do find the soreness after surgery more significant than others, but on the average, most patients are quite surprised at how quickly they are able to return to normal activity.
WHICH SPECIALISTS DO LIPOSUCTION?
Liposuction is a type of surgery that is appropriately performed by surgeons of several different specialties. The specialists who most commonly perform liposuction are plastic surgeons, dermasurgeons (dermatologists), and cosmetic surgeons. Increasingly gynecologic surgeons are seeking training in liposuction surgery. Dermatologic surgeons and plastic surgeons are usually taught liposuction surgery during their residency training.
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