IN THIS ARTICLE
During the Procedure
On the day of the procedure, the patient typically has an initial opportunity to ask questions to the nurse and surgeon, after which a final consent form is signed. At this time, the surgeon marks the areas to be suctioned and an intravenous line (IV) is placed to deliver fluids and medications as necessary. If tumescent liposuction is planned, the patient will be given an oral mild sedative pill and is taken to the operating room. In the operating room, a nurse will then inject approximately four to 20 tiny areas with numbing solution and start to inject the tumescent fluid with a small needle.
Depending on the area to be suctioned, the process of numbing an area can take from 30 minutes (chin or knees) to several hours (most other areas). To get good anesthesia to the area, it is important to perform the numbing slowly, as this can make the experience more pleasant. Most patients have very little, if any, discomfort during this part of the process. Additionally, they may fall asleep, watch TV, or listen to music at this time.
If the surgeon is performing the non-tumescent method (without injecting the solution into the area to be suctioned), anesthesia ranging from intramuscular-only to general anesthesia may be given. Both the tumescent liposuction procedure and the non-tumescent procedure yield excellent results; however, the former avoids the risks of injected anesthesia. Additional benefits of tumescent liposuction include the use of smaller cannulas, less bleeding, less need for post-procedure pain control, less bruising, and quicker recovery.
After the area is anesthetized (if performing tumescent liposuction) or the patient is sedated, the surgeon will suction the area(s). Before the tumescent method or suction, the laser-assisted liposuction portion may be used to help melt the fat and seems to result in larger amounts of fat being suctioned, with potentially more retraction of the areas as well.
In tumescent liposuction, generally less areas can be suctioned at one time as the fluid that tumesces, or anesthetizes, the area contains lidocaine and several other ingredients. The total amount that can be used is based on the weight of the patient. Typically, this means that no more than one large area or two smaller areas can be done at one time except in unusual cases.
On the other hand, in the traditional method, many areas are typically able to be suctioned at once. However, a large amount of fat suctioning at one time may increase risks to the patient.
The entire procedure may last an hour or less, depending on the areas to be suctioned. It may be necessary to give a little more numbing material during the procedure. Additionally, some surgeons may use an intravenous relaxant medication, such as Versed, during the procedure.
Joel Schlessinger, MD
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External ultrasound-assistedliposuction (XUAL) is a new technique that requires traditionalaspirative liposuction after the application of high-frequencyultrasonic fields delivered through the skin into wetted tissue.