What is “tumescent liposculpture?”

A method of removing fat cells permanently from an area of the body. With this technique, a solution of Lidocaine (local anesthetic) and epinephrine (to constrict the blood vessels) is infused into the space between the skin and muscle using a cannula (a thin rod with a hole through the center). The cannula is placed under the skin using a few very small incisions (about 1/4″ long), which are usually placed in the skin folds so they will not be readily visible. This process not only provides anesthesia, but helps liquefy the fat so it can be suctioned out. The epinephrine in the solution constricts blood vessels to minimize bleeding. Next, another cannula is used, through the existing incisions, to suction out the fat cells, using a high-pressure vacuum pump. The entire procedure takes 2-4 hours, depending on the area and the amount of fat to be removed. Using different sized cannulas, we can “sculpt” the areas treated to achieve the contour you want.

How does it differ from traditional liposuction?

This relatively new technique differs from original liposuction in many important ways. First of all, no general anesthesia is required. This reduces the risk, expense and recovery time dramatically. Second, no hospitalization is needed. Third, bleeding is virtually non-existent with the tumescent liposculpture technique. Lastly, the risk of large volume losses and shock are virtually eliminated because of the infused fluid and the use of “microcannulas”, which are much smaller than those used with traditional liposuction.

Is it safe?

Yes. With the avoidance of general anesthesia, minimizing of blood loss with the use of epinephrine in the anesthetic solution, and the use of microcannulas to avoid sudden and large fluid shifts, this is a generally safe procedure. Additionally, there has been some scientific evidence to show liposuction may actually improve levels of cholesterol, glucose and insulin secretion. (Annals of Plastic Surgery, 2004;52(1):64-67). As with any surgical procedure, however, certain risks do exist, and vary from patient to patient. These risks will be discussed with you in detail at the time of your consultation.

What is “PAL”?

PAL, or power-assisted liposculpture, replaces the original manual suction cannula (tube) with one that vibrates. Any one of several types of liposuction cannulas can be attached to a power-handle to help us remove fat and shape the body. This allows the cannula to go through the fat and fibrous (scar) tissue more easily, and breaks up the fat, so it is easier to pull out. The advantages are a quicker procedure, less discomfort to the patient, and less bleeding and bruising.

Do I have to go to the hospital?

No. The procedure is done in an outpatient surgical center.
Who is a good candidate for the procedure?
Anyone who is generally in good health can have liposculpture. Most of us have unwanted fatty deposits on our body. Many times, these are hereditary and not necessarily related to being overweight. They are frequently resistant to diet and exercise, and even at ideal body weight, these fatty areas remain a problem. Liposculpture permanently removes these fat cells. Overweight people also benefit from the procedure in that much (but not all) of the excess fat can be removed. Remember, though, that liposculpture is not meant to be a treatment for obesity, nor a substitute for weight loss and exercise.

Which areas can be treated?

Almost any area that has unwanted fat deposits. Typical areas are tummy, love handles, hips/thighs, buttocks, chin/neck, back of arms, upper back (“bra-bulge”) and male breast. Female breast reduction by liposuction is also very effective.
Can I have more than one area treated at the same time?
Sometimes, yes. The limiting factors are the amount of fat to be removed, and the amount of Lidocaine we need to use. To remove too much fat at one time is hard on your system and could result in hypotension (low blood pressure) and dehydration. Also, we can only safely use a certain amount of Lidocaine for anesthesia-after that, it can become toxic. Typically, if you don’t have a lot of fat to remove, we can frequently do two different sites. We can let you know for certain when we see you for a consultation.

Is it painful?

You will undergo procedural sedation for the surgery. You should have no memory of the procedure itself.

Will I lose much blood?

No. Using epinephrine to constrict the blood vessels, and small “micro-cannulas”, blood loss is negligible.

What is the postoperative period like?

At the end of your procedure, we will instruct you on how to take care of your wounds and give you all the necessary supplies.
Your first few days will feel as if though you have done a 1000 setups. Although pain after the procedure is rare, you will probably have some tenderness. This is caused by bruising of the tissues from the liposuction process and is not a cause for concern. It typically resolves in 2-3 weeks. Some temporary skin bruising is possible. You will be given pain medication for those few who may need it. Most can tolerate the discomfort with tylenol or nothing at all.
Wearing a compression garment (which we will supply for you) is a very important part of the healing process. It helps reduce swelling and bruising, and promotes faster drainage of the retained fluid. It also aids in allowing your excess skin to retract more quickly. We request you wear the garment 24 hours a day (except for using the bathroom or bathing) for the first 2 weeks, then 12 hours a day for another 2 weeks.

What is the recovery time?

You will be up and around immediately after the procedure. Most people return to light work and activity within 1-2 days, and full activity within a week. We prefer you avoid heavy labor or high-impact exercise for about 2 weeks.

What are the side-effects?

Bruising can occur, although it is usually minor, and heals within 7-10 days. Bleeding, post-procedure pain, infection are rare but can occur. Lumpiness and scar tissue can form in the regions treated, especially if large amounts of fat are removed. Initially the skin may look saggy, but the elastic properties of skin will usually allow it to contract within a few months.

Will I have scars?

Usually, only a few very small incisions (about 1/4″) are needed, depending on the area treated. These almost always heal with minimal to no scar formation.
Will the fat come back if I gain weight?
The fat we remove is permanently gone. Those particular fat cells can never return. However, if you gain weight, you can engorge existing fat cells in surrounding areas or elsewhere on your body.