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Dr. Susan treating to her patient for Tumescent Liposuction at Perfect Skin MD
Tumescent Liposuction
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What is Tumescent Liposuction

The concept of liposuction is quite straightforward: unwanted fatty deposits are removed using small stainless steel tubes (cannulas) connected to a powerful suction device. These cannulas are inserted through very small incisions (1-2 mm adits). Fat is removed as the suction cannulas create tunnels in the subcutaneous fat. Post-operatively, these tunnels collapse, resulting in an improved body contour.

Probably the most significant improvement to the liposuction technique came about in the mid-80s when the tumescent technique was developed. In this manner, liposuction can be performed without general anesthesia, completely under local anesthesia. Tumescent liposuction is now considered the safest form of liposuction worldwide. There is minimal blood loss, less pain, post-operative recovery time, and expense, and the cosmetic results are beautiful.

Tumescent Liposuction: still the gold standard for removing unwanted fat

Tumescent Liposuction, How it works

Dr. Susan explain about Tumescent Liposuction and how it works
Want to know the difference between regular liposuction and tumescent liposuction and which best suits you? Check out this video.

Those warmer, warmer, temps come in all right, well you know what today is Fat Tuesday and honour of Fat Tuesday we’re talking about how to get rid of that fat and many devices promises to they promise to reduce fat but none of them have the satisfaction rate efficiency, safety record as to Tumescent liposuction. Doctor Susan Schroder dermatologist at perfect skin dermatology is here to tell us how it works. So, thank you so much for coming today, My pleasure, happy Fat Tuesday. Happy fat Tuesday, no more fat, no more fat Tuesday, right, so tell us the difference between regular liposuction and Tumescent and how it kind of differs, okay so well liposuction is performed using small cannulas blunt cannulas that are tunnelled through the skin and into the fat and they remove tunnels of fat and it’s connected to a very powerful suction device but with the tumescent technique which was developed about 10 years after regular liposuction in the mid-80s we use a local numbing medication that’s infiltrated into the fat enlarging that fat and allowing us to do it so much more safely with so much more down so much less excuse me downtime, which is perfect because when you think liposuction you think giant bruises everywhere, you’re sore you know you see those videos on Instagram or the doctors just really go in and it looks very rough, and people are worried about the dangers of it too most people are completely safe but it is a little bit more risky to do it under general anaesthesia. Alright so tumescent is not under general aesthesia. Not yes, the Tumescent is just local. You are sedated a little bit it may be something to relax you but you are awake and we can stand you up and turn you around and make sure that there is nothing that’s missed and that you’re very even and its really nice result. Absolutely and so what I hear with that is less money because you’re not under the general aesthesia you don’t need an anaesthesiologist right so that also helps. So, what are the areas that can be treated because when I think full-body regular liposuction, I mean you could do the full body is the same with tumescent? It you’re really limited about how what limits you excuse me is how much aesthesia we can actually give you. When I say anaesthesia, I am talking about numbing medication, okay you, okay you could overdo that as well. So, what you just will do certain areas but the areas that can’t be treated are you know the lower legs the calves the thighs the hips the abdomen. We can even reduce breast size with liposuction with just tiny little incisions without the traditional yeah, wow, yeah chin cheek and jowls people that are heavy through here this causes a really nice lift and some controlled fibrosis, so you really do have some tightening through here and these are it’s very little downtime most of my patients if we do it on a Friday, they’ll feel tired through the weekend because this is surgery even they only have tiny little incisions and you may feel somewhat tired when you go back to work on Monday but it’s you know that’s it you’ll be a little tired but you’re, you’re, really ready to go back and you know be in their regular world. You know and I’ll feel a little tired for a banging body you know, absolutely, especially before summer just a couple of days, yeah, but you know if someone wants to invest in something like this, right, it’s not as expensive as they think but are the results permanent. They absolutely are permanent. You have two times in your life when you actually produce fat stores and so if, if, ou’re prone to gaining weight in the thigh area for instance, we go in there and we tunnel and we remove some of those fat cells, you’re not I can’t tell you that you’re never going to gain weight again if you don’t exercise and you’re not eating correctly you’re going to gain weight but it’s not going to be in the areas that we treat those fat stores are going to be permanently removed. That is awesome maybe it’ll get you to the gym feeling a little bit more confident right because you’ve already shed some, some, layers there some, some, inches. All right so let’s talk really quickly about the difference in anaesthesia we kind of mentioned it you just put numbing medication underneath right that expand those fat cells. Right so it’s actually in normal saline bags kind of IV bags that you might see in a hospital and we dilute we use anaesthetics and it’s a connection of not connection it’s a combination of lidocaine and epinephrine and some something to make it less stinging as it goes in, and we infiltrate this into the fat and it does blow it up temporarily, but if we let it sit there. It’s just like what we would use to do a skin biopsy, just a local anaesthesia. That’s perfect so that’s how it could be less invasive less expensive which is amazing so more affordable for everybody out there and you know one question that we didn’t get to was how does it compare to the non-invasive methods and I know we had talked beforehand about those, those, feet free the ones that freeze off or that heated off. They just can’t get the inches that you can and, and, that is not going to you know that could come back with you know liposuction with tumescent it’s you know definitely those fat stores are gone, right? Most patients actually watch the little the, the, container where the fat comes out because it’s so satisfying to see that it’s actually leaving your body. Exactly you could see how much weight you lost right, yeah, we could with the Kos we could be so much more precise. I’d mentioned we do ankles we can sculpt arms that’s a little bit more difficult to do if you’re using a machine and this is a one-shot deal, all right, with those non-invasive machines. It’s usually a number of treatments and it ends up being about the same costs. Most liposuction procedures that we do in our office started about three thousand dollars right yeah most are under six thousand. So, it’s between depends on how much we’re removing and how many areas we’re doing. A lot more affordable I think than people think especially when you’re looking at CoolSculpting or the heat, you’re looking at spending the same because you have to do a series of like you know three to six. Well doctor I want to thank you so much for coming on this morning and educating us we could get that birth perfect summer body here on Fat Tuesday so for more information you can go online to perfectskinderm.com

What Areas are Treated By Tumescent Liposuction?

In women, the most commonly treated areas are: the abdomen, hips, flanks, thighs, knees, calves, ankles, and the chin/neck/jowl area. Men comprise about 25% of our patients and usually request treatment of love handles, abdomen, breasts, and neck/chin.

Are the Results Permanent?

YES! Fat cells removed by liposuction do not recur. Removing fat cells from the desired location means that there is no longer a fat deposit that can enlarge or diminish. A patient who previously may have easily put-on weight on her thighs and hips, for instance, will find that after liposuction to these areas, it is less likely that these areas will accumulate fat with weight gain.

Am I a Good Candidate?

The best patients for liposuction are those in relatively good health with realistic expectations. Most of our patients have few localized areas of fat they would like removed. Liposuction is not a treatment for obesity or a substitute for lap band surgery. Rather, it is an effective and permanent procedure to remove fat deposits resulting in a more pleasing silhouette.

How Does Tumescent Liposuction Compare to That Under General Anesthesia?

Large volumes of dilute anesthesia are infiltrated through small cannulas into the areas treated, causing the targeted area to become temporarily swollen and enlarged. This technique magnifies the fatty area, causing untreated areas to become more easily detected. For this reason, there are fewer post-surgical irregularities and asymmetry. Because patients are awake, it is common practice to have patients stand or change position so that the surgeon can evaluate for symmetry and residual areas that may have been missed, allowing for a superior result.
Your post-operative recovery time is significantly reduced, as recovery from general anesthesia is eliminated. You will feel tired for a day or two, and certainly achy, but most patients are able to return to work and moderate activity by day 3-4.

What are the Risks?

As with any surgical procedure, there are some associated common side-effects: bruising, swelling, and temporary numbness. There can be irregularities of the skin, but this finding is less-common with the tumescent technique than with traditional liposuction. There are more uncommon risks, such as infection, but since the local anesthetic “kills” bacteria, this risk is quite rare. The safety of the Tumescent Technique has been evaluated for 40 years, and to date there has never been a single death associated with this technique on its own.

Are the Scars Visible?

Because very small cannulas are used, only tiny incisions are made (1-2mm). The wounds heal on their own and become inconspicuous over time.


Tumescent Liposuction before and after results of real patients at Palm Beach (cause 21)

Before the Treatment

After the Treatment

Tumescent Liposuction before and after of actual patient at Perfect Skin MD

Before the Treatment

After the Treatment

Will My Skin Be Loose After Tumescent Liposuction?

Skin change after liposuction is similar to that one would realize after dieting. Multiple connections between the skin and the underlying structures remain, as liposuction is achieved through removing small tunnels of fat in the targeted ares, preserving many fibrous connections. With the healing process, these remaining connections contract and maintain the position of the skin to the tissue beneath. Excessive folds of skin are not a worry. In fact, many patients that would have required a tummy tuck, for instance, find that they do not need one after post-liposuction contraction has occurred.

How Does Tumescent Liposuction Compare to Non-invasive Methods of Fat Removal?

Results from Tumescent Liposuction are more dramatic than what fat removal via cryotherapy (CoolSculpting), ultrasound, radiofrequency, or fat-dissolving injections can achieve. Most of these other modalities require multiple sessions to achieve a desired subtle result. Inch-for-inch, liposuction is much more cost-effective for patients.

Why Don’t All Liposuction Surgeons Offer the Tumescent Technique?

From a surgery standpoint, liposuction under local anesthesia is more time-consuming. There are, however, other variables, including the surgeon’s training. All Dermatologic Surgeons who perform liposuction use exclusively the tumescent method, whereas most U.S. Plastic Surgeons use general anesthesia, as that is what is taught in respective training. Currently, there is a growing trend toward the use of the Tumescent Technique across all specialties.