Before the invention of tumescent anesthesia, the Liposuction surgical procedure was performed with general anesthesia. In 1986 tumescent anesthesia was discovered by Dr. Jeffrey Klien specifically for Liposuction surgery. Based on the principle of hypodermoclysis Dr. Jeffrey’s concept of tumescent anesthesia has phenomenally changed the process of Liposuction surgery procedure performed nowadays. By adding epinephrine in buffered saline and perfect volumes of dilute lidocaine to the adipose layer, both hemostasis and local anesthesia can be achieved, resulting in safe and painless removal of large amount of fat and fat cells with very minute blood loss.
The tumescent technique works on the principle of increasing the adipose space, increasing anaesthetic efficiency and minimising toxicity of drugs and medicines.
The tumescent solution used for Liposuction surgery is combined of triamcinolone acetonide, general saline, sodium bicarbonate, epinephrine and lidocaine. Lidocaine not just provides anesthesia but it has shown to be bacteriocidal for organisms isolated from skin.
Tumescent Solution Technique
Tumescent anesthesia is performed by blunt tipped small diameter cannulas. These blunt tipped are less painful than the old conventional sharp tipped needles and keeps the neurovascular structures safe, minimize the risk of deep penetration and damaging the tissue structures. Majorly the doctors use the above mentioned technique for anesthetizing the jaw line, jowls and lateral cheeks.
Proper incision places must be predetermined to analyse the length of the Liposuction cannula to be used, to provide enough access to all treatment areas and to assist draining of tumescent fluid during the post operational period.
A good Liposuction surgeon can maximize the use of anatomic landmarks during the Liposuction procedure, like hiding an incision close to the umbilicus, under the breasts, or within the lower abdomen/ bikini line. Slow insertion of cannula results in more patient comfort. The anesthetic fluid serves to hydro dissect the tissue, making a plane for cannula to move on.
Tumescent anesthesia has changed the safety and efficiency of Liposuction. Surgeons have operated small volume Liposuction under strictly local, tumescent anesthesia in well equipped, outpatient settings with a desirable safety record. The risk of high blood loss and excessive fluid overload has been vanished with the use of tumescent anesthesia technique.
Studies have shown and confirmed the safety of lidocaine dosages of upto 55mg/kg when tumescent anesthesia is used. Lower doses of licodaine are recommended for the Liposuction patients with complicated medical conditions or medicines which may interfere with lidocaine metabolism.