Tumescent liposculpture refers to the use of tumescent fluid to distend and numb fat tissues prior to sculpting with liposuction.
The tumescent technique has revolutionised fat reduction surgery. The infiltration of tumescent solution serves many purposes:
- Numbing the tissues, so minimal intravenous sedation is required
- Stops bleeding by constricting blood vessels in the area
- Distends the tissues, allowing easier surgery
The tumescent fluid comprises local anaesthetic, epinephrine and sodium bicarbonate in normal saline. For more techniques, the volume infiltrated is equal to the anticipated fat extraction volume.
The solution is injected into the tissues by a high pressure delivery system. Generally, this is administered to the areas of operation only.
Although tumescent liposuction has greatly increased the safety of liposuction surgery, it does contain some inherent risks of its own, primarily related to its local anaesthetic component. To numb the area completely, large amounts of local anaesthetic are used. However, because it is administered with epinephrine, the local anaesthetic stays in the operative site, rather than goes into the circulation. As the epinephrine wears off some 12 hours after the surgery, the local anaesthetic can slowly be released into the circulation and taken to the liver for metabolism.
Occasionally, a large amount of local anaesthetic is absorbed into the circulation at one time. If this is over the safe dose, some toxicity reactions can be observed. These include timgling around the mouth, fingers, drowsiness and heart arrhythmias. These are fortunately rare.
In general, tumescent liposculpture is safe and greatly enhances the results of liposuction surgery.
