American Society for Dermatologic Surgery: Tumescent Liposuction

Tumescent Liposuction


Liposuction was first developed in the late 1970s to remove undersired fat from nearly all body areas, including the face, neck, chin, breast, abdomen, hips, flanks (love handles), inner and outer thighs, buttocks, knees and ankles. Developed by dermatologic surgeons in the 1980s, a major advancement called the tumescent technique of liposuction completely revolutionized the procedure. The use of tumescent liposuction allows dermatologic surgeons to safely and effectively remove deep and superficial layers of fat under local anesthesia with relatively little discomfort, virtually no complications and improved cosmetic results.


Liposuction is the removal of excess fat with a small, straw-like instrument called a cannula that is attached to a suction machine. The fat layer under the skin is converted to a network of tunnels, and the cannula is manipulated within the layers to remove unwanted fatty deposits. An elastic garment is then worn for compression and healing. The result is a resculpting of bulging areas into more attractive contours.


Liposuction is most effective for removing localized fat deposits in body areas that do not respond to dieting or exercising. Liposuction is not intended as a substitute for weight loss, but rather is a contouring procedure. It is best utilized in a program of exercise and optimal weight maintenance.

Liposuction also has many valuable therapeutic applications and has been used effectively to treat medical conditions like excessive sweating and non-cosmetic fat accumulation, such as lipomas (benign fatty tumors) and gynecomastia (enlarged, male breasts).


Before surgery, a complete medical history is taken and a careful examination is conducted in order to evaluate your condition. During the consultation, your dermatologic surgeon describes the procedure and what results might realistically be expected. Your doctor also will review alternative treatment options and explain the possible risks and complications that may occur. Photographs are frequently taken before and after surgery to help evaluate the amount of improvement.


Liposuction can be performed in the dermatologic surgeon’s office facility, in an outpatient surgical suite or in a hospital. If general anesthesia is not otherwise indicated, its potential complications can be avoided by the use of local anesthesia (often used with light sedation) via the tumescent technique. This breakthrough technique refers to filling the skin with local anesthetic in order to remove unwanted fat more efficiently.

With tumescent liposuction, large volumes of a solution containing dilute lidocaine (a local anesthetic) and dilute epinephrine (a drug to shrink capillaries and prevent blood loss) are injected with minimal discomfort directly into areas of excessive fatty deposits. Once the liquid is injected, a small incision is made in the skin, and a tube connected to a vacuum is inserted into the fatty layer. Using to and fro movements, the fat is drawn through the tube into a collection system. The tumescent method enables the dermatologic surgeon to remove large amounts of fat more uniformly with fewer skin irregularities and less bleeding and bruising.


The local anesthesia injected into the tissue remains for 18 to 24 hours following liposuction surgery, greatly minimizing postoperative pain. After tumescent liposuction, patients are usually alert and able to function without nausea, grogginess and the “washed out” feeling associated with general anesthesia. With the tumescent technique, there is minimal bruising, and many patients do not require postoperative medication for pain. You can usually return to a desk-type job within 48 hours; physical exercise generally can be resumed three to seven days after liposuction.


The tumescent technique of liposuction is a remarkably safe procedure with few significant side effects. A recent study in the Dermatologic Surgery Journal reported that 112 patients who the tumescent procedure had an average of two quarts of fat removed with no significant complications. Clinical studies by other specialists have also demonstrated the safety and efficacy of tumenescent liposuction.


Liposuction is not intended as a method for weight toss. It is used as a shaping procedure for areas where hereditary fat deposits resistant to diet and exercise have accumulated. The best results from liposuction occur in body areas where there is muscle tone, where skin has good elastic quality, and where fat is not excessive. In cases where there is a significant loss of tone and elasticity, superior cosmetic results may require a combination of both liposuction and surgical skin tightening to remove the excessive loose tissue.

Your dermatologic surgeon can advise you of the likelihood of the need for additional treatments, depending on the specific condition of your skin.


Another advance in tumescent liposuction is the use of internal or external ultrasound. The ultrasonic method introduces high-frequency sound waves and mechanical vibrations with a hand-held cannula placed into or on top of skin or fatty tissue to gently break down and liquefy the fat cells prior to liposuctioning. The fat is then removed via tumescent liposuction under local anesthesia. Potential advantages to this approach include the ability to remove fat in difficult areas such as the upper abdomen, the flanks, the back and the male chest.


The ASDS provides continuing training and education for its members in new dermatologic surgical techniques and procedures. Represented in the American Medical Association House of Delegates, the ASDS was formed in 1970 to promote the highest standards of patient care for the surgical treatment of the skin, hair, nails, veins and mucous membranes.


For more information on skin conditions and liposuction treatment, along with a referral list of dermatologic surgeons in specific geographic areas, please call the ASDS toll-free hotline, 1-800-441-2737, during weekday business hours (CST) or visit our Web site at Thank you for your interest.

COPYRIGHT 1999 American Society for Dermatologic Surgery; 930 North Meacham Road, Schaumberg, IL 60173-6016; Consumer Hotline–1-800-441-2737(ASDS);

COPYRIGHT 2007 Gale Group