Tumescent Fluid and Its Role in Liposuction

Published on August 30, 2018

Tumescent liposuction has become a popular form of liposuction. Now, you might be curious about what tumescent means, especially in the context of liposuction. Well, the word ‘tumescent’ is used here because this particular form of liposuction involves injecting something called tumescent fluid before moving forward with the liposuction treatment.

The term itself actually means ‘firm’ or ‘swollen’. The fluid is made up of epinephrine, which is a capillary constrictor, and diluted lidocaine, which serves as an anesthetic. This tumescent fluid is what’s injected into the subcutaneous fat.

Once injected, the fluid causes the targeted tissue to become swollen or firm. In other words, the tissue becomes tumescent.

The tumescent liposuction method makes it possible for large areas of subcutaneous fat to receive anesthesia. As a result, tumescent liposuction can be carried out completely under local anesthesia. There is no need for general anesthesia or class IV sedatives/narcotics.

Tumescent fluid helps in constricting capillaries, providing local anesthesia, blood loss prevention and eliminating the need for IV fluids (since fluids are provided via subcutaneous injection).

The History Behind Tumescent Liposuction

Tumescent liposuction was developed in 1985 and was first presented to an expert panel in 1986. Jeffrey Klein, the inventor of the tumescent technique, also published a book titled ‘The Tumescent Technique’, which is considered to be the definitive book on the topic.

The book contains around 500 pages of detailed information about the procedure and the science behind it. It discusses everything including local anesthesia, tumescent anesthesia, pathophysiology, microcannular liposuction, pharmacology, pharmacokinetics, postoperative care, complications, surgical technique, and even the special considerations to be made for each part of the body.

Why Tumescent Fluid is Safe

Tumescent liposuction with tumescent fluid has, time and again, been proven to be very safe, even in instances where larger doses of lidocaine and epinephrine have been used. This is because the tumescent fluid undergoes extreme dilution.

Large quantities of dilute epinephrine deliver a high level of constriction in the capillaries of the targeted fat, which allows for the delayed absorption of the tumescent fluid. The undiluted combination of lidocaine and epinephrine gets absorbed into the bloodstream in no more than an hour.

Capillary constriction occurs on a widespread basis due to tumescent dilution, which results in the absorption process occurring over a period of 24 to 36 hours. This limits the lidocaine from achieving peak concentration in the blood, which reduces the toxicity of the lidocaine.

As for the epinephrine, in concentrated doses, it can cause the heart rate to go up drastically. However, the diluted epinephrine in tumescent fluid leads to vasoconstriction occurring over a wide area, which slows down the rate at which it is absorbed. As a result, there is no increase in the heart rate.

Contact Our Office

If you’re struggling with losing stubborn fat in different areas of your body, a liposuction surgery can prove to be highly beneficial. Contact our office to learn more about tumescent liposuction with skilled plastic surgeon Dr. Richard Bartlett. With his guidance, you’ll be on your way to the body of your dreams.