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University of
Washington
UW
Dermatologic Surgery
Tumescent
Liposuction
UW DERMATOLOGIC SURGERY
CENTER
Daniel Berg, M.D., Director
206-598-6647
INFORMATION ABOUT
LIPOSUCTION
BY THE
TUMESCENT TECHNIQUE
WHAT IS TUMESCENT
LIPOSUCTION?
One of the most significant improvements in liposuction
in recent years has been the use of tumescent anesthesia,
introduced by dermatologist Dr. Jeffrey Klein a few years
ago. Tumescent liposuction (Tumescent Technique) refers to
the performance of liposuction using large volumes of a
dilute solution of lidocaine, a local anesthetic, in
combination with the drug epinephrine which temporarily
shrinks capillaries. This is comfortably performed with
minimal sedation required.
The Tumescent Technique minimizes post-operative
discomfort. Because the residual local anesthesia lasts for
12-18 hours or more, plain Tylenol is sufficient to treat
post-operative discomfort, although you will be provided
with stronger medication if needed. With the Tumescent
Technique there is no post-surgical nausea, nor the
unpleasant feeling of "hang-over" usually associated with
general anesthesia.
The Tumescent Technique dramatically reduces both the
bleeding during surgery, and the post-operative bruising and
swelling as compared to liposuction done purely by general
anesthesia.. Minimal bleeding reduces post-operative
recovery time. Most patients can return to work within three
to four days after surgery. An elastic support garment is
worn for a few weeks following surgery.
About 90% of patients can actually see at least some
improvement in their silhouette by one week after surgery.
However, because of the slow resolution of post-surgical
swelling, the FINAL results following liposuction
cannot be assessed until 6 months after surgery.
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The fat cells that are removed by liposuction do not grow
back. The patient's new, more pleasing silhouette is
permanent. If the patient gains or loses weight, the change
tends to be distributed proportionately over the entire
body. The change of silhouette produced by liposuction is
equivalent to being able to focus the effects of dieting to
specific areas of the body.
Since the fat is removed by suctioning small "tunnels"
through the fat, the skin remains intimately connected to
the underlying muscles by multiple fibrous attachments. As
healing occurs after surgery, these fibrous strands contract
and pull the skin into close proximity with the muscles. It
is this process which helps the skin redrape to the new
contour after liposuction. The tumescent technique permits
accurate removal of fat, with greater assurance that the
liposuction cannula will not inadvertently be allowed to
approach too near the undersurface of the skin which would
cause irregularities. Thus the tumescent technique helps to
minimize the risk of post-surgical irregularities or
rippling of the skin.
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Although the results of liposuction are often quite
spectacular, it is not realistic to expect perfection.
Liposuction of the thighs, while improving the silhouette,
does not usually eliminate the subtle "puckering" of the
skin often called "cellulite". Cellulite results from the
pull of fibrous tissue that connects skin to underlying
muscle. Liposuction with the tumescent technique may or may
not reduce the degree of cellulite and is unlikely to
eliminate it.
As with any surgical procedure, liposuction is associated
with certain expected side-effects such as bruising,
swelling, and temporary numbness. Although irregularities of
the skin are possible following liposuction, this
side-effect is minimized by the tumescent technique,
especially when performed with small cannulas. Touch-up
procedures may be required to achieve the best result and
should not be considered as a complication. As judged by
current world-wide experience, tumescent liposuction is very
safe. Serious complications such as blood clots, infection
and allergic reactions are extremely rare. Detailed
information about risks of surgery and expected results are
provided at your consultation
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WHAT CAN I EXPECT ON THE DAY
OF SURGERY?
Your surgery will be performed at The University of
Washington Dermatology Center, 4225 Roosevelt Way NE. We are
located on the third (main) floor of the UW Medical Center.
Shortly after your arrival, you will change into an
operating gown and the areas on your body that are to be
treated with liposuction will be marked with a felt-tipped
pen. It usually takes about an hour getting set-up before
the surgery actually begins.
A blood pressure cuff will be placed on one arm and
depending on the area to be treated, an intravenous line
(IV) established in the other arm. A small instrument will
be placed on one of your fingers to monitor the oxygen
levels in your blood. Next, using very small needles, the
doctor or nurse will anesthetize the skin at sites where the
longer needles will be inserted to anesthetize the
subcutaneous fat. The actual injection of the anesthetic
solution is almost painless. Patients usually experience a
slight pricking sensation under the skin as the area becomes
numb.
Once an area has been well infiltrated with a large
volume of dilute anesthetic solution, it is usually
completely numb. You will be checked for any incompletely
anesthetized area which will then be completely anesthetized
by infusing more anesthetic solution through the small
cannula exactly where it is needed. After completing the
infiltration of the local anesthetic but before your doctor
actually begins removing the fat by liposuction, you will be
escorted to the bathroom to empty your bladder.
Only mild sedation is required when using the tumescent
technique for liposuction. Our usual sedation consists of 10
mg of Valium or a similar medication.
After completing liposuction, an antibiotic ointment is
applied to the tiny incision sites. The incision sites are
so small that stitches are not generally used. Elastic
garments will be placed and you are ready to get up and go
home. Because of residual local anesthetic, it is several
hours after completing the liposuction before any
significant soreness begins. Although you will feel well
enough after surgery to drive yourself home, you should not
do so because large amounts of local anesthetic and the
Valium may cause some drowsiness.
Click
here for link to American Society for Dermatologic
Surgery information on tumescent liposuction and
other procedures. Please bookmark our page before leaving
the website in order to be able to return.
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SAMPLE
PHOTOGRAPHS
 D
Berg M.D
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 D
Berg M.D.
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Thighs - Pre Liposuction
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Thighs - After Liposuction
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 D
Berg M.D
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 D
Berg M.D
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Abdomen - Pre Liposuction
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Abdomen - Post Liposuction
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Neck - Pre Liposuction
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Neck - Post Liposuction
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