Why is tumescent lipo the safest technique?
Ask any doctor what type of anesthesia they choose for any operation when they need surgery. Almost every single physician will choose local anesthesia for themselves if it’s an option. Tumescent Lipo is the safest liposuction technique because it is done completely under local anesthesia and is virtually bloodless. It avoids all of the risks associated with general anesthesia, epidural anesthesia, spinal anesthesia and deep sedation. Tumescent lipo avoids intubation and all of the strong paralyzing drugs and gases necessary for general anesthesia. When your body is paralyzed under general anesthesia, you cannot breathe on your own. To keep you from suffocating, the anesthesiologist places a tube down your throat to deliver oxygen and anesthetic gases. If you vomit during the intubation process, stomach acid can spill into your lungs and cause serious and sometimes lethal injury. If the breathing tube becomes dislodged during surgery, your life is at risk. Lipo surgery involves more frequent repositioning of the body than just about any other procedure and breathing tube dislodgement is a very real concern.
In some parts of the world, epidural and spinal anesthesia are used for liposuction. This is the same anesthesia that many women use for cesarean section and has all of the same problems when used for lipo. These include bleeding at the needle site, leakage of spinal fluid which can cause severe headaches, a medication overdose which is extremely dangerous, chronic back pain at the needle site, and hot spots – areas that are being operated which don’t become numb. Tumescent lipo avoids all of these problems.
Tumescent lipo avoids the temporary paralysis of the leg muscles that accompanies all surgeries performed under general anesthesia, epidural anesthesia and spinal anesthesia. This paralysis is the number one cause of lethal blood clots after surgery (thromboembolism). The longer the surgery, the higher the risk of developing blood clots in the deep veins of the legs. Tumescent lipo reduces the risk of these lethal blood clots by keeping the muscle tone of your legs intact.
Tumescent lipo keeps the tone of the abdominal wall muscles intact during surgery. This means that your surgeon can easily distinguish where the fat layer ends and where the muscle layer begins. Under general anesthesia, the muscle layer is paralyzed and might feel like it is part of the fat layer. This could be dangerous and could result in significant postoperative pain, muscle injury, bleeding or perforation of your internal organs. With tumescent lipo, the layers are not only easier to distinguish, but the patient can easily communicate with the surgeon if they have overestimated the border of the surgical field.
Tumescent lipo eliminates the guesswork involved in estimating your fluid needs. Since, you are awake and alert during tumescent lipo, your body’s own thirst mechanism and metabolism will signal the need for a glass of water or juice during the procedure. Also, since you do not need to fast for 8 hours before your surgery, unlike general anesthesia, you will not be dehydrated and hypoglycemic when the surgery starts. Under general anesthesia, fluids are given intravenously and your fluid needs are very roughly estimated. They are usually based on body weight alone, cannot account for individual differences in metabolism, and are more prone to overload (too much IV fluid) or underload (too little IV fluid) with procedures such as lipo that have long operating times.
Tumescent lipo is virtually bloodless. Tumescent anesthesia temporarily shrinks all of the blood vessels in the area being treated. This is produced by the epinephrine (adrenaline) included in the tumescent anesthesia. The amount of blood lost during tumescent liposuction averages 5ml per liter (one half-teaspoon per pound!) of fat removed. This also enhances postoperative comfort because residual blood at the site of the lipo procedure increases irritation, inflammation, bruising and discomfort. When lipo is performed under general anesthesia, epinephrine is also used in the surgical field, but not to the same degree and its effects are partially counteracted by the systematic effect of general anesthesia which dilates (widens) blood vessels throughout the body.
With the Tumescent technique, infiltrating the local anesthesia is associated with minimal discomfort. Once the area has been completely numbed, surgery in that area is essentially painless. In addition, because the numbness remains in the treated area for more than 12 hours, there is no pain immediately after surgery.
What are the risks of liposuction surgery?
As with any surgical procedure, liposuction is associated with certain common side effects such as bruising, swelling, and temporary numbness. Although irregularities of the skin are possible following liposuction, this side effect is minimized by Tumescent Lipo. When larger cannulas are used, occasionally there are patients with an irregularity of the skin. Since smaller, microcannulas became available, noticeable irregularities are very rare. Because of the slow resolution of post liposuction swelling, the ultimate results following liposuction usually require 12 to 16 weeks to become fully apparent. Nevertheless, patients can usually see dramatic improvements within two to four weeks after surgery.
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 necessarily eliminate the subtle “puckering” of the skin that is often referred to as “cellulite.” Liposuction with the Tumescent technique does reduce the degree of cellulite but it is unlikely to eliminate it. Rare problems that can potentially occur with any surgical procedure include infections, bleeding and nerve injury, The Tumescent technique, however, minimizes these risks.
How does tumescent lipo reduce the risk of infection?
Infections are extremely rare, regardless of whether or not the anesthetic technique is that of general anesthesia or local anesthesia. Lidocaine, the local anesthetic that is used for the tumescent technique, kills bacteria. With the Tumescent technique the areas that are being treated surgically are those same areas that will receive the local anesthetic that kills bacteria.
When can i return to normal activities?
Because of the significant decrease in swelling and decrease in inflammation and pain after surgery, patients are able to return to normal physical activities very soon after the procedure. There is no limitation of physical activity other than what common sense would dictate. Some patients are able to return to jogging, golf, or light aerobic exercise within a day or two after surgery. Some patients do find the soreness after surgery to be more significant than others, but on the average, most patients are surprised at how quickly they are able to return to normal activity.
How does tumescent lipo result in better and smoother results?
Because very small cannulas are used with the Tumescent technique, it permits a more delicate and gentle approach to liposuction as the surgeon can control the direction and position of the cannula with much more accuracy. This results in a greatly reduced risk of inadvertently approaching the undersurface of the skin too closely and unintentionally causing skin irregularities. Further, the use of very small cannulas enables the surgeon to make such small incisions that no stitches are used. The wounds heal by themselves and virtually disappear over time.
By not using stitches to close skin incisions, the rate of healing is faster. Another benefit of not stitching the incisions closed is that, after the procedure, the open incisions permit easy drainage of the slightly blood-tinged anesthetic solution. This has a dramatic effect in minimizing bruising. Most patients notice that bruising is almost entirely absent after surgery.
What type of liposuction is the best?
The best lipo technique is one that achieves the desired results with maximum safety and efficacy. There may be situations in which some techniques work better than others and situations in which any technique will work well. Nonetheless, most if not all of the claims of safety, rapid recovery and minimal discomfort touted by companies which produce high-tech lipo equipment have more to do with the use of tumescent anesthesia than with any particular technology.
How much liposuction is excessive?
There is no universally agreed upon definition for excessive liposuction at a single surgical session (Megaliposuction). Nonetheless, there is a limit to the amount of liposuction from which a healthy person can be expected to heal without significant risks. The patient’s size and weight and the amount of fat aspirated are the main factors.
For patients who require megaliposuction exceeding the safe limit for one sitting liposuction procedure, Dr. Gaviria offer the alternative option of serial or staged liposuction. Liposuction is performed over the course of two or more sessions spread several days or weeks apart. Serial liposuction allows Dr. Gaviria to remove safely very large amounts of fat over a protracted period of time with no untoward complications.
Staged liposuction is a less invasive and safer alternative to bariatric surgery (gastrointestinal bypass procedures) for carefully selected obese patients in relatively good health. Liposuction will not treat the cause of the obesity, but it will result in a significant improvement of body contouring, and will remove large quantities of fat cells, while creating a partial retraction of the excess skin.
Staged liposuction has shown that large quantities of fat can be extracted with minimal risk and that the large localized obesities can be definitely improved while avoiding the significant morbidity associated with bariatric surgery. The operation is also beneficial to treat residual adiposities following bariatric procedures.