• Tumescent Liposuction: Brigitte Nielsen Plastic Surgery
• What is Tumescent Solution and How Can it Help your Liposuction Procedure?
• What is Liposuction?

A patient who requests a liposuction generally dislikes what he or she sees in the mirror. Such a patient looks to plastic surgery as a way to remove certain sections of unwanted fat. The patient expects that a small incision in the skin and insertion of a long needle, cannulae, will rid the patient of at least some excess fat. Specifics about the removal process dictate how the liposuction is to be carried out.

Thanks to the popularity of cosmetic surgery, liposuction procedures have undergone repeated refinements since their introduction in 1982. Selection of the how for a liposuction generally introduces the need for a review of those refinements. The patient and doctor choose how the procedure should be performed. The patient must study carefully the pros and cons associated with each of the available liposuction methods.

When first performed on patients, the plastic surgery now called liposuction required the use of general anesthesia. Dermatologists in the U.S, found a way to offer some forms of liposuction using local anesthesia. Liposuction done with local anesthesia is called tumescent liposuction. The patient should not assume that a tumescent liposuction, one that covers fat with a saline solution, involves use of the so-called “wet method”.

The tumescent liposuction, unlike traditional liposuction, can often be done in the doctor’s office. For that reason, it allows the doctor to lower the costs of the cosmetic surgery. The tumescent liposuction also uses a smaller needle, and therefore produces a smaller incision. A patient can expect to heal more quickly after a tumescent liposuction.

Sometimes patients have sought the removal of fat from areas with very fibrous tissue. A doctor specializing in plastic surgery would expect added problems when seeking to draw out the fat from such tissue. Some specialists have developed a way to liquefy the fat using ultrasound. Though now refined, that original method had certain drawbacks.

Prior to the introduction of present-day refinements, the use of ultrasound introduced risks not usually associated with cosmetic surgery. Prior to introduction of the refinements, the shaking of the cannulae could cause breakage. Shattered cannulae could expose a patient’s internal organs to potentially harmful objects.

The current liposuction that makes use of ultrasound has managed to remove the threat of cannulae breakage. It offers the patient a safe procedure, assuming that it is done by a competent specialist. A competent specialist avoids removing too much fat, thus giving the patient an area of lumpy skin. A competent surgeon also makes every effort to remove the fat without damaging any blood vessels or connective tissue. The competent surgeon arranges for replenishment of any fluids removed along with the body fat.

• Why Laser Lipo
• What You Should Know About Tumescent Liposuction
• What is Tumescent Solution and How Can it Help your Liposuction Procedure?

Liposuction, after 25 years, is still one of the most popular plastic surgeries. How it works, however, is not generally well understood. It is more than ‘sticking a tube in and sucking it out’. The basics principles of flow mechanics apply

At its simplist, liposuction is a two-steo process for removing fat. A hollow tube (cannula) is put under the skin, the tube is moved back and forth until the fat is dislodged, and the attached vacuum source draws the fat back through the cannula into the tubing and finally into the plastic bottle.

Despite this apparent simplicity, there is more science to it than that. There are three interesting components about liposuction, all of which contribute to its safety and effectiveness. These include the concept of tumescence, water vaporization and suction, and tubing size and design.

An integral part of the oepration is the placing of fluid into the areas where the fat will be suctioned. I frequently get asked by patients if I do tumescent liposuction. Most patients think that tumescence is a special liposuction technique when, in fact, it is part of every liposuction procedure. Putting large amounts of fluid into the fat areas to be suctioned beforehand is known as tumescent infiltration. This achieves two fundamental things, substantially reduces bleeding (from the fat being broken up by the liposuction tube and it distends the fat compartments which make the tube easier to pass through the fat being suctioned. Without tumescent infiltration, liposuction would quite bloody, give patients more pain, and have them bruised for a month, if not longer.

The amount of suction generated by the liposuction machine, in short, makes liposuction possible. At the accepted amount of suction needed for liposuction (-20 cms of water or -1 atmosphere of pressure), the pulling of fat through the tubing certainly occurs. But it also causes the vaporization of water. If you have ever witnessed an actual liposuction procedure, you may have seen bubbles in the fat or bubbling in the plastic cannister. To some degree, this is actually water boiling….or the vacuum pressure exceeding the vapor pressure of the water in the fat being removed. It is this vaporization that makes the viscosity (how thick it is) of fat, which is actually a combination of fat, blood, and infiltration fluid, less to improve its ease of flow through the tubing. From a flow standpoint, water that is vaporized ( a gas) flows 100 times faster than liquid water. This is also why liposuction done at higher altitudes, where the water vapor of pressure is less, is somewhat easier to do. (takes less suction from the machine)

The tube (cannula) that is actually used under the skin differs in diameter and the holes at the tip. In days gone by, the cannulas were quite large but left a lot of depressions in the overlying skin after due to removing too much fat too fast and in large pieces. Today, small cannulas are used which removes fat more carefully and in smaller pieces, decreasing the problem of skin irregularities after surgery. The tip of the cannula is rounded so that it travels through the fat easier with less chance of penetrating something you shouldn’t. The holes at the tip are where fat sticks to and then gets sucked into the cannula. The more holes there are at the tip achieves two effects; increases the shearing effect (like a blade) on fat and makes more cross-sectional area through which fat can be suctioned.

Currently, there are newer methods of liposuction or to be accurate, methods of loosening up the fat. These include ultrasonic and laser-assisted. While they sound quite advanced (and they are), there is no convincing evidence at this time that they are actually better than traditional liposuction. Better meaning….you get more fat oout, smoother skin, and heal faster. Manufacturers market them as such but no study has yet proven it. And suction is still required to pull out loosened fat.

• Why Laser Lipo
• What You Should Know About Tumescent Liposuction
• What is Tumescent Solution and How Can it Help your Liposuction Procedure?

The improved safety and effectiveness of liposuction are largely due to newer and better equipment and procedures. It is true of any medical procedure that the better the technology is, the safer and more efficient that procedure becomes for the patient and doctor. Of course the cosmetic surgeon’s skill is another factor in safety and effectiveness, and you would always want to choose a fully qualified and experienced plastic surgeon who is certified by the American Board of Plastic Surgery.

The types of liposuction currently being performed are:

• Ultrasonic-assisted

• Power-assisted

• Tumescent

• Super-wet

• SmartLipo

• Microcannula liposuction

• External ultrasound-assisted liposuction (XUAL)

Originally, liposuction was done without any fluid injected. This was traumatic for the patient, difficult for the doctor, and required substantial recovery time. As the years have gone by, fluid injection has gained more importance, with the amounts of fluid increasing in Wet Liposuction, then Super-Wet Liposuction, and then Tumescent Liposuction.

The fluid used is a saline solution (to match the salt content of natural body fluids), with two things added:

• Lidocaine – as a local anesthetic

• Epinephrine – to close off any blood vessels that might be damaged by the cannula

Why is fluid injected?

Mixed with fluid, the fat suctions out more quickly and smoothly. There has always been the question of: How much fluid? In tumescent liposuction, a larger amount is injected, as much as three or four times the amount of fat to be removed. All this fluid expands the area, creating more space for the cannula movements.

Cannula movement

The cannula is used to break up the fat cells. Breaking their surfaces emulsifies (liquefies) the fat, again making it easier to remove. In the early days, the cosmetic surgeon broke up fat cells by vigorously moving the cannula back and forth by hand. To reduce the risk of broken blood vessels or perforated body organs, methods were sought to make cannula movement more subtle and controlled.

Power-assisted liposuction (PAL)

An electrical-powered cannula was developed to refine cannula movement. A PAL procedure does not inject much fluid, so this was a limited improvement.

Ultrasound-assisted liposuction

A specialized cannula was developed which transmits ultrasound vibrations. This makes any manual movement unnecessary and reduces blood loss somewhat. It works well on fibrous areas like the male breast or the upper back. This cannula can be used in tumescent liposuction.

External ultrasound-assisted liposuction (XUAL)

In this method, the ultrasound is applied not through the cannula, but from a handpiece held against a special gel on the patient’s skin. It can help with one risk of UAL, namely the formation of seromas (pockets of fluid build-up which show as bumps on the patient’s skin). It’s the cosmetic surgeon’s judgment as to how much vibration to apply so its effectiveness is to some extent operator-dependent.

Microcannula liposuction

By using a more narrow cannula, incisions are smaller and fat can be removed from smaller areas than were first treated, such as the jawline.

Using a laser

SmartLipo™ is the name of a procedure which uses a laser to liquefy the fat. Lasers have been introduced to more and more medical and dental procedures because they are fast, precise, and safe. In SmartLipo, the laser directly dissolves the fat and can seal off any leaking blood vessels as it works, which reduces risk of infection. It is used with tumescent liposuction. Other lasers such as the CoolLipo and ProLipo lasers use different wave lengths to work on fat emulsification by heating the water inside the fat cells, which breaks the cell membrane.

The best cosmetic surgeons keep up with new technology through their professional memberships and various advanced-level seminars. But newest doesn’t always mean best, so if you’re considering liposuction for yourself, ask your potential cosmetic surgeon what he thinks of each liposuction variation, and choose one who has tested them and come to his own experience-based conclusions.

• Why Laser Lipo
• What You Should Know About Tumescent Liposuction
• What is Tumescent Solution and How Can it Help your Liposuction Procedure?

Introduction

If you’ve ever heard about liposuction or its technique, you’ve probably heard of tumescent liposuction. Body-Jet liposuction was developed from the tumescent technique, allowing this new procedure to bring about better results.

Body-Jet new technique makes it different from and superior to the tumescent technique, which we will discuss in greater detail.

Why Body-Jet is safer and better

The Body-Jet, also referred to as Water Jet Liposuction (WAL), uses a thin, fan-shaped jet that is channeled into the fat tissue. As a result, the fat easily loses its structure and is released.

For the Body-Jet, a pressure system has been developed. This pressure system directs the infiltration solution through a closed tubing system via a piston pump and into a very thin application cannula.

The application cannula is surrounded by an external cannula, which can have different diameters and openings depending on its purpose.

The surgeon who performs liposuction using the Body-Jet technique can choose the rate of infiltration and the level of pressure by using computer software.

The solution

To minimize the side effects of liposuction, this new technique was developed with a two-stage concept.

Pre-infiltration produces rapid anesthetization and vasoconstriction in the liposuction treatment. Then, the liposuction will be carried out through a rinsing solution.

The two-stage concept uses two tumescent solutions that are combined for the water jet technique. The infiltration is performed with a short-acting analgesic with rapid uptake. In this process, the infiltration is also performed with a long-acting analgesic with slow uptake.

The process is performed under continually added and almost immediate aspiration during the liposuction treatment. Therefore, the concentration in the rinsing solution can be reduced.

The surgeon can avoid the “tearing up” effect because the Body-Jet technique gives the surgeon ability to easily “suck” the fat off the patient’s body.

Preparation

With the Body-Jet, the patient will be prepared as though for a typical liposuction treatment. Anesthetization and vasoconstriction take place over a shorter period of time, compared with the tumescent technique.

The patient will be awake during the process and can work with the surgeon to obtain the desired result. The patient can get up during the treatment and look in the mirror to see the results. This is another advantage of the Body-Jet, since it gives the patient the ability to see the results, even before the process has ended.

Result

As you can see, the way the Body-Jet performs the liposuction process makes it easier for the surgeon to remove fat out from the patient’s body.

To summarize, the advantages of the Body-Jet technique are the following:

1. The tissue is not destroyed.

2. Pain, swelling and blue patches are reduced.

3. A smaller quantity of analgesia is required.

4. The result can be optimized during the treatment.

5. Subsequent corrections are minimized.

6. The results can be seen immediately.

7. The operation period is significantly shorter.

Summary

Body-Jet gives the patient better results and satisfaction. If you compare Body-Jet with tumescent technique, you can see that Body-Jet is the better choice.

• Tumescent Liposuction : A Better Technique?
• What You Should Know About Tumescent Liposuction
• Understanding The Tumescent Liposuction Procedure