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A large volume of a very dilute solution of local anesthesia (lidocaine and epinephrine) is injected into the fat beneath the skin, causing the targeted area to become tumescent, in other words, swollen and firm. The local anesthetic lidocaine in the tumescent solution provides such complete local anesthesia, that it eliminates the need for general anesthesia or IV sedation.
The drug epinephrine in the local anesthetic provides localized vasoconstriction virtually eliminates surgical bleeding during tumescent liposuction. The use of microcannulas less than 3 millimeters yields a smoother cosmetic result by removing fat in a more uniform and painless fashion.
By eliminating the risks of general anesthesia and excessive surgical bleeding, the tumescent technique done entirely by local anesthesia has eliminated the dangers associated with the older procedures. The use of microcannulas less than 3 millimeters, yields a smoother cosmetic result by removing fat in a more uniform and painless fashion. Tumescent liposuction results in less swelling and bruising than traditional methods. Most patients return to work in 3-5 days with minimal downtime.
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Tumescent liposuction refers to a technique that uses large volumes of very dilute local anesthesia that is injected into the body fat causing the targeted areas to become tumescent (swollen and firm). Local anesthesia is widely regarded as the safest form of anesthesia. Because local anesthesia persists for many hours there is no need for narcotic pain medications after tumescent liposuction surgery.
Liposuction is defined as the removal of fat from deposits beneath the skin using a hollow stainless steel tube (called a cannula) with the assistance of a powerful vacuum. Liposuction can be accomplished either through the use of general anesthesia, or with heavy IV sedation, or totally by local anesthesia.
Liposuction complications are often the direct result of lack of caution, poor judgment, over confidence, ignorance about pharmacology, or adherence to faulty dogma.
Risks of Liposuction must be well understood by all prospective liposuction patients. Lilly Dermatology liposuction emphasizes the need to constantly be aware of patient safety issues. In order to minimize the risk of liposuction surgery, the patient must be aware of the following facts:
The removal of excessive volume of aspirated fat, or an excessive number of areas treated in same day can increase risk of complications. Excessive surgical trauma (excessive liposuction) is dangerous and is an important cause for serious liposuction surgery complications. Unrelated surgical procedures on the same day as liposuction surgery are unnecessary. Prolonged exposure to anesthesia is dangerous and is an important cause for serious liposuction complications.
Skin irregularities and depressions can occur with liposuction and lead to undesirable cosmetic results. A liposuction cannula is a stainless steel tube inserted through an incision in the skin that is employed to suction the fat. The size of the liposuction cannula can influence the smoothness of the skin after liposuction. The use of large cannulas tends to create irregularities more commonly than microcannulas (outside diameter less than 3 millimeters). Lilly dermatology only uses microcannulas when performing liposuction.
The tumescent technique for liposuction is the safest form of liposuction. When tumescent liposuction is done correctly (not excessively), it is a very safe procedure. For example, there have been no reported deaths associated with tumescent liposuction totally by local anesthesia. Even when general anesthesia is combined with the tumescent technique, liposuction is quite safe provided the volume of fat removed and the number of areas treated during a single surgery is not excessive. The dilute epinephrine contained in the tumescent anesthetic solution profoundly shrinks capillaries and thus virtually eliminates surgical blood loss.
The tumescent technique permits the use of microcannulas which in turn yields smoother cosmetic results. Traditional liposuction cannulas (stainless steel tubes) have a relatively large diameter and remove fat rather quickly. However, with the use of large cannulas (diameter greater than 3 millimeters) there is an increased risk of irregularities and depressions in the skin. Tumescent liposuction performed by Dr. Odueyungbo using microcannulas with a diameter less than 3 millimeters, allow fat to be removed in a smoother and more uniform fashion. Some surgeons prefer larger cannulas because it allows liposuction to be done more quickly.
After tumescent liposuction, there is a certain amount of blood-tinged local anesthetic solution that remains under the skin. This excess fluid is either slowly absorbed over several weeks into the bloodstream, or it can be rapidly removed by drainage through skin incisions and absorbed by special absorptive pads.
Rapid drainage of blood-tinged anesthetic solution out of incision sites, accelerates the rate of healing, and reduces postoperative pain swelling, and bruising. Post-liposuction drainage of blood-tinged anesthetic solution can be maximized by 1) leaving incision sites open and not closed with sutures, 2) placing several round holes used for the liposuction procedure in the skin to encourage drainage, 3) placing super absorbent pads on the skin to absorb the drainage, and 4) wearing spandex compression garments to encourage drainage.