Development of the Tumescent Technique
Although liposuction is a relatively new form of cosmetic surgery, there have been several recent improvements in the technique. One of the most significant improvements has been the introduction of the Tumescent Technique, developed by Dr. Jeffrey A. Klein, M.D. in 1985. It permits liposuction totally by local anesthesia instead of general anesthesia. This technique is now considered the safest form of liposuction for removing very large amounts of fat because there is virtually no blood loss. Not only has the Tumescent Technique proven to be safer than the standard technique using general anesthesia but it also has proven to be less painful, has minimized post operative recovery time, and has produced optimal cosmetic results.
The Tumescent Technique was first presented by Dr. Klein in 1986 at the Second World Congress of Liposuction Surgery in Philadelphia. His article that first described the technique appeared in the American Journal of Cosmetic Surgery in 1987. Dr. Stickler has received training from Dr. Klein in the use of the Tumescent Technique.
Liposuction totally by local anesthesia
The word tumescent means swollen and firm. The Tumescent Technique uses large volumes of a dilute solution of lidocaine, a local anesthetic, in combination with the vasoconstrictive drug epinephrine, which temporarily shrink capillaries.
Local anesthesia used in the Tumescent Technique for liposuction is so effective that patients no longer need intravenous sedatives, narcotic analgesics, or general anesthesia. Over the years, numerous patients who previously had liposuction with general anesthesia have had second treatments with the Tumescent Technique. Virtually every one of these patients has found the Tumescent Technique to be less painful, to provide better results and to result in more rapid healing and recovery.
Virtually no blood loss
As a result of the widespread capillary constriction caused by the epinephrine in the anesthetic solution, there is minimal bleeding during and after surgery. This is a major improvement in the liposuction technique compared to older methods that simply use general anesthesia.
Dr. Klein recently completed a study of large volume liposuction of 112 patients, each of whom had between 1,500 ml to 3,400 ml (1.5 quarts to nearly 1 gallon) of fat removed using the Tumescent Technique. None of these patients required a blood transfusion. In fact, the average patient lost approximately three teaspoons (15 ml) of blood. The Tumescent Technique is so effective at minimizing blood loss that the majority of patients with large volume liposuction lose less blood during the surgery than they do at the time of their routine pre-operative laboratory studies.
When are blood transfusions necessary?
Because of the minimal blood loss associated with the Tumescent Technique, there is no need for blood transfusions.
Recently, a number of surgeons who use general anesthesia have begun to use the Tumescent Technique together with general anesthesia. Although these patients still must endure the risks and unpleasant side effects of general anesthesia, they do have the benefits of minimal blood loss associated with the Tumescent Technique.
Risks of general anesthesia
The drugs that are used to produce general anesthesia are relatively dangerous compared to those used for local anesthesia. It is estimated that fatal complications associated with general anesthesia occur somewhere in the neighborhood between 1 in every 2,500 patients to 1 in every 10,000 patients. The severe complications associated with general anesthesia are eliminated as serious risk factors just by not using these medications. It is well recognized that local anesthesia is considerably safer than general anesthesia.
Is an anesthesiologist necessary?
Anesthesiologists are specially trained to use dangerous anesthetic drugs. Even with this expert training, dangers of general anesthesia persist. The safest approach is simply to avoid using these drugs altogether. An anesthesiologist is not necessary when dangerous general anesthetic drugs are not used, and local anesthesia is the only anesthetic.
