Liposuction and Body Contouring- What Is the Difference Between Regular and Tumescent?

I'm considering having liposuction done on my abdomen and thighs. One clinic boasts of its postoperative care to help the body regain nice contours after lipo, eg endomology. Another recommended tumescent liposuction but has no contour services. Is body contouring necessary after liposuction? I can imagine the skin to be slightly saggy after that. Will wearing a compression garment alone make skin firmer? How good is tumescent lipo? Will I have unbalanced body from lipo? Thanks for your input!!

Doctor Answers (12)

Liposuction Techniques for Body Contouring

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The terminology and marketing terms that are used for liposuction in sales literature can be confusing because they have not been used consistently or correctly.  Since you are interested in doing a significant amount of liposuction on the abdomen and thighs I would recommend you pick a board certified plastic surgeon that is not trying to sell you on any given brand or technique.  Your success and results depend more on the experience and training of the surgeon than on a piece of equipment or technique.

The after care of girdles and ultrasound and endomoly are useful, but not proven to change the final results or fix the skin laxity.

Best Wishes

Dr. Peterson


Saint George Plastic Surgeon
4.0 out of 5 stars 14 reviews

For lipo choose a qualified surgeon not the brand

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Liposuction of any type is surgery and choosing an experienced plastic surgeon is more important than choosing the technology or "brand" of lipo. For example, a recent survey found that around 90% of board certified plastic surgeons see no benefit to laser lipo (for example "smart lipo") yet it is hyped as somehow being safer despite the additional risk from the laser. I think post-lipo treatments such as endermologie can be helpful in some cases but they will not tighten skin if there is some laxity.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 23 reviews

Types of liposuctioning

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Searching for liposuctioning options can be very, very confusing. Here are some of my observations as a Board Certified Plastic Surgeon who does only body work.

Tumescent technique involves injection of a lot of fluid that contains dilute lidocaine. The purpose being to numb the area and compress the blood vessels so that there is less bleeding. Most Dr.s do the super wet technique(although they call it tumescent) and that works very well also. I don't think anyone uses the old tech of no fluid or epinephrine. Neither of the above techniques is better than the other.

There are many ways to do liposuctioning from traditional with just the lipo cannulas, laser lipo where the area is treated with the lase first(has better skin contraction), ultrasonic lipo where the area is treated with ultrasound first, water assisted lipo where the area is treated with a water jet at the same time as the lipo and other less defined techniques. They all work and some may work better than others in the hands of certain plastic surgeons.

After lipo there are many ways to treat the area. You can massage with a machine or with a therapist-it fells good but may not be any better than no massage. You can treat with ultrasound, again there is no definitive proof that this is better than other methods. You can wear compression garments for variable periods of time and again there is no scientific evidence that there is a big difference.

Probably the MOST IMPORTANT issue is the experience of the Plastic Surgeon who is doing the procedure.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 17 reviews

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"Regular" vs "Tumescent" Liposuction

+2

Most people would assume "regular" liposuction to mean liposuction under general anesthesia. Tumescent liposuction means you are awake, breathing on your own, mildly sedated and the anesthesia is not general but localized to the area of treatment. Limiting the numbing to the area of treatment is done by putting in  dilute lidocaine which is like Novacaine but specialized for liposuction. 

The questions you have about what the skin will look like after lipo depends mainly on you. Younger skin contracts well and shows good contour after liposuction. Also, are you overweight? If so, it is likely the skin may not be smooth afterwards, no matter what is offered (such as special garments or Endermology).

You are wise to be doing your homework. If you haven't already, you might wiki liposuction. You will see that the inventor of modern liposuction was Illouz, a gynecologist. Doctors Klein and Lillis are dermatologists that advanced liposuction by inventing the tumescent technique. So you can see that there is no one specialty that "owns" liposuction.

It all really boils down to the person who does your treatment. Keep doing your homework and trust your instincts.

Best wishes,

T. Wayne Day, MD
Nashville Dermatologic Surgeon
5.0 out of 5 stars 1 review

Liposuction techniques & post op

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Hello Ms Asian!  With so much advertising, one needs to separate medical advertisement from medical facts.The term tumescent liposuction has been commonly misunderstood by patients as being a technique. It is a prelude to any liposuction technique (SAL,PAL,VAL Vibro lipo) where in fluid with local anaesthesia & adrenaline is injected into the fat for haemostasis before sucking it out.

First & foremost, seek out a board certified plastic surgeon who understands your concerns, following which he emphasises & establishes realistic expectations rather than trying to "sell" a technique. Post-op management does go a long way in making the overall experience more comfortable. We recommend lymphatic massages to all our patients 7-10 days post op to decrease the swelling, soreness & stiffness. Pressure garments have to be worn ideally for 2 months 24x7 to aide in skin contraction & body contouring. Both help. 

Choose the surgeon well, act responsibly in the post op & you can expect a good balanced result with liposuction. All the best.

 

Sameer Karkhanis, MD
India Plastic Surgeon
5.0 out of 5 stars 45 reviews

Difference Between Regular Lipo and Tumescent?

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Thank you for your question. Tumescent liposuction is a solution that fills the fatty layer of the skin and causes it to swell and become firmer, allowing the surgeon to have better control when contouring the area. Compression garment should be worn after treatment to help decrease swelling. Vaser shape treatment can be done after liposuction to help smooth out and reduce the appearance of cellulite.  I would recommend being treated under the supervision of  a Board Certified Dermatologist or Plastic Surgeon for safest and best treatment option. I hope this helps.

Vivek Bansal, MD
Danville Plastic Surgeon
5.0 out of 5 stars 9 reviews

Tumescent Liposuction Is Great

+1

Tumescent liposuction is a technique that adds fluid to the fat.  The pressure form this fluid is greater than capillary pressure, therefore it drives the blood out of the fat which leads to less bruising, less swelling, less blood loss, and quicker recovery.  Tumescent does nothing to improve skin tightening any better than just traditional liposuction, and there is no scientific proof that any of the laser liposuction techniques, such as Smart Lipo, actually tightens skin better than traditional lipo.

That being said, traditional lipo plus tumescent is a brilliant combination with proven excellent results, and I have seen amazing skin tightening with this technique.  The contouring of your body comes from the surgeon's technique and not any machine used inter or post operatively other than the liposuction machine. 

I have my patients wear a post operative compression garment for two weeks.  Usually, by that time, it has gotten so loose, it has little merit.  I do use post operative ultrasound (the kind physical therapists use for sore muscles) to speed the healing process. 

S. Larry Schlesinger, MD, FACS
Honolulu Plastic Surgeon
5.0 out of 5 stars 204 reviews

Abdomen

+1

Tumescent liposuction means that prior to fat removal, the fat layer is injected with sterile fluid containing local anesthesia and epinephrine.  The term tumescent means  literally "swelling" , and most surgeons do some form of it whether the patient is awake or asleep during the procedure. The use of a compression  garment is also typical after surgery to reduce swelling  but also encourages even contration of the skin.  Endermology is a fancy kind of massage, but it has never been shown to really be of any use.  It's okay to have it done after surgery, but I wouldn't pay extra for it.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 10 reviews

Lipo & Body Contouring. What's Diff Between Regular & Tumescent?Answr:

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All types of lipo have one thing in common: an incision is made and a small tube is passed back and forth under the skin and fat is suctioned out. Where they differ is what you do to the fat before you suction it out. You can do nothing (regular, which is not done too much anymore), you can soften the fat by injecting fluid, kind of the gold Standard now(tummescent technique) or you can melt the fat (Vaser, SmartLipo, SlimLipo). It is unknown if the after lipo treatments really help but massage is good and encouraged.

John J. Corey, MD
Phoenix Plastic Surgeon
4.5 out of 5 stars 17 reviews

Liposuction

+1

I have used almost all the technologies available to a surgeon to perform liposuction. In my opinion, it is not the wand but the magician that creates the magic!  AS for post-op contouring, in the majority of cases all I have them do is wear a garment for 3-6 weeks.  Occasionally I will have them massage firm areas.  I do not find it necessary to perform lympahtic drainage massage or need to use any of the "fancy" machines which in my opinion do not do much.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.