Tumescent Liposuction Vs. Liposuction

Hi there-
Tumescent liposuction, VASER Lipo, Smart Lipo, Cool lipo, Pro Lipo, Slim Lipo, Water Jet lipo...
What does this all mean? If I don't get Smart lipo does that mean I'm dumb? If my surgeon recommends Slim Lipo does that mean he/she isn't a "Pro"? It truly is a ridiculous situation we have come to with regard to liposuction and the number of people trying to cash in on America's desire to be rid of its collective fat.
In well motivated patients, body contour improvement can be a very healthy endeavor, but how is an otherwise intelligent and well-adjusted person to know the difference between a responsible provider of aesthetic services offering them safe options for help with their body contour and a poorly trained and inexperienced provider more interested in their wallet than in your outcome and safety?
It is first important to realize that all of these devices will require you to undergo a liposuction procedure. The only difference is the approach to the treatment of the fat prior to its removal.
Because they all involve liposuction, and this is in fact a surgical procedure, it is very important that you "do your homework" and find a surgeon certified by The American Board of Plastic Surgery who has the years of training in liposuction necessary to give you the safe experience and superior outcome you deserve and desire. Behind the amazing number of machines now available to remove your fat, there has followed an army of their sales representatives and an equally impressive number of providers marketing themselves as "liposuction experts".
What has made them "liposuction experts"? In almost all cases, a few days or weekends training with the salesman for the device or with someone more experienced in the procedure. It is their promise that if you have the device in their possession brought to bear on your behalf, your fat will be gone, your skin will miraculously shrink away, you won't need any anesthesia because the device allows painless removal of the fat, and it can be done on your lunch hour. The only thing I am surprised by at this point is that they don't promise you'll get rich and be more sexually alluring after the procedure too.
Selling the particular device to patients is not unlike someone saying to you that because they will give you access to Tony Stewart's racing car that you will be able to win this weekend's race and make a million dollars. Tony Stewart wins races because he is a great racing car driver AND he has a great car...This is no different.
Getting the best outcome from a body contouring procedure depends most on finding a well-qualified and experienced surgeon, and much less on the device used.
Most of these people are so aggressive in their marketing of these questionable devices because they are, in fact, not trained plastic surgeons but rather are either not physicians at all, or they are doctors with core training which would not have prepared them to do liposuction. Many have read recently about a death in my home state of Florida after a healthy 40ish year old mother had liposuction performed be a rehabilitation medicine doctor. Amazingly, I know of eye doctors (!!) doing liposuction as well- and yes, they market themselves as "liposuction experts".
The particular device used can affect the overall experience, however.
Despite the claims of the manufacturer and the practitioners who plunked down the large sum the device costs, Smartlipo has never been proven to shrink skin better than tumescent liposuction. SmartLipo, SlimLipo, Prolipo, and Coolipo all use a laser to destroy the fat cells, allowing them to be removed by liposuction. My problem with these is that, first of all, as a scientist and doctor I am offended when false claims of benefit are made, and that because the lasers will burn whatever you point them at, I worry that your nerves, blood vessels, muscles, and skin may be injured by the laser.
Bottom line (and in my opinion) -- there is no benefit to these devices, they are expensive (meaning that the cost to you, the patient, will be higher as well), and the risks are higher.
Tumescent liposuction is the gold standard to which all other techniques must be compared. It has been proven to be safe and effective over many years (provided that it is performed by a well-trained surgeon). It involves the injection of a fluid into the fatty tissue layer that causes blood vessels to shrink and the fat to expand, making it easier to remove and lowering the risk of a complication.
VASER lipo involves an additional step, in which the fat (after injection of fluid but before suction is applied) is treated with ultrasound energy. Unlike the laser filaments used in SmartLipo and the other devices mentioned above, the VASER probe is blunt and the ultrasound energy it uses is much more specific for fat, so that the risk of injury to the blood vessels and nerves, as well as the muscles and skin are much lower. This is seen in the patient experience of reduced swelling and bruising.
Each time a new (revolutionary!) liposuction machine comes out, I think the most important questions to ask are not "Does it work?", but rather, "Does it work better than what is already available, is it less expensive (not more), and is it safer than what is already available?"
The VASER (in my opinion) passes this test, while the laser based devices do not.
Having said all of that, I would emphasize that it is the education, training, experience, and skill of the surgeon at the end of the liposuction device that will make the greatest difference in your outcome and safety. There is not substitute for the years of training Board Certified Plastic Surgeons receive in liposuction, directly supervised by other Board Certified Plastic Surgeons. A well trained and Board Certified Plastic Surgeon would be more than capable of achieving a better outcome through tumescent liposuction than any eye doctor with a Water Jet. As in the analogy of Tony Stewart above- a great professional with a great tool (like the VASER) would only make those results and their safety even greater.
Please know that I have no financial relationship with any of these companies and have personally tried each of the discussed technologies myself on patients.

Your question about the difference between liposuction and tumescent liposuction is a common one, and understanding the distinction can help you make informed decisions about your cosmetic procedures.

Traditional liposuction involves the removal of excess fat through suction using a cannula, a thin tube inserted through small incisions in the skin. Tumescent liposuction, on the other hand, is a specific technique of liposuction that involves the use of a tumescent solution.

The tumescent solution is a combination of saline (sterile saltwater), local anesthetic (such as lidocaine), and epinephrine (a medication that constricts blood vessels). This solution is injected into the targeted fat deposits before the fat is removed. The purpose of the tumescent solution is to numb the area, minimize bleeding, and facilitate the fat removal process.

One of the key benefits of tumescent liposuction is its ability to reduce post-operative pain and discomfort, as the local anesthesia in the solution helps numb the treated area. Additionally, the vasoconstrictive effects of the epinephrine help minimize bleeding during the procedure, resulting in less bruising and swelling afterwards.

It's important to note that all liposuction procedures involve the use of tumescent solution to some extent, as it enhances safety and patient comfort during the surgery. However, when people refer specifically to "tumescent liposuction," they are usually describing the technique in which the tumescent solution is the primary method of anesthesia and fluid management.

In summary, while both liposuction and tumescent liposuction aim to remove unwanted fat deposits, tumescent liposuction involves the use of a specialized solution to improve patient comfort, minimize bleeding, and optimize results.

I hope this explanation helps clarify the difference between the two procedures. If you have further questions or would like to explore liposuction options in more detail, I recommend scheduling a consultation with a board-certified plastic surgeon.

Sincerely,
Dr. Katzen
Plastic Surgeon

People used the term tumescent differently. Many use it to describe the wetting solution that is injected prior to liposuction to facilitate fat removal, minimize pain and minimize blood loss..
Technically, Tumescent refers to a liposuction technique and describes the amount of wetting solution infiltrated relative the amount of lipoaspirate (what goes into the canister during liposuction) harvested or area treated. It also relates to the amount of blood loss (EBL) that can be expected. There are 4 types of wetting solution techniques used in liposuction.
1) Dry - no wetting solution used (EBL ~ 25-40% of lipoaspirate volume). No longer used2) Wet - 200/300cc of wetting solution per area treated (EBL ~4-30% of lipoaspirate)3) Superwet - 1:1 wetting solution to lipoaspirate ratio. (EBL ~ 1% of lipoaspirate)3) Tumescent- 3:1 wetting solution to lipoaspirate ratio. (EBL ~ 1% of lipoaspirate)
Hope this helps!