What is Tumescent Anesthesia?

Doctor Answers 8

Tumescent Anesthesia and Tumescent Liposuction

When Liposuction was introduced in the early 1970's, as soon as the suctioning was begun significant amount of bleeding accompanied the fat removal. Early text on Liposuction had formulas on removal of how much fat / blood required blood transfusions.

In the 1980's the excessive bleeding encountered with liposuction was stopped with the introduction of TUMESCENT LIPOSUCTION. To stop the bleeding, the fat to be vacuumed is engorged with physiologic / IV fluid (either Saline or Ringer's lactate) which is mixed with dilute amounts of Adrenaline (Epinephrine to reduce bleeding) and a small amount of Lidocaine (or similar local anesthesia medication to reduce pain during and after the procedure). The sheer pressure of the fluid in the fat displaces blood out of the areas. The Adrenaline causes blood vessels to spasm so they do not bleed and the local anesthesia reduces the discomfort.

So - Why is it called TUMESCENT ? Would it sound better if it was called SWELLING, PUFFY or DISTENTION LIPOSUCTION?? Of course not. Tumescent is derived from the Latin - tumescere to begin to swell, from tum?re (ALSO origin for tumor...). And we all KNOW, if something sounds foreign - well, it sounds more sophisticated. Doesn't it?

Since EVERY Plastic surgeon in the world practices tumescent anesthesia (IE infiltrates the fat about to be suctioned with a tumescent solution) - there is NO MYSTIC to it. However, the differentiation often comes from certain disciplines who falsely claim exclusivity to the use of this technique.

Plastic surgeons can choose to perform Tumescent Liposuction with EITHER without any sedation, with oral sedation, IV sedation or general anesthesia. The choice of the technique is up to the surgeon and his / her patient.

Dr. P. Aldea

Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Tumescent liposuction provides anesthesia and eliminates bleeding.


With the tumescent technique, a lot of very dilute local anesthesia and very dilute adrenaline is injected into the treatment areas.  We wait 20 minutes for it to take effect, and then the liposuction is done.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Tumescent anesthesia is commonly used in Liposuction

It is the use of physiologic fluids(saline) to which have been added local anesthetic  and agents to constrict blood vessels in the area to fascilitate the proceedure and reduce bleeding. It is most commonly used in liposuction but is a useful tool in oher proceedures.

Barry H. Dolich, MD (Retired)
Bronx Plastic Surgeon
4.0 out of 5 stars 1 review

Tumescent anesthesia

Tumescent anesthesia involves the injection of large volumes of very dilute local anesthetic solution, for example lidocaine containing epinephrine into subcutaneous fat. With tumescence, the subcutanous tissue becomes firm and hard. Tumescent anesthesia is used for microphlebectomy (varicose vein surgery), VNUS Closure, EVLT (endovenous laser therapy) and probably the most common surgical procedure done in the U.S., i.e., liposuction.

Hratch Karamanoukian, MD, FACS
Buffalo Phlebologist
4.8 out of 5 stars 41 reviews

Modified local anesthesia

Tumescent translated means hard.

Originally, the tumescent technique was developed in the 1980's for use in liposuction. Sterile saline was mixed with various agents and this was pumped into tissues to be liposuctioned, until the area was literally hard as a rock.

Nowadays, we usually don't pump that much fluid in, preferring a "wet" technique, which doesn't render the tissue rock hard. Despite this, the term tumescent has stuck.

Typically, the tumescent fluid is comprised of normal saline, local anesthesia such as lidocaine with epinephrine (adrenaline, which reduces bleeding), and bicarb which reduces the pain of infiltration.

Scott E. Kasden, MD, FACS
Dallas Plastic Surgeon
4.7 out of 5 stars 101 reviews

Tumescent anesthesia

Tumescent anesthesia usually refers to the injectable solution that is used during liposuction. This usually consists of  a salt water solution mixed with local anesthesia and epinephrine. All three combined help minimize blood loss and provide a relatively pain-free experience.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Tumescent done in Liposuction Cases

Tumescent anesthesia is when the surgeon injects fluid containing lidocaine (which is like the medication you get injected at the dentist) and epinephrine (which is like adrenaline) which helps constrict the blood vessels.

This fluid is injected prior to performing liposuction to help the procedure as well as to provide comfort after the surgery and help with bruising.

Be aware who will be doing your surgery if you are planning on getting liposuction done. Some doctors claim to perform liposuction under tumescent anesthesia instead of putting you to sleep. The reason for that may be that they are not a plastic surgeon and cannot perform this procedure at a surgery center or hospital where they would put you to sleep. Make sure you are seeing a BOARD CERTIFIED PLASTIC SURGEON.

Hope that helps.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 77 reviews

Tumescent Anesthesia or Technique

Tumescent is a medical word which means swollen or engorged.

Tumescent technique is used when we pump tissues full of fluid. When the fluid contains local anesthetics it is called tumescent anesthesia. It is most often used for liposuction but is also used in other surgical procedures.

The basic benefits of this are:

  1. Diminshed blood loss
  2. Improved fat extraction (particularly lutrasonic)
  3. Prolonged anesthesia (18-24 hours)

There are a variety of formulas and different surgeons use differing preparations.

The essential ingredients are lidocaine and epinephrine (also known as adrenaline)

Although lidocaine can be used at a total of 5-7mg/kg which typically lasts 2-4 hours, tumescent preparation allow us to use it at a higher doses of 35mg/kg due to its delayed absorbtion over 18-24 hours.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 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.