Should tumescence be greater than lipospirate? (Photo)

Question

Hello! I had lipo to my flanks and "lateral thighs". Not much change to either area post op. I read through surgical center report and would like 2nd opinion. If i requested "saddle bag" lipo, is that the same as lateral? Saddle bags are not directly side of thigh. Second, in my report, the same exact amt of tumescence was introduced as was obtained of lipoaspirate. To me, that sounds like nothing addtl was removed. Is that correct?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question about whether the tumescent fluid should be greater than the liposuction aspirate. Your history and pictures provide valuable context for this discussion.
Regarding the term "saddlebags," it is often used informally to describe a specific anatomical area. In plastic surgery, "saddlebags" typically refer to the sides of the hip, just below the belt line, or the lateral thigh. However, the area you are holding in your third picture is not the "saddlebag" but rather the "love handles" or, more accurately, the "superior iliac crest." It's important to note that this is not the lateral thigh area.
As for your question about tumescence and liposuction, it is normal for the tumescent solution volume to exceed the volume of the liposuction aspirate. The four primary liposuction techniques are dry, tumescent, wet, and super wet. Each technique varies in the ratio of tumescent solution to aspirate and the amount of blood loss involved:
Dry Technique: No infiltration is used. This technique has fallen out of favor due to excessive blood loss.
Tumescent Technique: The ratio here is typically 3 parts tumescent fluid to 1 part aspirate, with about 1% of the aspirate volume being blood.
Wet Technique: About 200 cc of tumescent solution is injected per treatment area, resulting in a 2:1 ratio of tumescent to aspirate. Blood loss represents 4-30% of the total aspirate.
Super Wet Technique: The ratio is 1:1 between tumescent fluid and aspirate, with less than 1% of the aspirate containing blood. Based on your description of the tumescent being equal to the liposuction aspirate, it appears you experienced the super wet technique.
I hope this clarifies your concerns regarding the tumescent and liposuction volumes and clarifies what constitutes saddlebags versus love handles or the superior iliac crest.
Good luck.
Sincerely,
Dr. Katzen

Randal Haworth, MD, FACS · Answer

Saddlebags and lateral thighs are similar but not exactly the same. Saddlebags typically refer to the fat deposits on the outer part of the upper thighs, just below the hips. The term "lateral thighs" can include this area, but may also refer to other parts of the thighs, such as the outer portion of the lower thighs.

In terms of the amount of tumescence solution used during the procedure, it is not uncommon for the amount introduced to be similar to the amount of lipoaspirate obtained. Tumescence is used to help numb the area, control bleeding, and facilitate the removal of fat. It typically contains a dilute solution of local anesthetic, epinephrine to constrict blood vessels, and saline. The amount used will depend on the extent of the procedure and the patient's body size.

However, it's also possible that not much fat was removed during your procedure, which may explain the limited change to the treated areas. Lipo is designed to remove localized pockets of fat, but it's not a weight loss procedure and may not significantly change overall body shape or weight.

It's important to discuss your concerns and goals with your plastic surgeon to determine if additional treatment or revision may be needed to achieve your desired outcomes. They can also help explain the details of your surgical report and clarify any questions you may have about the procedure.

Best of luck !

Should tumescence be greater than lipospirate? (Photo)

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Should tumescence be greater than lipospirate? (Photo)

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Everything you need to know about Power-Assisted Liposuction (PAL)

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