Why did I feel some poking/jabbing during the tumescent liposuction?

Dear jojo_lip08,

Feeling sensations of poking or jabbing during tumescent liposuction can certainly catch you off guard, and it's natural to seek clarity on why this occurred. Tumescent liposuction, known for minimizing discomfort due to the tumescent solution—which includes an anesthetic—still can have moments where sensations are felt. Let’s address the possible reasons for your experience:

1. The Nature of Tumescent Solution: The tumescent technique involves injecting a large volume of a diluted local anesthetic into the fatty tissue being treated. This solution not only swells the area, making fat cells easier to remove, but also numbs the site to reduce pain. However, the effectiveness of the anesthetic can vary slightly depending on the individual’s response to the medication, the area being treated, and the amount of solution used.

2. Cannula Movement: The technique of moving the cannula (the thin tube used to remove fat) back and forth can contribute to sensations felt during the procedure. Even under the effect of the tumescent solution, certain areas might have less anesthetic saturation, or there may be moments when the cannula touches areas that are less numb.

3. Individual Sensitivity and Distribution of Anesthetic: Each person’s body distributes and reacts to the anesthetic differently. In some cases, there might be spots that are not as fully saturated with the tumescent solution, leading to brief moments where you might feel more sensation than intended. This variability doesn’t necessarily indicate insufficient filling of the area with the solution but highlights the challenges in achieving uniform numbness in a dynamic, fluid-filled space.

4. Surgeon’s Technique: While the skill of the surgeon plays a crucial role in the procedure's overall success and comfort, feeling some degree of sensation does not immediately suggest a lack of expertise. Surgeons strive for the utmost care in ensuring patient comfort, but the nature of the procedure and individual patient factors can contribute to varying experiences.

Feeling some poking or jabbing does not typically indicate a complication or a flaw in the surgeon's technique. However, your comfort and peace of mind are paramount. If the sensations were particularly uncomfortable or if you have concerns about your procedure, discussing them directly with your surgeon is important. They can provide specific insights into your procedure and reassure you about the steps taken to ensure your comfort and safety.

Patients have different experiences and timelines when it comes to sensations during procedures, influenced by many factors unique to each individual. Your feedback is also valuable for your medical team, as it helps in refining approaches for future patients and ensuring that the experience is as comfortable as possible.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

If you elect to have liposuction while awake with the tumescent technique only then it is normal to have some sensations during the procedure.  You will feel the numbing solution as it is introduced into the tissue and after is sets up you will still feel "movement" of the tissue.

I am always very careful when someone elects to have awake liposuction to ensure that they "get numb at the dentist".  If someone tells me that they have a hard time getting numb at the dentist then they will almost always have  a difficult time becoming numb with the tumescent technique and I try to encourage using a general anesthesia.

If you have a tough time becoming numb then poking and jabbing sensations may be expected.  I have had one or two patients that have had fairly miserable experiences despite using the maximum amount of numbing medicine.

The tumescent solution really only provides numbness to the skin and fat.
The deeper tissues such as the muscle and skeleton are not truly anesthetised with tumescent technique.
If the cannula is done in areas of fribrous tissue the force of pushing the cannula through the dense tissues can be transmitted to the muscle or skeleton.