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.

Tumescent anesthesia is a term used by some docs to mean safer local anesthesia by tumescing or swelling up the fat with diluted local anesthesia. They may still be using the older method of sucking out the fat with the larger cannulas, which give more wavy, dimply irregular results like traditional liposuction and still may or may not use the general anesthesia to put patients to sleep as well.

This is still traditional liposuction. True tumescent anesthesia doesn't use general anesthesia at all. Tumescent liposuction has evolved to mean a more complex technique of local anesthesia and fat removal. Many docs who now specialize in tumescent liposuction have also learned to use the micro canulas, which is what gives the best end results.

These smaller cannulas take more time to suck the fat out but give far superior results than the larger cannulas, which are quicker but give worse results. The smaller the cannula, then the smoother the results.

The most appropriate term is Tumescent anesthesia liposuction with micro cannulas for the best results. We now just shorten it to Tumescent Liposuction.

Some docs still use general anesthesia and say they are doing tumecent liposuction because they are also injecting the tumescent solution before sucking out the fat with the larger cannulas. This is a little misleading. They are trying to adapt to the latest improvements in liposuction, but they are still stuck in the old method of general anesthesia and probably still using the larger cannulas for quickness sake.

Really they are still doing the old traditional liposuction. They may even add that they do a wet or modified wet or super wet or dry technique. This is all old school stuff that really means that you should politely get out of there while you still can.

You can use lasers or ultrasound or water jets, etc. to assist with the fat removal, but these are of very limited, if any, value. They are more gimmicky than anything. Even now the liposuction world is still advancing and Zerona laser is the latest new technique that is proving helpful for small areas of fat removal without any surgery at all.

It is painless, no surgery, no downtime but works only for small areas and runs $3000 for a series of 6 sessions over a 2 week period. Results are seen 2 weeks later. That is impressive, and time will see if it continues to get advanced or what the next new procedure will be.

Hope this is helpful.

1. What is tumescent liposuction?  Tumescent liposuction is using fluid to tumesce or blow up the tissues with fluid. The purpose of this is that the fluid contains lidocaine which helps numb the area and epinephrine which helps minimize oozing and subsequently bruising.

2. Standard liposuction does not use this fluid and is rarely used by plastic surgeons anymore.

3. A far majority will agree that the benefits of the tumescence solution by far out weight any disadvantages for not using it.

4. Don’t forget that this extra fluid on board may make you feel heavier the first day or two after surgery. It does take 48hrs for the body to resorb the extra fluid and eliminate through the kidneys.

I hope this clears up any questions.

Dr. S

Tumescent liposuction is easy. It injects fluid into the liposuction area.

All liposuction done is tumescent. Usually 1 cc fluid for every 1 cc fat to be removed.

Why? The fluid spreads fat, so it's easier to remove. Plus it has local anesthetic to reduce pain. Epinephrine to reduce bleeding. Fluid to avoid dehydration.

Other ways to get confused? Brand names. All liposuction removes fat with suction. Four additonal techniques help to break up the fat: Microaire uses vibration; water jet uses water; Vaser uses ultrasound, Slimlipo uses laser heat. All other brand names are using one of these 4 techniques.

See a surgeon with access to all of them. They all have different uses. Good luck!

All liposuction procedures performed today involve some degree of tumescence.  Tumescence simply refers to the injection of fluid (usually a mixture of saline, lidocaine, and epinephrine) into the areas of planned liposuction prior to the actual removal of fat.  The addition of the fluid decreases operative blood loss, decreases pain, and increase the tissue turgor so that removal of fat can be performed  more effectively.

1.  Tumescence Liposuction-  the injection of approximately 3x the amount of fluid as the amount of planned fat removal

2.  Super Wet Liposuction-  the injection of approximately the same amount of fluid as planned fat removal

3.  Wet Liposuction-  the injection of about 300cc of fluid into each area of planned liposuction

4.  Dry Liposuction- the injection of no fluid prior to liposuction.

Options 3 and 4 are rarely performed today.

Jaime Perez, M.D.

Liposuction Specialist in Tampa, FL

Plastic Surgery Center of Tampa, FL

Most current liposuction techniques involve the tumescent technique which involves the injection of a wetting solution.  This helps to magnify the space as well as decrease intra operative bleeding.  

Tumescent liposuction is hydrating the area prior to removing the fat cells.  The medicines in the solution help to control pain and bleeding.  Most liposuction cases involve some sort of tumescent solution. 

Almost all Liposuction done today is Tumescent Liposuction. Tumescent Liposuction involves injecting an anesthetic, blood vessel constricting and fat dissolving solution into the fat before doing liposuction.

Tumescent Liposuction technique  operative painsignificasntly reduces bleeding during liposuction and long acting local anesthetic can reduce post

Nowadays TUMESCENT LIPOSUCTION is a role when treating with suction an adipose tissue excess. Usually we infiltrate a fluid solution in the zone we are going to treat, 20 minute prior to suction surgery. This tumescent solution usually is compossed of a dilution of adrenaline, lidocaine and bicarbonate in saline or lactate ringer. The most used pattern is 3:4 or 3:5 (three parts injected for four-five parts of extraction planned). Postoperative pain reduction and a decrease in operative bood loss are the two main advantages of tumescent liposuction techniques.

Tumescent solution weeting in the operative field definitely improves the qualityand security of a liposuction.

All liposuction techniques utilize a wetting solution that helps magnify the treated area, decrease blood loss, and in some cases provide a local anesthetic. "tumescent" is used by many to describe the above. In the scientific literature, "tumescent liposuction" is a term used by doctors who perform lipo in their offices and inject roughly 3 times as much fluid in as they remove. Most plastic surgeons use a "superwet" technique which infiltrates approximately equal amounts as one removes.