Tumescent Technique for Local Anesthesia Improves Safety in Large-Volume Liposuction

1993 ◽  
Vol 92 (6) ◽  
pp. 1085-1098 ◽  
Author(s):  
Jeffrey A. Klein
1987 ◽  
Vol 4 (4) ◽  
pp. 263-267 ◽  
Author(s):  
Jeffrey A. Klein

The tumescent technique of lipo-suction is a modification of the wet technique. A large volume of very dilute epinephrine is infiltrated into a targeted fat compartment prior to lipo-suction, producing a swelling and firmness. This tumescence of fat permits an increased accuracy in lipo-suction and minimizes postsurgical irregularities or rippling of the skin. Epinephrine-induced vasoconstriction minimizes blood loss, bruising, and postoperative soreness. Safe, rapid infiltration of large volumes of solution is achieved using a closed sterile system featuring a newly designed blunt-tipped, 30-cm-long, 4.7-mm-diameter needle having a hollow handle that accommodates a 60-cc syringe. Attached to a liter bottle of anesthetic solution by an intravenous line, the needle is inserted via the same incision and deposits the solution along the same path as that intended for the lipo-suction cannula. Thus, the solution is infiltrated exactly where it is needed for hemostasis or local anesthesia. Used in conjunction with general anesthesia, the tumescent technique saves time in achieving maximal vasoconstriction of the targeted fat compartment. If dilute lidocaine (0.1%) is added to the solution, the technique permits lipo-suction of more than 2 liters of fat totally by local anesthesia. Twenty-six patients, having received a mean lidocaine dose of 1250 mg (18.4 mg/kg or 8.5 mg/kg/hr) infiltrated into subcutaneous fat, had a mean serum lidocaine level of less than 0.36 μg/ml 1 hour after completion of the infiltration.


1997 ◽  
Vol 14 (3) ◽  
pp. 263-267 ◽  
Author(s):  
Edward B. Lack

Advances in liposuction, primarily involving the tumescent technique of local anesthesia, have fostered the advent of large-volume liposuction. Such major alterations in the volume of an organ system must have physiologic implications. This paper attempts to describe fat metabolism as it relates to fat storage and expenditure and the possible effects of large-volume liposuction on fat metabolism.


1999 ◽  
Vol 104 (6) ◽  
pp. 1887-1899 ◽  
Author(s):  
Lázaro Cárdenas-Camarena ◽  
Angel Tobar-Losada ◽  
Alberto Mario Lacouture

2003 ◽  
Vol 20 (2) ◽  
pp. 97-102 ◽  
Author(s):  
Edward B. Lack ◽  
Kimberly J. Butterwick ◽  
Neil Sadick

Introduction: Liposuction has undergone many revisions since 1980, the most notable being the introduction of the tumescent technique of local anesthesia by Jeffery Klein, MD. Since then, in an effort to improve the aesthetics of the technique and the ease and safety of the procedure, other techniques have been introduced. These include superficial liposuction, UAL, external ultrasonic liposuction, mechanically assisted liposuction, and, most recently, laser-assisted liposuction. Materials and Methods: Four centers in the United States, operating under an 1RB protocol, performed liposuction with the tumescent technique of local anesthesia on specified cosmetic units of the body. One side was exposed to 635-nm laser therapy after tumescence was achieved, whereas the contralateral side was not. Observations were recorded during surgery and at 2 weeks postoperatively. Results: Observations of intraoperative technique did not show an advantage to laser-assisted liposuction. Observations of the postoperative course were equivocal, though there was evidence of reduction of edema in certain patients. Discussion: The addition of laser therapy to liposuction technique is based on years of experience demonstrating improved wound healing using a technique of low-level laser therapy. Although the recorded observations did not support an advantage to the addition of laser therapy, there was a paradoxical difference of opinion among patients and surgeons who participated in the study. These individuals believed that, compared with patients not treated with low-level laser therapy, there was at least a reduction in degree and duration of postoperative pain and induration. As low-level laser therapy may have systemic effects on wound healing, comparing treated and untreated contralateral sides may not be valid because both sides experienced improvements in postoperative course. Laser-assisted liposuction has a potential advantage, not supported by this study, in the intraoperative and postoperative course of liposuction surgery. New studies using double-blind techniques will need to be conducted.


2020 ◽  
pp. 074880682095649
Author(s):  
Roland Boeni ◽  
Paul von Waechter-Gniadek

Large-volume fat transfer to the buttocks and breast has rapidly become popular. Lipofilling using syringes is tedious, time-consuming, and carries the risk of contamination. Most often, systemic anesthesia is being used. This study aims to evaluate the efficacy of large-volume lipofilling in local anesthesia. Local anesthesia was performed with 2 anesthetics: lidocaine and prilocaine. We performed vibration amplification of sound energy at resonance (VASER) and reciprocating power-assisted liposuction (PAL) for fat collection in a closed-loop system using a peristaltic pump. In a reverse pump setting, fat was then used for expansion vibration lipofilling. Pre- and postoperative data were collected. There were no major complications. Liposuction volumes up to 3.100 mL were extracted, and injection volumes ranged from 200 to 1600 mL. Mean operation time was 96 minutes. Satisfaction rate was high. Anesthesia was sufficient in all patients. Using a closed-loop system for fat extraction–purification and transfer is not only time- and cost-effective but also ideal for large-volume fat grafting. Recovery time is 1 to 2 days and satisfaction rate is high.


1995 ◽  
Vol 21 (4) ◽  
pp. 315-318 ◽  
Author(s):  
MONIQUE S. COHN ◽  
ERIC SEIGER ◽  
SANDY GOLDMAN

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