How Does Tumescent Liposuction Work?

Tumescent liposuction is a type of fat removal technique that uses local instead of general anaesthesia, so the patient stays awake during the surgery. Since it was introduced in the 1980s, this procedure has been around for decades and is widely considered a safe and effective treatment for getting rid of localised fat pockets in different areas of the body.

Tumescent liposuction differs from traditional liposuction in many ways, including the amount of fat that can be removed, the size of incisions, recovery and downtime. In this guide, you’ll learn more about tumescent lipo and how it compares to its traditional counterpart.

What Is Tumescent Liposuction?

Tumescent liposuction is a type of liposuction technique that is performed using a special tumescent fluid to remove subcutaneous fat – fat located just underneath the skin.

Tumescent refers to making something firm and swollen, and this surgery does so by using a fluid that can contain:

• Lidocaine (lignocaine) – a local anaesthetic to numb the area so you don’t feel pain.
• Adrenaline – a vasoconstricting agent (narrows the blood vessels) to reduce bleeding and bruising
• Saline – Swells up the fatty tissue in the target area
• Sodium bicarbonate – a buffering agent to prevent stinging

As a result of this “tumescence of the fat,” it’s possible to perform this surgery more accurately while at the same time reducing blood loss, bruising and soreness that can occur after surgery, according to the 1987 study titled “The Tumescent Technique for Lipo-Suction Surgery” published by the inventor of this technique. Additionally, the author also noted that it minimised “irregularities or rippling of the skin” that occurred after surgery.

Another aspect of this surgery that makes it relatively safer than traditional liposuction is that it uses local anaesthesia (even though both carry risks of their own). It’s also said to be less painful as it uses a smaller cannula than the one used in a traditional liposuction. This technique can be done on different areas of the body, such as:

• Abdomen
•  Thighs
•  Breasts
•  Hips and buttocks
•  Back
•  Neck

It may be done on other areas of the body as well, and according to Medscape, tumescent liposuction can also be used for removing lipoma, axillary hyperhidrosis (excessive sweating in the armpits), pseudogynecomastia (enlarged fatty breasts commonly seen in obese men), and Madelung disease (a disorder of fat metabolism), among other conditions.

Who Is A Good Candidate For Tumescent Liposuction?

To be considered a suitable candidate for tumescent liposuction, you might need to meet the following requirements:

• You should be in good health.
• You should already be close to your ideal weight and understand that this procedure is not for weight loss.
• You have localised deposits of fat that you can’t get rid of with diet and exercise.
• You have realistic expectations.
• You have good skin elasticity.

It’s important to get an assessment from a board-certified surgeon to determine your candidacy for this surgery.

What Is The Procedure For Tumescent Liposuction?

Once you arrive at the facility, first, you’ll have a consultation with your surgeon. They’ll mark the target areas on your body from where the fat needs to be removed.

For the surgery itself, 4-8 incisions of the order of 1-3 mm are made, as per a 2008 review published in the Journal of Cutaneous and Aesthetic Surgery. The tumescent fluid is then infused into the fat layer, which will fill up the target area, making it firm and swollen. Following that, micro-cannulas are used to remove the excess fat.

Since you’ll be awake during the procedure, you can not only turn around, but also see the overall contour of your target area once the surgeon is done. And if you feel that more needs to be done, you may be able to ask your surgeon to further look into it.

Compared to traditional liposuction, this procedure can take longer because it uses smaller cannulas. In comparison, large cannulas can take out fat more quickly. Still, overall a tumescent liposuction might take 3-4 hours. It may, however, vary depending on the size of the surgical area that needs to be treated.

After the surgery, you can head back to your hotel or home since it’s an outpatient procedure. Before that, your surgeon is likely to give you a compression garment for your recovery process, along with certain medications and aftercare instructions.

Does Tumescent Liposuction Hurt?

Since you’ll be awake during tumescent liposuction, pain is a very understandable concern.

However, the tumescent fluid will contain a local anaesthetic, so you won’t experience discomfort or pain during the procedure.

You can experience pain after the procedure (although, could relatively be less so) for around a day, but your surgeon will likely prescribe you medications for its management.

If, however, your pain worsens, lingers, or, in general, you’re not recovering normally, make sure to get in touch with your surgeon.

What To Expect After Tumescent Liposuction?

Tumescent liposuction may have a downtime of around 2-3 days. You can experience side effects, such as:

• Pain
• Leaking of fluid
• Bruising
• Soreness
• Swelling

Your doctor should give you a normal recovery timeline. Your aftercare instructions can also include avoiding strenuous activity for some time, maintaining a healthy diet, etc.

You should be able to see the final results of your surgery after a few months. And keep in mind that while the fat is permanently removed from the body, you need to maintain your weight to continue enjoying the results.

Is Tumescent Liposuction Safe?

Liposuction with tumescent local anaesthesia is considered safe as long as it’s done by an “experienced surgeon” with the strict following of the “guidelines of care,” as per a 2021 study published in Dermatologic Surgery.

Not only does this technique use the more safe local anaesthesia, but it also causes less bleeding. Still, that does not mean that it is completely without risks. Some of them include:

• Infection
• Seroma
• Hematoma
• Contour irregularities
• Scarring
• Sagging skin

Make sure you understand these risks before having the surgery so you can make a more informed decision.

How Much Does Tumescent Liposuction Cost?

In the UK, tumescent liposuction might cost you £3,000 to £10,000 or more. The prices can vary depending on the:

• Size of the area you’re getting treated.
• Facility where your procedure will take place.
• Location of the medical clinic
• Experience and qualifications of your surgeon

Because of its cosmetic nature, it’s unlikely to be available on the NHS (although you should check with your GP), so you’ll have to take the private route.

If you are, however, looking to get this surgery more affordably, you can consider getting it in Turkey, where the procedure may cost you somewhere between £1,500 to £2,000.

Tumescent vs Traditional Lipo: What’s The Difference?

One of the main differences between tumescent and traditional liposuction is the type of anaesthesia used. While the former uses local, the latter requires general, so you’ll be unconscious during the surgery. There are, however, other differences between the two, the summary of which is as follows:

	Tumescent Liposuction	Traditional Liposuction
Procedure	Tumescent fluid containing lidocaine, epinephrine, saline and sodium bicarbonate is infused in the target fat to swell it up. It is then removed using micro-cannulas.	General anaesthesia is used, after which relatively larger cannulas are used to break fat and vacuum it out.
Surgery time	3-4 hours	2-3 hours
Hospital stay	Outpatient	Can be inpatient
Amount of fat removed	4-5 litres	8-10 litres
Downtime	2-3 days or less than a week	1-2 weeks
Results	Permanent (but need to be maintained through a healthy lifestyle)	Permanent (but need to be maintained through a healthy lifestyle)
Side effects	Relatively less pain, bruising, swelling, smaller scars, etc.	Relatively more bruising, swelling, pain, soreness, larger scars, etc.

Conclusion

Tumescent liposuction is a safe and effective way to get rid of stubborn pockets of subcutaneous fat in the body. The technique reduces bleeding and bruising, and it also uses instruments that don’t require as large incisions. However, compared to traditional lipo, it removes a relatively small amount of fat.

To determine which technique will best suit your needs, it’s important to get a detailed consultation with a board-certified surgeon. They’ll assess your target area and aesthetic goals and prepare your treatment plan accordingly.

Reviewed and approved by Prof. Dr. Fuat Yuksel

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