Tumescent Liposuction

Thank you for taking the time to visit our website. If you are considering having tumescent liposuction, please read as much information as you can. We have provided you with many links regarding the subject. We also have a very helpful book in our office that you may borrow and read at your leisure. In addition, you may e-mail any questions or concerns you have by clicking on the e-mail link. The Registerd Nurse who assists with the liposuction in our office will respond.. We want all of our patients to be as educated as possible on the subject so that they can make an informed decision. If, after reading all the material, you feel that tumescent liposuction is something that would be of benefit to you, please call our office to schedule a consultation. During this initial consultation, we will answer any other questions you may have, and Dr. Burton will examine you to see if you are a good candidate for the surgery. There is no charge for this visit. No surgeries are scheduled without this consultation. It gives you a chance to meet with us and make sure you're comfortable, and for us to evaluate what your expectations of the surgery are.

Because of it's superior safety, the tumescent technique is now regarded as the worldwide standard of care for liposuction. The tumescent technique for liposuction has evolved into two distinct standards of care: tumescent liposuction totally by local anesthesia and tumescent liposuction with systemic anesthesia. Our office performs the surgery under local anesthesia only. It has a superior safety record as compared with systemic anesthesia, and we feel that elective surgery should be as risk-free as possible. General anesthesia allows the surgeon to perform multiple procedures at the same time, such as a face lift or breast surgery along with the liposuction. This adds significant risk to the procedure and there have been several deaths recorded in these instances. As of this writing, there have been no deaths associated with liposuction using local anesthesia. Dr. Jeff Klein, the dermatologist who pioneered the tumescent technique states "I would estimate that the risk of death associated with liposuction is at least 100 to 1000 times greater with general anesthesia compared with pure tumescent local anesthesia."("Tumescent Technique:Tumescent Anesthesia and Microcannular Liposuction") Our patient's safety and well-being are paramount to us, and we follow the standards set by Dr. Klein in 1985 when he performed his first case of tumescent liposuction.


Frequently Asked Questions

What Does Tumescent Mean?

The word "tumescent" means swollen or firm. This technique is accomplished by injecting a large volume of a dilute solution of lidocaine, which is a local anesthetic, and epinephrine, a vasoconstrictive drug which shrinks capillaries. This capillary constriction results in minimal blood loss both during and after the surgery.

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How is the Fat Removed?

First, the fat that is to be removed is numbed up, or "tumesced". This part of the procedure is performed by a Registered Nurse. After numbing the skin, she will make tiny incisions that will allow the tumescing cannula to enter the fat just beneath the skin. With the help of an infusion pump, she will slowly instill the tumescent fluid until the entire area to be liposuctioned is anesthetized. This is usually the most time-consuming portion of liposuction. Depending on how much fat there is to remove, and how many areas you are having done, it could take anywhere between 1 and 3 hours.

After allowing the tumescent fluid to take full effect (about an hour), Dr. Burton will begin the actual liposuction. A cannula (a hollow tube with an opening near its' blunt end) is inserted through the small incisions made by the nurse and into the fatty tissue overlying the body's musculature. This cannula breaks up the fatty tissue, creating a "honeycombing" of the fat. A vacuum pump connected to the other end of the cannula then evacuates the loosened fat cells. The smaller the cannula, the smaller the tunnels and the more even the reduction. The cannulas that Dr. Burton uses are generally 1.3 to 3.0 mm in outside diameter. After surgery, these tiny tunnels collapse resulting in a improved body contour. The tiny incisions remain open so that fluid may continue to drain. After about 24-36 hours most patients incisions close on their own, and the drainage ceases. The tumescent fluid that does not drain before the incisions heal must then be absorbed by the body. This takes place over a 4-6 month period. That is why you must be PATIENT when waiting for your final results.

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Who performs Liposuction?

Liposuction is a newer surgical technique that has been embraced by dermatologic surgeons, cosmetic surgeons, and plastic surgeons. In fact, it was a dermatologic surgeon, Dr. Jeff Klein, that devised and perfected the tumescent technique. Dr. Burton began studying liposuction in 1986, and has taken part in numerous courses throughout the past ten years. In 1995, he was taught the tumescent technique by Dr. Klein, and firmly believes it is the safest and most effective type of liposuction.

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Why don't more surgeons use the Tumescent Technique?

One of the most significant factors in determining which technique a surgeon will use is time. From a surgeon's point of view, the liposuction will take less time when a general anesthetic is used. Plastic and cosmetic surgeons commonly use general anesthesia. Dr. Burton performs liposuction using local anesthetic by the Tumescent Technique. You can also be given mild sedation orally to relax you during the procedure, but you will remain awake throughout your surgery. Your blood pressure and cardiac rate and rhythm will be continuously monitored.

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Can Fat Re-accumulate in the Contoured Areas?

Fat cells do not multiply after puberty. Therefore, the fat cells that are liposuctioned will not return. As long as the patient does not gain excessive weight, the new silhouette is permanent. If weight gain does occur, it will usually be noticed as an overall, even distribution of fat. It has been reported that women often notice their weight gain in either the face or the breasts. FAT REMOVAL DOES NOT ALLOW FOR ABUSE OF DIET LATER. As one gains weight the size of the individual fat cells increase, and too much weight gain may mask the benefit of the liposuction.

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What is the Cost?

It is difficult to quote an exact fee without seeing how much fat needs to be removed, but we would like for you to have a general idea so that you can make a better-informed decision. Generally, an abdomen would range between $2000-$4000, depending on the size. Saddlebags are $1000, and a Gasparotti procedure (under the buttocks and around to the side of the legs) costs about $1800-$2000. Our fee for liposuctioning the neck is $1200. There are several other areas that can be liposuctioned, but this will give you a general idea of the fees involved. If you would like more than one area done, it would be best to have both areas done on the same day. The cost to you decreases, since we will use less of our disposable materials. However, depending on your height and weight, there IS a limit as to how much tumescing fluid we can use for each patient. UNDER NO CIRCUMSTANCES will we go beyond the acceptable amount that has been proven to be safe. Your health is our primary concern, and no one should take a risk to have an elective procedure done. If you decide to have liposuction, plan on spending the day with us! It is a very time-intensive procedure. You'll spend the morning being tumesced, and the afternoon being liposuctioned. Of course, if you only want a small amount done (inner knees, for example) your time with us will be considerably less.

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Can the Procedure be Performed in an Office Setting?

Liposuction is performed in our specially equipped in-office operatory. We have medical equipment that monitor your heart rate and blood pressure electronically throughout the procedure. Dr. Burton is trained in ACLS (Advanced Cardiopulmonary Life Support), and at least two nursing personnel are present during the procedure.

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Who is a Potential Candidate?

There are no definite age or weight limits. Some patients have certain bulges irrespective of their weight that they just can't get rid of, no matter how much they diet or exercise. These bulges are almost always genetic, and will only improve if they are suctioned out. We've performed liposuction on patients between the ages of 20 and 67, and all have done well. The best candidates for liposuction are in good health, and have REALISTIC expectations of the benefits of liposuction.

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Is Liposuction a Treatment for Obesity?

No! Liposuction is not an effective treatment for obesity and is not an alternative to a healthy diet and regular exercise program. The procedure works best on those whose weight is stable and/or have localized areas of fat deposits.

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What Areas of the Body Can Benefit From this Technique?

The most frequently treated areas in women include the waistline, lower abdomen, upper abdomen, outer thighs, inner thighs, buttocks, knees, and neckline. In men, the most commonly treated areas are the love handles, breasts, and abdomen.

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What Complications May Occur?

Surgical complications of liposuction are quite rare, but as with any surgical procedure, bruising, swelling, and numbness can occur. Skin irregularities are also possible, and Dr. Burton does everything he can to prevent this. However, since it is impossible to suck out every fat cell, these irregularities are not uncommon. That is why we stress that this procedure is for those who want to LOOK AND FEEL BETTER IN THEIR CLOTHES, and not for those who want to look great in a bikini.

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How Long Before I Can Resume My Usual Activities?

This totally depends on the patient. We've performed liposuction on patients who went to work the next day and did fine. We don't recommend this if you've had a large number of areas done, since the drainage may be a problem. You're encouraged to take a shower when you get home, and maybe a short walk that evening. You must wear a compression garment, which we provide and is included in our fees for liposuction. The garment should be worn as much as possible in order to achieve the most favorable outcome.

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If you have any questions that were not addressed in the information we sent you, please call our office, and we will be glad to help you. If you would like a consultation with Dr. Burton, please call and schedule an appointment. There is no charge for the initial consultation. We also have a very informative book on liposuction surgery that we encourage you to read either before or after deciding to have the surgery. We have several copies on hand, so don't hesitate to drop by and check one out to read at your leisure.

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May 29, 2002