Liposuction is the most commonly performed aesthetic surgical operation performed in North America. The procedure may be done under local or general anaesthesia and it is really meant to improve the appearance of fullness, as opposed to trying to result in weight loss or significant size reduction. The ideal candidate is in good health and desires a more shapely appearance. Liposuction will make a large thigh more shapely, but will not necessarily significantly reduce the diameter of the thigh; It is a sculpturing operation.

Tumescent Liposuction

Tumescent liposuction refers to the use of large volumes of physiologic saline containing small amounts of epinephrine (also called adrenaline) and dilute xylocaine (a common local anaesthetic, of the type used by dentists to

numb your teeth). The solution is injected into the areas to be liposuctioned until the area is firm and swollen with fluid (that is what 'tumescent' means).

If the procedure is being done under local anaesthesia only, it is important to wait about 20 to 30 minutes after injecting the fluid in order for the fluid to diffuse through the tissues and to provide maximum numbing and vasoconstriction (a temporary constriction of the blood vessels in the area injected). Most patients find the procedure minimally uncomfortable, but some patients request a tranquilizer or a sedative. Some patients can not bear the thought of 'knowing what is going on' and request a general anaesthetic. In any case, as with any surgical procedure, it is critically important that you are properly monitored and that emergency equipment is available in the event of a surgical mishap or if you suffer an untoward reaction.

Liposuction is then performed in the areas that have been numbed by the local anaesthetic. Small tubes are used to vacuum out fat cells in the areas of concern. The smaller the tubes used to vacuum out the fat cells, the less likely ridges are to occur, but the longer the procedure will take. It is important to crisscross the pattern from at least two different directions in order to remove the fat evenly and without dimples, ridges or irregularities. This method of liposuction does not result in skin shrinkage and is ideal for small to medium sized problem areas. About 30% of patients experience significant bruising, despite gentleness of touch. The areas remain numb for about a day after the procedure. Liposuction is then performed in the areas that have been numbed by the local anaesthetic. Small tubes are used to vacuum out fat cells in the areas of concern. The smaller the tubes used to vacuum out the fat cells, the less likely ridges are to occur, but the longer the procedure will take. It is important to crisscross the pattern from at least two different directions in order to remove the fat evenly and without dimples, ridges or irregularities. This method of liposuction does not result in skin shrinkage and is ideal for small to medium sized problem areas. About 30% of patients experience significant bruising, despite gentleness of touch. The areas remain numb for about a day after the procedure. It is a good technique overall.

A WORD ABOUT ANESTHESIA:

Having your procedure done in the back room of a doctor's office without an IV and without monitors and without proper emergency equipment may be less expensive. This is also dangerous and unsafe. Dr. Callegari only does this type of procedure under proper safety precautions; it is done in an accredited facility with proper backup equipment and properly trained personnel. Just because you are wide-awake, it does not mean that the procedure is completely safe, because the act of surgery will cause large shifts in fluid volume in your body. That is why responsible surgeons monitor your blood pressure and pulse throughout the procedure and in the recovery room. Bottom line: although local anaesthesia is a safe and effective means of doing liposuction, make certain that appropriate monitoring and emergency equipment is available.