Liposculpture (technically, "Tumescent Microcannular Liposuction") is a dramatically improved alternative to liposuction. Unlike conventional liposuction, this technique requires no general anesthesia, avoiding significant risk, post-operative pain, cost and recovery time. (Conscious sedation, also known as "twilight sleep" is available if requested.) Blood loss and bruising are also greatly reduced. With the advent of microcannulas (much smaller and finer suction tubes) we are able to achieve a smoother and more sculpted outcome. The results can be remarkable (click HERE for pictures.) As with all of our services, your initial consultation is free.

LIPOSCULPTURE Q & A
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• What is "tumescent liposculpture?"
• How does it differ from liposuction?
• Is it safe?
• What is "PAL"?
• Do I have to go to the hospital?
• Who is a good candidate for the procedure?
• Which areas can be treated?
• Can breast reduction be achieved by liposculpture?
• Can I have more than one area treated at the same time?
• Is it painful?
• Will I lose much blood?
• What is the post-operative period like?
• What is the recovery time?
• What are the side-effects?
• Will I have scars?
• Will the fat come back if I gain weight?
• Is it expensive?
• Can I speak with someone who has had the procedure done?

What is "tumescent liposculpture?"

A method of removing fat cells permanently from an area of the body. With this technique, a solution of Lidocaine (local anesthetic) and epinephrine (to constrict the blood vessels) is infused into the space between the skin and muscle using a cannula (a thin rod with a hole through the center). The cannula is placed under the skin using a few very small incisions (about 1/4" long), which are usually placed in the skin folds so they will not be readily visible. This process not only provides anesthesia, but helps liquefy the fat so it can be suctioned out. The epinephrine in the solution constricts blood vessels to minimize bleeding. Next, another cannula is used, through the existing incisions, to suction out the fat cells, using a high-pressure vacuum pump. The entire procedure takes 2-4 hours, depending on the area and the amount of fat to be removed. Using different sized cannulas, we can "sculpt" the areas treated to achieve the contour you want.

How does it differ from traditional liposuction?

This relatively new technique differs from original liposuction in many important ways. First of all, no general anesthesia is required. This reduces the risk, expense and recovery time dramatically. Second, no hospitalization is needed. Third, bleeding is virtually non-existent with the tumescent liposculpture technique. Lastly, the risk of large volume losses and shock are virtually eliminated because of the infused fluid and the use of "microcannulas", which are much smaller than those used with traditional liposuction.

Is it safe?

Yes. With the avoidance of general anesthesia, minimizing of blood loss with the use of epinephrine in the anesthetic solution, and the use of microcannulas to avoid sudden and large fluid shifts, this is a generally safe procedure. Additionally, there has been some scientific evidence to show liposuction may actually improve levels of cholesterol, glucose and insulin secretion. (Annals of Plastic Surgery, 2004;52(1):64-67). As with any surgical procedure, however, certain risks do exist, and vary from patient to patient. These risks will be discussed with you in detail at the time of your consultation.

What is "PAL"?

PAL, or power-assisted liposculpture, replaces the original manual suction canula (tube) with one that vibrates. Any one of several types of liposuction canulas can be attached to a power-handle to help us remove fat and shape the body. This allows the canula to go through the fat and fibrous (scar) tissue more easily, and breaks up the fat, so it is easier to pull out. The advantages are a quicker procedure, less discomfort to the patient, and less bleeding and bruising. Because of the vibration, patients frequently describe a pleasant "massaging" sensation.

Do I have to go to the hospital?

No. The procedure is done in our office.

Who is a good candidate for the procedure?

Anyone who is generally in good health can have liposculpture. Most of us have unwanted fatty deposits on our body. Many times, these are hereditary and not necessarily related to being overweight. They are frequently resistant to diet and exercise, and even at ideal body weight, these fatty areas remain a problem. Liposculpture permanently removes these fat cells. Overweight people also benefit from the procedure in that much (but not all) of the excess fat can be removed. Remember, though, that liposculpture is not meant to be a treatment for obesity, nor a substitute for weight loss and exercise.

Which areas can be treated?

Almost any area that has unwanted fat deposits. Typical areas are tummy, love handles, hips/thighs, buttocks, chin/neck, back of arms, upper back ("bra-bulge") and male breast. Female breast reduction by liposuction is also very effective. See pictures.

Can breast reduction be achieved by liposculpture?

Yes. Breast reduction entirely by liposuction is a very simple and usually very effective procedure. In youth, breast tissue is mostly glandular (composed of gland tissue) with minimal fat. However, as we age, more glandular tissue is replaced by fat. This fat can then be taken out by liposuction, resulting in smaller breast volume. Traditional surgical breast reduction (reduction mammoplasty), consists of surgical skin incisions, removal of breast tissue, and frequently surgical removal and reimplantation of the nipples. It is a major operation, frequently necessitating general anesthesia. Our technique does not involve cutting any tissues. We simply suck out fat and some glandular tissue. A significant breast lift usually occurs naturally, as the weight of the breast is reduced, allowing Cooper's ligament (which supports the breast) to tighten and elevate the breast. Skin retraction also occurs naturally. For more information and pictures, click here.

Can I have more than one area treated at the same time?

Sometimes, yes. The limiting factors are the amount of fat to be removed, and the amount of Lidocaine we need to use. To remove too much fat at one time is hard on your system and could result in hypotension (low blood pressure) and dehydration. Also, we can only safely use a certain amount of Lidocaine for anesthesia-after that, it can become toxic. Typically, if you don't have a lot of fat to remove, we can frequently do two different sites. We can let you know for certain when we see you for a consultation.

Is it painful?

Discomfort is minimal. Some discomfort may be felt during the initial "tumescence" process, but once the anesthetic takes effect, there is virtually no pain. Conscious sedation "twilight sleep" is available if requested. Pain is likewise minimal during recovery.

Will I lose much blood?

No. Using epinephrine to constrict the blood vessels, and small "micro-cannulas", blood loss is negligible.

What is the post-operative period like?

 At the end of your procedure, we will instruct you on how to take care of your wounds and give you all the necessary supplies. Since there is always anesthetic fluid left behind, much of this blood-tinged fluid will continue to drain out through your incisions for the first few days after your surgery. Getting as much fluid out as possible helps reduce post-operative pain and swelling. Use of maxi-pads allows you to remain active without worrying about leakage. Most of the drainage occurs within the first 12 hours. Within 2 days, drainage becomes minimal or none at all, and you can switch to simple Band-Aids.

 Wearing a compression garment (which we will supply for you) is a very important part of the healing process. It helps reduce swelling and bruising, and promotes faster drainage of the retained fluid. It also aids in allowing your excess skin to retract more quickly. We request you wear the garment 24 hours a day (except for using the bathroom or bathing) for the first 2 weeks, then 12 hours a day for another 2 weeks.

 Although pain after the procedure is rare, you will probably have some tenderness. This is caused by bruising of the tissues from the liposuction process and is not a cause for concern. It typically resolves in 2-3 weeks. Some temporary skin bruising is possible.

 What is the recovery time?

You will be up and around immediately after the procedure. Most people return to light work and activity within 1-2 days, and full activity within a week. We prefer you avoid heavy labor or high-impact exercise for about 2 weeks.

What are the side-effects?

Bruising can occur, although it is usually minor, and heals within 7-10 days. Bleeding, post-procedure pain, infection are rare but can occur. Lumpiness and scar tissue can form in the regions treated, especially if large amounts of fat are removed. Initially the skin may look saggy, but the elastic properties of skin will usually allow it to contract within a few months.

Will I have scars?

Usually, only a few very small incisions (about 1/4") are needed, depending on the area treated. These almost always heal with minimal to no scar formation.

Will the fat come back if I gain weight?

The fat we remove is permanently gone. Those particular fat cells can never return. However, if you gain weight, you can engorge existing fat cells in surrounding areas or elsewhere on your body.

Is it expensive?

Not compared to conventional liposuction, which requires surgery center and anesthesia costs, both of which are avoided with tumescent liposculpture. Depending on the areas treated, costs for the procedure vary from $1800 to $4500. For more detailed cost info, click here.

Can I speak with someone who has had the procedure done?

Yes. We have a number of patients who would be happy to share their experience in our office with you. Let us know you wish to speak with them, and we will arrange the contact.

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