WHAT TO EXPECT THE DAY OF TUMESCENT LIPOSUCTION

You will have already taken an antibiotic with breakfast at home. Upon arrival in the office, ou will be given a sedative, an additional antibiotic, and a clonidine to keep your blood pressure from rising due to the epinephrine (Adrenalin) in the anesthetic mixture. You will put on the briefs we provide and pre-operative photographs will be taken. The skin will then be marked and time allowed for the markings to dry and the medications to take effect.

The skin is next anesthetized at the sites that will be used to pump in the anesthetic solution. A large volume of dilute anesthetic solution is now pumped into the area to be treated, starting with a small needle and then a larger needle, so there is minimal discomfort. A typical volume of anesthetic (abdomen) is about 3 liters, so this part of the procedure takes a while. Less than half of the anesthetic solution will be suctioned out with fat. You will absorb the rest. After allowing about 45 minutes for the anesthetic solution to take full effect, you will be escorted to the bathroom, and you may need to go again during the procedure as you absorb more of the fluid. Because this is a salt solution matched to the body’s fluids, you may nonetheless become thirsty, or you may get hungry. We have juice available for you.

By this time you will have been in the office about 2 ½ hours. Now the liposuction procedure itself is begun and should be painless. If some areas are not completely numb, additional anesthetic solution will be injected. Liposuction begins at the deepest level of the fat and then proceeds towards the surface. Grasping the skin allows a feel for how much fat remains and allows fairly precise control of fat removal. The paths of the cannulas cross at angles to ensure even results. It can take from 1 ½ to 3 hours to complete the removal of fat. The quantity to be removed plays a role as well as how fibrous your fat is. The cannula size must be chosen to pass easily through the fat so as to not disrupt the collagen fibers that will later draw the skin tight. Thus the more fibrous areas such as the flanks or over the lower ribs below the breasts require the use of smaller cannulas and take more time. Doing two separate areas such as outer thighs adds time too, because I complete one side before starting the other. Skin excision (breast lift or tummy tuck) also adds time. I only schedule one surgery per day so I never feel rushed.

As liposuction is nearing completion we will telephone the person who will be providing you a ride home. You are welcome to have a friend present for any or all of the procedure; often someone who is interested in having the procedure himself or herself will wish to see how it is done. You should in no circumstance plan on driving yourself home. The anesthetic (lidocaine) redistributes in your body and numbs up some of the nerves in your brain. It also persists in the treated tissues, wearing off slowly overnight.

Once liposuction is complete, absorbent dressings are taped into place and you then put on the compression garment we furnish which helps squeeze the fluid out of the spaces created by fat removal. The nicks made to insert the cannulas are not sutured; they are so small they don’t really need suturing, and we want them to stay open for a day or two anyway to facilitate drainage. All the dressing materials you will need for changes at home are provided.

As soon as you get home you should have something to eat, and then get off your feet. Your first dressing change will probably be required in about two hours; drainage then slows after that. Review the postoperative instructions and pay particular attention to the risk of fainting as you remove the compression garment.