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Liposuction Under Local Anesthesia
Tumescent liposuction, awake liposuction and lunchtime
liposuction are synonymous for the safest method of
liposuction and body contouring in the field of cosmetic
surgery. Developed and perfected by dermatologists in the
1980s, this type of liposculpture or lipoplasty as it is
sometimes called, derives its name from the type of local
anesthesia which was specifically developed for this
operation – tumescent local anesthesia.
 Tumescent local anesthesia, also referred to as TLA or
Klein’s Solution, is a carefully balanced blend of lidocaine,
epinephrine and sodium bicarbonate diluted in saline and
administered directly into the subcutaneous fat layers to
produce total anesthesia and vasoconstriction
lasting
effectively up to 12 hours.
After surgery, the tumescent lidocaine solution is slowly absorbed through the
bloodstream and metabolized through the liver completely in
about 36 hours. All patients must be evaluated prior to
surgery to ensure that they have a normal functioning liver,
no history of liver diseases and are not taking medications
or other substances which might interfere with lidocaine
metabolism in order to be considered for this type of
surgery. |
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Liposuction under local anesthesia is safer than liposuction under conscious sedation (IV sedation or twilight anesthesia) or liposuction under general anesthesia for several reasons. First, the patient maintains all of the reflexes which protect the airway – the gag reflex which prevents the accidental aspiration of vomit or corrosive stomach acids into the lungs is maintained and the patient is able to breath normally throughout the procedure. Second, the patient maintains control over all of the muscles which protect against the formation of deadly blood clots in the legs, lungs and elsewhere.
Staying awake is the easiest and most effective method of preventing deep vein thrombosis (DVT) or venous thromboembolism. Third, the patient maintains the ability to communicate with the surgeon throughout the entire surgery which gives both the patient and the surgeon instant feedback and the ability to adjust the technique or the local anesthesia for maximum effect. Finally, awake liposuction uniquely permits the surgeon to continually evaluate the cosmetic results of the procedure by having the patient stand up to determine if the desired body contours have been achieved.
Patients and surgeons alike, are quite familiar with the fact that the abdomen and other areas of the body have a completely different appearance when lying down as compared to standing up. Most cosmetic surgeons, plastic surgeons and dermatologists who have had experience with tumescent liposuction observe that their results are better than those that they achieve with either conscious sedation or general anesthesia.
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