In general, liposuction removes fat from a patient using surgical suction techniques. This allows the surgeon to contour the body into a slimmer shape. Wet liposuction can be performed in an office setting without the use of general anesthesia or the loss of significant amounts of blood. It makes use of local anesthesia, which is included in the fluid injected into the fat tissues along with saline and epinephrine. The amount of solution injected into the patient is one of the main factors in determining if the wet liposuction technique is classified as wet, super wet or tumescent.
Of all the wet liposuction techniques available, the tumescent technique is considered the gold standard. The term “tumescent” means firm and swollen. In this type of liposuction, large volumes of diluted local anesthetics are injected into the subcutaneous fat, which eliminates the need for general anesthesia and sedatives. In general, the total amount of fluid injected into the patient is usually up to three times the amount of fat that the surgeon expects to remove from the patient. The tumescent solution contains a dilution of lidocaine with epinephrine. Lidocaine is the local anesthetic while epinephrine is a blood vessel constrictor. Despite the large doses of lidocaine and epinephrine, the solution used in tumescent liposuction has been proven to be safe. To perform tumescent liposuction, the solution is first injected into the area of excess fat. The pressure from the injection of the solution destroys the fat cells allowing them to be easily removed using liposuction cannula. A cannula is a small stainless steel tube that sucks fat out of the patient’s body through a small incision in the surgical area. The diameter of a cannula ranges from 3 to 6 millimeters. Compared to other liposuction techniques, the tumescent method is less painful and a more pleasant experience for the patient.
Like the tumescent technique, wet liposuction also involves the injection of large volumes of local anesthesia with epinephrine. In this technique, approximately 100 milliliters of solution is used. The amount of blood loss is greater compared to the tumescent technique and comprises 15-20% of the total amount of tissue removed.
In super wet technique, the amount of fluid injected is less than half of the amount used in the tumescent technique. Since less fluid is used, general anesthesia is required to numb the patient. Blood loss using the super wet technique is greater compared to tumescent technique but is much less than the wet technique at 8%.
Ultrasonic-assisted liposuction is pretty much the same as tumescent liposuction except that ultrasound energy is also used to destroy fat cells. This technique makes use of devices that produce ultrasonic energy. In external ultrasonic liposuction, a special emitter is utilized to melt fat. Once melted, tumescent fluid is then injected to emulsify the fat and facilitate its easy removal. The use of this fluid prevents blood loss. Internal ultrasonic liposuction is when an ultrasonic cannula is inserted through an incision in the skin. To get the procedure done, the surgeon has to put the patient under general anesthesia. Internal ultrasonic-assisted liposuction is not as popular due to its side effects, which include severe skin burns and scarring. Ultrasonic-assisted liposuction is used to remove fats on areas such as the chin, cheeks and neck. It is also routinely performed on the knees, calves and ankles. Patients who have had prior tumescent liposuction, but still need a more precise contouring, are good candidates for ultrasonic-assisted liposuction.
Water jet-assisted liposuction works differently from other types of wet liposuction. Instead of injecting tumescent fluid into the fat tissue, the procedure makes use of a device that produces a steady pressurized stream of saline solution and local anesthetic to loosen the fat and simultaneously remove it from the body. This method is much more gentle and minimally invasive that other types of liposuction. As with any other liposuction techniques, there is some swelling and bruising but the recovery form the swelling and bruising is much faster.
In order to determine which liposuction technique is best suited for their needs, patients should consult with an experienced doctor who can perform an examination and make a decision on the technique to be used.