All modern liposuction techniques start with the infiltration of a solution into the fatty tissue. All modern liposuction techniques include “tumescent technique” (meaning, no other technology used, sometimes referred to as traditional liposuction), power assisted technique, VASER (ultrasound), Laser …you get the idea.
The tumescent solution has various formulas that differ based on:
- the amount of fat being resected
- whether or not general anesthetic is given
- plastic surgeon preference or experience
The basic starting ingredient is a physiologic solution, either Normal Saline or lactated ringers. These solutions are typically given via the vein for someone during intravenous hydration. In liposuction, they are not injected via the vein, but injected around the fat. The next ingredient is adrenaline, or epinephrine. This constricts the blood vessels, i.e, it makes the vessels in the area injected clamp down.
This obviously is very helpfull to reduce blood loss. The next ingredient is lidocaine. Unless one is using general anesthesia, then lidocaine is a good idea to help control the discomfort. A final ingredient, which is more optional, is sodium bicarbonate. This is added to reduce the acidity of the solution to make it sting less.
The exact formula depends on volumes of fat being resected, patient weight, patient’s home medications, etc, etc. But the tumescent solution is the KEY to successfull modern liposuction. Thus, all techniques use tumescent solution in one form of another as the starting point. Here’s a typical formula:
- 1 liter LR
- mixed with 50 cc of 1% lido
- mixed with 1 cc of 1:1000 epinephrine
- mixed with 8 cc of sodium bicarb.
Again, the mixtures differ with areas and volume being treated.