Tumescent Liposuction

Get Slimmer Contours with Surgical Fat Reduction in St. Louis

The tumescent technique is the cornerstone of modern liposuction. At our St. Louis practice, it is one of the most popular body-contouring procedures we perform—and we perform a lot!

Over the years, plastic surgeons have introduced many variations on the long-established practice of surgical fat removal. Tumescent liposuction has a long history of effectiveness, and it can be adapted to suit a range of individual patient preferences. When performed on the appropriate candidate, liposuction is a powerful body-contouring procedure—but patients should always remember that it is not an alternative to diet, exercise, or weight-loss surgery. The best candidates have discrete areas of excess fatty tissue surrounded by areas of good skin tone.

How Does Tumescent Liposuction Work?

First, the plastic surgeon injects the area marked for liposuction with a liquid mixture of anesthetic diluted with saline. This is known as a wetting solution, and it makes the tissue firm—or "tumescent"—which gives this technique its name. The solution also dulls sensation in the area and constricts blood flow to minimize bleeding during the procedure and bruising afterward.

Once the wetting solution is introduced and has had several minutes to take effect, the fat is ready to be loosened and suctioned immediately or treated first by an intermediate step using ultrasound energy that liquefies the fat cells and can also have skin-tightening benefits.

Liposuction Techniques

No matter which technique is used, the fat cells must be dislodged from their surrounding tissue prior to removal. Plastic surgeons can use a manual method that involves inserting a wand, known as a cannula, through an incision. Once inserted, the wand can be moved back and forth through the tissue to free and break up the fat cells, priming them for suction removal through the cannula's hollow center.

Liposuction Variations

Power-assisted liposuction or PAL is used to improve the efficiency of the procedure and can be combined with standard tumescent liposuction or VASER LipoSelection. This technique utilizes a rapidly oscillating handpiece that moves the cannula through the fatty tissue without the need for physical force on the part of the plastic surgeon. The end result is that the surgeon can concentrate on the task at hand: fat removal.

Great care will be taken to sculpt natural contours that stay in proportion with other parts of the body. The goal is not just volume reduction in one area, but a seamless integration of the newly slimmer area.

Ultrasonic liposuction, also known as ultrasonic-assisted lipoplasty (UAL), is used to enhance a surgeon's ability to remove fat, increase the amount of fat extracted, and improve patient comfort during and after the procedure. It can also minimize damage to surrounding tissues, leading to a reduction in recovery time and discomfort. Ultrasonic liposuction can be especially effective for patients with a small to medium amount of localized fat to extract, and it can be performed on multiple treatment areas as needed, decreasing anesthesia exposure and recovery time.

The energy used during ultrasonic liposuction also tends to tighten the skin while destroying the deep fat deposits. When used in conjunction with tumescent liposuction, it can effectively eliminate dense, fibrous tissue (commonly found on the back, outer thighs, upper abdomen, or in male breast tissue). These features make it an excellent tool for body contouring, gynecomastia treatment, and more.

Ultrasonic liposuction works by using high-intensity, high-frequency ultrasound energy to destroy and liquefy fat cells so that they can be more easily aspirated through a suction device. During ultrasonic liposuction, the energy is applied through a small metal cannula, or tube, specially designed for this purpose. VASER LipoSelection® is an ultrasonic-assisted lipoplasty system.

During the ultrasonic liposuction procedure, the treatment area is first filled with the saline solution used in traditional tumescent liposuction. Next, a cannula transmits the ultrasound energy to break up and dislodge fat. Finally, these fat cells are gently suctioned through a cannula—often the same one used to deliver the ultrasound energy. Ultrasonic liposuction is typically smooth and efficient, minimizing trauma, bruising, and blood loss.

Ultrasonic liposuction recovery and results depend largely on the size of the treatment area, how much fat was removed, and your overall health and fitness. Your surgeon can give you a better indication of what to expect during your recovery period and how long it will last. Most patients notice results right after surgery, with full results visible after three or four months.

These variations are not exclusive techniques in any way; in fact, many are utilized during the same procedure to achieve optimal results. Although different techniques and technologies have their benefits and drawbacks, for some patients, only ultrasonic liposuction can enable them to achieve sculpted, defined body contours.

Far more important than the specific lipoplasty technique are the skill and expertise of the surgeon performing it. Certification by the American Board of Plastic Surgery demonstrates that a plastic surgeon has received extensive, rigorous education and hands-on training performing these procedures, and that he or she has successfully completed exams demonstrating their expertise in this area. For board-certified plastic surgeons Dr. Terry Myckatyn and Dr. Marissa Tenenbaum, your safety and satisfaction are their foremost concerns, and they can help you determine which procedure or combination of procedures would best achieve your individual goals.

Click here to view a video on liposuction.

Liposuction: What You Should Know

Anesthesia: Liposuction can be performed with the patient under local anesthesia in the office or under general anesthesia in the operating room.

Length of procedure: 1 to 5 hours, depending on the location and volume of fat to be removed.

Estimated recovery time: You can return to work after 2 to 14 days, depending on the volume of fat removed. You should avoid vigorous activities for 1 to 3 weeks. Visible bruising or swelling should clear up within 7 to 10 days. To learn how to prepare for tumescent liposuction and what to expect afterward, click here to download our patient instructions for liposuction.

Side effects: Common side effects include bruising, swelling, tiny well-hidden scars, and some numbness and itching in the treated areas. Click here to download a detailed consent form from the American Society of Plastic Surgeons that lists the risks and benefits of liposuction.

To view before-and-after photos of liposuction results, click here.

Dr. Terry Myckatyn, MD and Dr. Marissa Tenenbaum, MD

Dr. Terry Myckatyn and
Dr. Marissa Tenenbaum:

Trusted. Experienced. Committed.

Procedures Associated With Liposuction

Liposuction is an excellent complementary piece that can be combined with several other cosmetic procedures at West County Plastic Surgeons. These include:

Abdominoplasty (tummy tuck). Frequently, patients who want to improve the contour of their abdomen debate between liposuction and an abdominoplasty (tummy tuck). Some people can be candidates for either procedure, depending on their goals and the state of their belly. An abdominoplasty is best for people with loose skin and lack of abdominal muscle tone—especially those who have undergone significant weight loss. Women who are dissatisfied with their shape after having had children and are looking for a so-called "Mommy Makeover" tend to make excellent candidates. For these people, the abdominoplasty can be an ideal procedure for contouring the abdomen. These changes are complemented by surgical fat reduction of the sides, bra strap roll region, and the thighs.

Short-scar facelift surgery. This procedure can be performed with the patient awake in the office or under general anesthesia and is designed to rejuvenate loose tissues in the lower two thirds of the face, from the jawline to the upper cheek. Combined with liposuction of the neck, these procedures can effectively rejuvenate the neck and face without the patient undergoing a standard facelift.

Fat grafting. The fat that is removed during a liposuction procedure can be re-injected to replace lost volume in the face, including the lower cheekbone area, the folds between the cheeks and the upper lips, and between the jowl and the chin. The fat can also be used to correct other depressions or divots from previous surgery or injury. Only certain techniques can be used for this procedure, since the fat cells have to be whole—as in fully intact and alive—in order to function properly once grafted.

Buttock augmentation with fat grafting. Fat carefully removed during liposuction can be re-injected into the buttock area to provide more projection and volume for individuals who are dissatisfied with their current buttock shape and size.

Nonsurgical Alternatives to Liposuction

Some people are not quite ready for liposuction surgery, and are fine with the more gradual and subtle results available from nonsurgical fat-reduction options. CoolSculpting® is an FDA-approved treatment that uses a cooling device to drop the temperate of fat cells to damaging levels, which signals the body to break them down and clear them from the area. The process is known as cryolipolysis. A variety of applicators is available for use in different regions of the body.

Kybella® is an injectable approved by the FDA specifically for double chin reduction. This treatment uses a dietary acid-based formula to break down fat cells in much the same way the body does during the digestive process. Fat cell death and removal, known as apoptosis, gradually reduces the volume of the treated area.

The results of nonsurgical fat-reduction treatments appear on a scale of months, as opposed to liposuction results, which are visible as soon as the fat is surgically removed. Each patient should make a bodycontouring decision based on how dramatic the desired results are, the expected recovery and results timeline, cost, and other factors that can be discussed at a consultation.

The West County Plastic Surgeons team wants each person to love the results of their procedure or treatment, no matter the method. Learn about the unique benefits of each available option from a trained and experienced surgeon committed to beautiful results.


If you have questions or would like to book a consultation with one of the surgeons at West County Plastic Surgery, please call (314) 996-8800.

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