Awake Liposuction (Tumescent Liposuction)

At Alouf Aesthetics we are proud to offer Tumescent Liposuction and Vaser Lipo®. 
With Tumescent Liposuction offered here at Alouf Aesthetics, patients are awake and do not have to be subjected to general anesthesia. Also, in our experience, there is minimal bruising from this procedure. In addition, patients can be back to work in 1-4 days.
The word tumescent means swollen and firm. Tumescent liposuction uses large volumes of a dilute solution of lidocaine, a local anesthetic, in combination with the vasoconstrictive drug epinephrine, which temporarily shrinks capillaries. This feature of constricting blood vessels results in very little blood loss during the procedure. Actually there is more blood lost during a routine blood draw during a physical exam than during the entire Tumescent Liposuction procedure. Minimal blood loss results in very little bruising. The lack of bruising results in decreased pain and a much quicker recovery time.
Tumescent Liposuction is a technique that permits liposuction totally by local anesthesia, avoiding general anesthesia.


Our staff shares our commitment toward helping you achieve your goals for self-improvement. Your consultation will be personal and private, or you can bring your spouse or friend if you wish.  
Localized accumulations of fat, are often inherited and frequently prove impossible to eliminate by exercise or diet. Liposuction can now be used to permanently remove these accumulations of fat.  

Body fat of an adult tends to increase gradually over the years. After the age of 30, an individual tends to add fat according to a genetically predetermined pattern. This fat distribution is often resistant to exercising and dieting. An example of a genetically predetermined fat distribution which is resistant to dieting and exercise is the fat that appears on the abdomen and hips of a woman after pregnancy.


For many people who have inherited excessive accumulations of fat, liposuction is the only realistic mean of changing the body’s silhouette. In effect, liposuction is equivalent to being able to focus the effects of dieting to specific areas of the body.  


The concept of liposuction is surprisingly simple. Liposuction is a surgical technique that improves the body’s contour by removing excess fat from fatty deposits located between the skin and muscle.


Liposuction involves the use of a small stainless steel tube, called a cannula. The cannula is connected to a very powerful suction pump and is inserted through small skin incisions. The removal of fat is accomplished as the suction and cannula creates tiny tunnels through the fatty layers. After surgery, these tiny tunnels collapse resulting in an improved body contour.
Fat cells that are removed by liposuction do not grow back. As long as the patient does not gain excessive amounts of weight, the new, more pleasing silhouette is permanent. A woman who always tends to put weight on her thighs and knees, will find that after liposuction, these areas are less likely than other areas to accumulate fat when she gains weight. In fact a number of patients have had liposuction and have subsequently gained weight. The areas originally treated by liposuction have maintained their new desirable silhouette, whereas areas not treated by liposuction have been the sites of new deposits of fat.  

The best candidates for liposuction are individuals in good health and have realistic expectations. There is not an age limit for patients who are “good candidates” for liposuction. Most of our patients have localized accumulations of fat.  It is important to emphasize that liposuction is not a treatment for general obesity. Liposuction surgery is not effective as a last resort for people who are unable to maintain a reasonable weight by dieting. However, an overweight person whose weight has been stable for many years and has certain problem areas of fat may be a candidate for liposuction.  


Liposuction surgery is a success when the patient is happy with the results. The doctor's goal is to achieve an optimal aesthetically appealing result rather than to maximize the amount of fat removed. The cosmetic success of liposuction relies on removing inches rather than pounds. For example, removing an amount of fat equivalent to a half-pound of weight from each outer thigh of a woman’s "saddlebag" area or from a man’s "love handle" areas would result in a dramatic change in silhouette, but would not significantly change the person’s weight.  


Although liposuction is not a relatively new form of cosmetic surgery, there have been several recent improvements in the technique. One of the most significant improvements has been the introduction of tumescent liposuction, developed by Jeffrey A. Klein, M.D. in 1985. It permits liposuction by local anesthesia instead of general anesthesia. Despite being developed about 20 years ago, it has taken some time to become popular in the medical field. This technique is now considered the safest form of liposuction for removing very large amounts of fat because there is virtually no blood loss. Not only has tumescent liposuction proven to be safer than the standard technique (ie. dry technique, wet technique) using general anesthesia but it also has proven to be less painful, has minimized post operative recovery time, and has produced optimal cosmetic results.


Tumescent liposuction was first presented by Dr. Klein in 1986 at the Second World Congress of Liposuction Surgery in Philadelphia. His article that first described the technique appeared in the American Journal of Cosmetic Surgery in 1987.  


As a result of the widespread capillary constriction caused by the epinephrine in the anesthetic solution, there is minimal bleeding during and after surgery. This is a major improvement in the liposuction technique compared to older methods.


Dr. Klein recently completed a study of large volume liposuction of 112 patients, each of whom had between 1,500 ml to 3,400ml (1.5 quarts to nearly 1 gallon) of fat removed using tumescent liposuction. None of these patients required a blood transfusion. In fact, the average patient lost approximately three teaspoons (15 ml) of blood. Tumescent liposuction is so effective at minimizing blood loss that the majority of patients with large volume liposuction lost less blood during the surgery than they do at the time of their routine pre-operative laboratory studies.


With tumescent liposuction, our patients have never required hospitalization, blood transfusion, nor have there been any serious infections or other serious complications.


Dr. Alouf’s philosophy is that safety comes first. Tumescent Liposuction meets effective standards in the cosmetic field. Dr. Alouf also believes in being prepared to handle any unexpected complications, while at the same time being well prepared and trained to take care of any potential emergency.  


As with any surgical procedure, liposuction is associated with certain common side-effects such as bruising, swelling, and temporary numbness. Although irregularities of the skin are possible following liposuction, this is minimized by using smaller (micro) cannulas. Since using micro cannulas, noticeable irregularities are less common.  Please note that more serious complications have been noted in the literature. 


Because of the slow resolution of post surgical swelling, the ultimate results following liposuction usually require 12 to 16 weeks to become fully apparent. Nevertheless, patients can usually see improvements within two to four weeks after surgery.


Although the results of liposuction can show drastic improvements, it is not realistic to expect perfection. Liposuction of the thighs, while improving the silhouette, does not necessarily eliminate the subtle “puckering” of the skin that is often referred to as “cellulite.” Tumescent liposuction does not reduce the degree of cellulite but it is unlikely to make it worse.  


Rare problems that can potentially occur with any surgical procedure include infections, bleeding, etc.., but tumescent liposuction minimizes these risks.  


Infections are extremely rare, regardless of the anesthetic technique. Although there have been reports in the medical literature of patients who have had serious infections following liposuction surgery, using the tumescent technique "reduces the risk of infection, Dr. Klein".  Also stated by Dr. Jeffrey Klein, "Tumescent Liposuction has the lowest infection rate of any surgery".   


Because tumescent liposuction uses very small cannulas, only tiny incisions are required.  The wounds heal on their own and most of these tiny incisions disappear spontaneously with time.


The degree of skin change after liposuction is the same as one would expect if it were possible to lose an equal amount of fat by dieting. Because the small cannulas simply make small tunnels through the fat, there remain multiple connections between the skin and the underlying tissue. These fibrous connections contract with the healing process and maintain the skin in its natural position.  However, one who loses extreme amounts of weight may have lots of extra skin left over and would not be a candidate for tumescent liposuction.

There is less bruising using local anesthesia for liposuction as compared to traditional liposuction (ie. dry technique, wet technique). There are two reasons for this significant decrease in bruising. First, there is minimal bleeding with tumescent liposuction and there is very little blood that remains beneath the skin after surgery to cause bruising.


The second reason for decreased bruising is that with tumescent liposuction there is a considerable amount of post-operative drainage consisting of a slightly blood tinged anesthetic solution.  The incision sites remain slightly open for two to three days after the surgery and permit more of the residual anesthetic solution and a minute amount of blood to drain out. This minimizes bruising and swelling and accelerates the rate of healing.
Dr. Alouf has had a diverse amount of training in Tumesent Liposuction. His training has taken him to Scottsdale, AZ, Los Angeles, CA, Boston, MA, Dallas, TX, Miami, FL, and to Rome, Italy where he has been personally trained and instructed by the Inventor of Liposuction (Dr. Georgio Fischer, Italy), the Inventor of the Syringe Technique in Liposuction (Dr. Pierre Fornier, France), and the inventor of the Tumescent Technique (Dr. Jeffrey Klein, California).

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