Introduction
Since the turn of the millennium in particular, cosmetic surgery has experienced an unstoppable boom. In 2014, the number of cosmetic operations in Germany was around 287,000, in the USA as many as 1.5 million. The USA leads this statistic ahead of Brazil and South Korea, while Germany ranks 6th.
Increasingly better methods and more cost-effective offers are tempting many patients – and in recent years more and more patients as well – to have a minor correction of their body. One of the most popular methods is liposuction, which is supposed to remove unwanted fat deposits. Liposuction operations are not new and were first performed in the 1950s.
While back then the operations led to amputation of the leg and injury to various internal organs, the technique is relatively sophisticated today, and when used correctly, it is quite safe. The most common liposuction procedure currently used is the so-called tumescent technique. The tumescent technique derives its somewhat complicated name from the Latin “tumescere”, meaning to swell or inflate.
This is due to the nature of the technique. At the beginning of the liposuction, the patient is injected 0.5 to 1 liter of liquid mixture into the fat areas to be suctioned. The mixture contains, among other things, sterile water, sodium carbonate, cortisone, and an anesthetic – i.e. narcotics.
The purpose of this procedure is to make it easier to remove the fatty tissue from the subcutaneous connective tissue. After all, the connective tissue is something like the framework of the skin and subcutaneous tissue. After half an hour to an hour of application, the anesthetic has taken effect and the patient no longer feels the need to proceed.
On the other hand, a kind of emulsion has now formed from the solution and fatty tissue, which can be removed much more easily by suction. Suction cannulas are now inserted into the fatty tissue. They usually have a diameter of 3-8 millimeters, or 1-2.5 mm when microcannulas are used.
The latter make the procedure somewhat more complex, since the smaller cannulae allow less rapid and more suction. However, in certain areas where only a small amount of fatty tissue is to be removed, the use of such small cannulas is definitely sensible. In no case, however, is it to be feared that the effect of the anesthetic will diminish and pain will be felt due to the longer duration of the procedure.
With the tumor technique, the anesthesia lasts up to 18 hours if performed correctly, which is enough time for the surgeon to perform the procedure. The long anesthetic time does not result from the supposedly high dose of anesthetic. Rather, as in real life, fat cells react very slowly to changes and therefore store anesthetics for a long time before they are released – a circumstance that has caused many anesthetists headaches during general anesthesia. When performed correctly, the tumescent technique is a very safe and complication-free procedure for liposuction, and has now established itself as the gold standard.
