Liposuction, tumescent

The surgical suctioning of fat deposits from specific parts of the body, the most common being the abdomen (the "tummy"), buttocks ("behind"), hips, thighs and knees, chin, upper arms, back, and calves after pumping several quarts/liters of a salt water solution underneath the skin of the area to be suctioned. Tumescent liposuction is the most common cosmetic operation in the U. S. with over 400,000 such surgical operations done annually. Liposuction breaks up and "sucks" fat out of the body. This is done through a cannula (a hollow instrument) inserted subdermally (under the skin). A strong vacuum is applied to the cannula. The technique of tumescent liposuction has become especially popular, in part because of its purported safety. It involves pumping several quarts/liters of a solution below the skin (subcutaneously) in the area to be suctioned. The solution is saline (salt water) to which has been added the local anesthetic lidocaine to numb the area and the vessel-constrictor epinephrine (adrenaline) to help minimize bleeding. The fat is suctioned out through microcannulas (small suction tubes). Tumescent liposuction is now the most used form of liposuction. Tumescent liposuction can be fatal. This may be, it has been suggested, because of the toxicity of lidocaine or drug interactions related to lidocaine (N Engl J Med 1999;340:1471-5).