Liposuction and Tumescent Surgery

In 2006, Hunstad and Aitken discussed the evolution of liposuction, emphasizing the tumescent technique developed by Klein in 1987, which involves injecting large volumes of saline, dilute epinephrine, and lidocaine to minimize blood loss and improve safety. They highlighted the importance of not exceeding 35 mg/kg of lidocaine and careful monitoring of fluid intake and output. The technique's broad application, including in breast reduction and hair restoration, was noted due to its vasoconstrictive effects. The authors also described a method for estimating the volume of fat to be removed by comparing subcutaneous fat to a 60-cc syringe, recommending the infusion of 100 mL to 200 mL of tumescent fluid for each estimated volume. The use of a CO₂ pressurized system for infiltration and the importance of monitoring volumes and clinical status were emphasized to prevent complications. The document concluded that tumescent surgery is effective and safe for various aesthetic procedures when guidelines are followed.