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There are several different forms of liposuction: please read the Table of Comparisons. Please note that the wet method is just a modification of the original Klein Tumescent liposuction. Notice the usual specialists that practice what they choose to call "the wet method." PLEASE REMEMBER THAT THE "WET METHOD" IS NOT THE SAME AS TUMESCENT LIPOSUCTION. The tumescent technique utilizes large volumes of natural saline (lightly salted water) solution, containing a precise amounts of a very dilute local anesthetic (specifically and only lidocaine), and adrenaline, which is dispersed into the fatty tissue. The injected area then becomes locally anesthetized—"numbed." Unfortunately, there may be some discomfort during the initial process of injection. With the tumescent technique, liposuction patients usually need no general anesthesia, as contrasted with the traditional/standard liposuction methods, which do require general anesthesia. However, some patients choosing to undergo the tumescent technique may require intravenous sedation ("twilight"). In fact, many patients receive only minor sedation to help them relax and then they remain completely conscious and comfortable during the suctioning portion of tumescent liposuction surgery. After true tumescent liposuction surgery, many patients may get up and walk out of the office without assistance. Most patients are usually back to their regular routine in a couple of days. With the tumescent technique, postoperative (after surgery) discomfort is usually significantly reduced, since the local anesthesia remains in the treated tissue, usually causing numbness that may last for sixteen hours or more after surgery. Patients frequently require only Extra Strength Tylenol® or Tylenol® with Codeine to control the relatively minor discomfort that may occur after liposuction surgery performed using the tumescent technique. The tumescent technique allows for the use of much smaller cannula (or tubes) to remove the fat. Bleeding and bruising is also minimized as a result of the special, yet well-published, combination of ingredients. It is not commonly known that liposuction surgery works by two mechanisms. When liposuction is performed, the cannula is passed through the fat to create "Swiss-cheese–like tunnels." Obviously, fat cells are removed from the body. However, in addition, the motion of the cannula damages many of the remaining fat and other fibrous cells. These remaining damaged fat cells may take weeks to be absorbed or repaired by the body, a fact that plagues even some experienced surgeons. Failure to take this second fact into account has resulted in many cases of "over-suctioning," which causes large dents or scarred-down portions in the patient's skin. A key factor in liposuction results is the width of the surgeon’s cannulae (internal suction probes). Wider and bigger cannulae appeal to many surgeons' schedules, since they can remove more fat in less time. Although larger cannulae may provide their surgeon with the advantage of saving time; however, they usually are a DISADVANTAGE to patients, especially to those who are not obese. Consider the following logic: the cannula moves through the fatty portion of the skin creating many tunnels, just like those found in Swiss cheese. When these tunnels eventually collapse, RIDGES are left behind. The bigger/wider the cannula, the bigger/wider the ridges, and therefore, the more noticeable are the ridges (which may be extremely obvious and disfiguring). Small cannulae usually make it more difficult to detect ridges and usually provide a more natural result. An important pitfall of the tumescent technique is that for complete comfort, many patients need sedation during the injection phase ("putting in" of the Klein solution) of the surgery. The Klein solution may sting or burn temporarily when it is injected, thereby causing pain and discomfort. Beware of this concern — the author of this website, Dr. Weber believes that tumescent liposuction patients should always be given the option of having a board-certified anesthesiologist present to provide "twilight" sedation. In summary, the use of the original Klein tumescent technique in conjunction with smaller cannulae is known to produce smoother results (following liposuction for even large areas of fat), to minimize bruising and bleeding, and to provide a more rapid recovery, all while using local anesthetic as the major source of pain/discomfort control.
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