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The tumescent technique utilizes large volumes of saline (physiologic salt solution) that contains dilute lidocaine (local anesthetic or "numbing" agent) in combination with epinephrine (adrenaline). Adrenaline temporarily constricts (closes) the capillaries. In addition, depending upon the pH (acidity), dilute sodium bicarbonate (baking soda) in the solution helps to minimize further the unpleasant stinging otherwise associated with the lidocaine and epinephrine. The Klein formula tumescent solution is injected into the fatty tissue through small, "numbed" slit incisions in the skin. Many of these slit incisions are made, when possible, in inconspicuous places. The tumescent fluid is injected under pressure, which causes the target fatty tissue to become firm and inflated (tumescent or "ballooned"). This ballooning allows the surgeon to later extract the fat in a more accurate and uniform fashion, thereby producing smoother results. The anesthetic and other agents in the tumescent solution should be allowed sufficient time to diffuse (percolate) and take full effect throughout the fatty tissue. The solution will numb the areas as well as reduce bleeding by temporarily closing down capillaries. Constricting the capillaries is important to reduce bleeding during and after surgery. Less bleeding means less bruising. Not only does this make the surgery safer, it also speeds up recovery. As a result, most patients can return to work or their regular routines in a couple of days. The tumescent technique is useful and helpful in virtually all liposuction cases but is especially well suited to office surgery. This is because allowing the tumescent solution the time to diffuse (percolate) and take effect throughout the target fat is paramount! Any patient should readily see why hospital-based plastic surgeons may not use the tumescent method. Time is money. Only one case can be performed in the hospital operating room at a time. Hospital operating rooms cost much money to run because of expensive maintenance and equipment and numerous personnel. Surgeons who wait for solutions to percolate and take full effect (usually 30–60 minutes extra) may not do as well financially as those who choose to use the "wet method" or another "dry method". Performance of a procedure in a properly equipped office surgical suite allows the staff and doctor to handle other tasks while solutions percolate. Patience is a virtue in the case of Klein solution diffusion. Surgeons who are able to take the necessary time in a surgicenter or hospital-based setting can have equivalent results with the tumescent method. The tumescent method provides for the highest safety levels possible in liposuction. Klein has thoroughly studied the formula he invented and developed. Klein has quite correctly pointed out that certain medications change the way the body handles the medicines you are taking or have taken. Here is a list of medicines that may be important if you are about to have tumescent liposuction (remember that the list grows larger every month and that new drugs may be added to the list as well):
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