Abdomen - Words that usually mean the same thing regarding external appearance (looks) in liposuction are belly, and tummy. Medically speaking the words gut and stomach really do not mean the same thing and represent the tubed-organs of digestion. It is best not to use the words gut and stomach to mean tummy, belly or abdomen.

Abdominoplasty - abdomen (tummy) + plasty (to change, shape or mole). See tummy tuck.

Anesthesia - loss of feeling or sensation (numbness), with or without loss of consciousness (Webster's Collegiate Dictionary). Usually implied is the loss of sensation of pain. Various types of anesthesia include general anesthesia and local anesthesia.

Anesthetic - chemical that causes anesthesia (loss of sensation, numbness).

Anesthetist - literally means one who administers an anesthetic. An anesthetist can be a nurse anesthetist (see CRNA) or an anesthesiologist (see).

Anesthesiologist - a special physician, who has extensive medical school and hospital training in giving anesthesia. An anesthesiologist is usually medical doctor (M.D.) who completed college, 4 years of medical school and 3 years of anesthesia residency. The best anesthesiologists are usually board certified by the American Board of Anesthesiology.

Artery - Blood vessel through which blood flows away from the heart to the capillaries, where oxygen is released from the red blood cells for use by the body.

Aspirate - can be used as a verb or a noun in relation to liposuction. v. To suction something (fat and fluids in the case of liposuction). n. The material (fat and fluids) that has been suctioned from the body and has passed into the cannula, hose or collection apparatus.

Aspirator - the suction machine that creates the vacuum that draws the fat into the cannula. The aspirator is usually an electrical pump with filters and usually contains collection bottles, bags or containers into which the fat and any suctioned material (aspirate) accumulates and settles.

Board Certified - Having passed a test given by a "board" of "authoritative" individuals. Some board-certification exams test only a doctor’s memory on paper or by computer. Some tests are oral (verbal questions and answers) and some tests are physical, in which examiners observe the doctor being tested, and involve treatment or examination of a patient. Board examinations also provide the ability to restrict the practice of a certain portion of medicine to doctors who "studied" to perform that particular branch of medicine and are "qualified" to do so. Unfortunately, these boards may be used as tools to restrain trade or limit other specialists. Some college students could pass the board-certification examination for various medical and surgical specialties if given the proper books. It is difficult for board examinations to completely test the competency of the individual plastic surgeon to practice that particular branch of surgery/medicine. It is difficult for a board certification test to check all of the abilities of the surgeon to cut or sew because so extensive a test would have examiner bias. If enough doctors were to fail they might complain or sue to pass. The same examiner simply cannot test all the applicants at one time under equal conditions to remove the bias of his/her individual prejudice. This explains the need for computer-graded, multiple-choice questions to determine who becomes your doctor. The same problems occur in the boards of dermatology and all other branches of medicine. Most importantly, how does one test for ethics.

Cannula - the hand-held instrument that is moved by the surgeon partly inside the patient to remove fat. Cannulas may be partly or completely made of metal or plastic. The cannula is usually described in three parts including the tip, shaft and handle. The tip of the cannula usually has holes in some type of pattern into which the fat first passes when suctioned. The shaft lies between the tip and the handle. The shaft is usually long and straight. Suctioned fat passes from the cannula tip through the shaft and handle and into the hose. The surgeon holds the handle portion of the cannula. The suction hose usually exits the cannula handle on its way to the aspirator (suction machine).

Cellulite - common term that describes the soft undulating non-scarring inpocketings in skin that usually occur on the thighs and buttocks. Cellulite is likely caused by a tethering of the fibrous connections from the deep fat and fascia attaching to the underside of the dermis (leather layer of the skin). The tethering may be possibly the result of tightening of the tethers (connections) or an enlargement of the nearby fat pouching out around the relatively constant tethers. Cellulite may or may not be improved, and may even be made worse, by liposuction. Endodermologie may help but the effect is usually temporary.

Certified Registered Nurse Anesthetist (CRNA) - a registered nurse, specially trained in anesthesia who has been certified by completion of special training (including hospital) and an examination. CRNA's have not gone to medical school and do not have the same length of training that anesthesiologists do.

Complication (surgical) - any problem that can arise during, or after, surgery. Complications can be transient (short-lived) or permanent. They can be minor or serious. They can be obvious or hidden. Doctors speak of complications in terms of the risk of having that complication. Risk is usually given as a percentage of chance of that problem happening at that time.

Computer imaging - the use of a computer to give the patient an idea of how they might look following liposuction. The use of these devices may be misleading because for example the computer works from a photograph made from a visible light image. However, visible light cannot detect how much muscle lies under the fat or how far the hip bone protrudes under the skin. The simple digital "shaving down" of a digital image is not nearly as informative to a patient as a simple properly performed physical examination showing the exact amount of fat that can be removed in a given area. The special physical examination is a method used by the website author to in minutes to demonstrate to patients the depth of fat able to be suctioned.

Cosmetic Surgery - (See also plastic surgery) Cosmetic surgery is a branch of plastic surgery which means to change, mold or shape, but only for the purposes of enhancing beauty. Cosmetic surgery is not confined to one specialty and is practiced by many different branches of medicine including Ear, Nose and Throat Surgeons, General Surgeons, Dermatologists, Ophthalmologists, Oculoplastic (a branch of Ophthalmology) Surgeons and Plastic Surgeons (common, usual variety). There are good and bad doctors in all specialties and thorough research on the part of the patient regarding the approach of several specialists to their problem may be well rewarded in the end. Furthermore, not all doctors who are good at one type of cosmetic procedure are good at another. How many times have you heard patients say the face-lift came out good but my eyes came out terribly? For example, not all board-certified plastic surgeons that perform good face-lifts perform good eye-jobs (blepharoplasty). In fact before liposuction, blepharoplasty was the common cause of a lawsuit against board-certified plastic surgeons (who usually train on only several patients during their short TWO-year training period). Perhaps the best approach for many patients is to have the face-lift performed by the plastic surgeon or ENT surgeon and the blepharoplasty performed by an Oculoplastic Surgeon after the patient reviews before and after results for each doctor.

Dermatologic Surgery (Surgeon) - a branch of dermatology in which the doctors are not only trained in dermatology (skin cancers, skin cancer surgery, skin healing, wound healing, etc) but also in dermatologic surgery which encompasses surgery taking place between and including the epidermis, dermis and subcutaneous fat. Tumescent liposuction, now accepted as the safest and most effective form of liposucton by all surgical specialists (including plastic surgeons), was invented and developed by dermatologic surgeons.

Dermatologist - a medical specialist of the skin (see skin, see specialists).

Dermis - The layer of the skin that lies just below the epidermis on most of the body. It is largely made up of collagen (fibrous or connective) tissue. The dermis, as a layer, makes up the bulk of the skin and is usually thickest on the back and the back of the neck. The dermis may best be thought of as the "leather layer" of the skin. The dermis protects the body from mechanical injury, binds water, stores water, maintains temperature and carries nerves to detect sensation and feeling. Blood vessels, lymph vessels, nerves, sweat glands, oil glands, hair follicles, hair erecting muscles, and other structures reside in or course through the dermis.

Dry Method - Oldest and most antiquated type of liposuction technique. The dry method of liposuction first type performed at the birth of the procedure and saw use in the early years. Dry implies that NO fluids are first pumped into the tissues about to endure the liposuction. The dry method was usually performed under general anesthesia since there was little pain control (as compared to the great pain control of today's tumescent method) because no fluids were pumped into the target fat. The dry method usually meant more bleeding into the suctioned areas and blood loss. Therefore transfusions were common with this method. Patients could not move for many days after the liposuction due to pain and blood loss or unwanted blood collections. Immobility lead to blood clots in the legs which could then break loose in the blood stream and travel to the lungs causing pulmonary embolism, a life-threatening condition. Amazingly, some plastic surgeons still practice the "dry method" of liposuction.

With the "dry method" the amount of non-fatty fluid (infranatant) removed in the aspirate is usually much less than with the tumescent method less than with the "wet method." With the "dry method" the relative amount of blood removed in the aspirate is usually greater than with the "wet method" and much greater than the amount of blood removed in the tumescent method. With the "dry method" the amount of fluid leakage following surgery is usually much less than with the tumescent method and less than with the "wet method."

Ear, Nose and Throat Surgeon - also known as an otolaryngologist (see specialists). ENT surgery is a branch of surgery. Many of these doctors are certified by the American Board of Otolaryngology and are members of the American Academy of Facial Plastic and Reconstructive Surgery

Endodermologie - a non-surgical vacuuming technique developed by a French man who was disabled. A vacuum with rollers as edges allows the technician to roll the vacuum over most parts of the outer skin that are not too curved. The technique is comfortable and is usually performed at least twice to three times a week. The effects are mostly temporary. No fat is removed and you should not lose any weight as a result of endodermologie alone. The technique is not invasive. The effect is to gently pull on the surface of the skin. The vacuum likely pulls on the tethers and loosens or stretches them. If you are one of the fortunate patients to have a good result, you will likely need to keep returning for endodermologie treatments forever in order to maintain it.

Entrance wound - the cut (incision) made in the skin (usually by scalpel = sharp exact knife) that is usually just large enough to fit a cannula (suction pipe). Any time the epidermis and dermis are violated, a scar must result. To get to the fat, the dermis must be completely violated by the entrance wound. Therefore, the entrance wound will form a scar and may possibly pigment. The degree to which the wounds will scar depends largely on cannula size (width), friction and whether or not the wounds are sewn. Large (wider) cannulas, and much friction causes more noticeable scarring and pigment (color, usually dark).

Epidermis - The outermost layer of the skin. The epidermis contains no nerves or blood vessels, so the epidermis alone is incapable of sensation or bleeding. Composed of a protective outer layer of nonliving keratin-derived scale cells, the epidermis acts as an envelope or seal against the environment and exerts some control on the amount of moisture lost to the environment. The epidermis contains keratinocytes (cells that make keratin) and melanocytes (cells that make pigment), as well as other specialized cells.

Epidural - a form of spinal anesthesia in which an injection of anesthetic is placed by an anesthesiologist or anesthetist into the area just around the spinal cord at a low level and is customarily used for deliveries of babies or surgery on the legs or lower abdomen.

Fat - When referring to the skin only, fat is stored in cells and usually makes up the bulk of the subcutaneous layer. This is the only layer in which liposuction takes place. However, it is interesting that there are many locations for body fat that are not part of the skin, including omental fat around the intestines, fat in the eyesockets, fat inside bone, etc. Fat is composed of triglycerides, which can take on the form of oil, lipid or lard, depending on the temperature, when removed from the body. Fat is a highly concentrated energy source well suited to helping our distant ancestors cope with starvation. Some fat deposits are genetically determined. There are two major deposits of almost pure fat: the subcutaneous fat and the omental fat. Both of these can almost naturally vanish with starvation, a condition which is unhealthy.

General Anesthesia - a state of unconsciousness produced by anesthetic agents with absence of pain sensation over the entire body and a greater or lesser degree of muscular relaxation; the drugs producing this state can be administered by inhalation (through the lungs), intravenously (through the veins), intramuscularly (injected into the muscle), rectally or through the gastrointestinal tract (through the intestines). The risk of a problem is slight but higher than with sedation which is higher than with local anesthesia (tumescent method numbing only).

Problem risk (overall not high) but:

General>sedation>local anesthesia (straight tumescent method only)

Gynecologist - also called obstetrics and gynecology. A gynecologist, Georgio Fischer, invented liposucton. Obstetrics regards the field of birthing and the study of it. Gynecology is the study and treatment of the female reproductive organs and areas.

Hydroliposculpture - a type of liposuction developed by the website author which is a compilation of layering of the water-based tumescent solution into which is placed low-diameter, longer cannulas so as to take advantage of easier and more accurate penetration and effects of the specialized instruments within the fluid-laden tissues.

Infiltrating needle - a small, thin, rounded, usually blunt (but sometimes sharp) needle used to place the tumescent solution into the target fat in order to swell the tissues before tumescent liposuction.

Infranatant - Infra means below or bottom. Infranatant refers to the layer of water-fluid and blood that sinks to the bottom of the liposuction collection canister (which usually sits on or next to the aspirator). Regarding liposuction, infranatant refers to sinking water-based fluids as opposed to the supranatant (oil and fat) which rises to the top because it is less dense. Water-based fluids and blood (which sink) because they are more dense than oil and fat (which float).

In-patient - a patient whose surgery is performed in a hospital or hospital associated surgicenter with the intention to spend at least the night after surgery in the hospital.

Insured Benefit - The payment by an insurance company for a covered procedure or examination. In these days of managed care and treatment, insurance companies have deliberately contrived gray zones regarding coverage of both diseases and treatments. Different insurance companies and, in many instances, different policies/plans issued by the same insurance company, vary tremendously in approving a given treatment. Currently, in America, difficult battles have been required in order to obtain coverage for many legitimate, truly necessary procedures. There are some instances in which liposuction could be covered by insurance depending upon the policy. If a patient is unsure of the insurability of their condition, it is best to ask the surgeon or approach the insurance company requesting a response in writing from the company.

Klein (Tumescent) Solution and Method - a special formula of sterile dilute salt water, adrenaline (natural simple human hormone that reduces bleeding), lidocaine (a numbing medicine that also is a heart medicine) and bicarbonate (to reduce the acidity of the IV which reduces discomfort). Not only is the formula special, but the formula was specially developed by Klein to balloon the target fat to a very large degree allowing easier penetration of the cannulas which reduces trauma to the fat. Bleeding, pain and complications are therefore reduced. These factors make the tumescent approach different from the "wet method". The Klein method (as used in this website) is the use of the Klein Solution together with tumescing (ballooning) the target fatty tissues.

Mega-session = mega-liposuction - "Mega" means giant. A mega-liposuction that is a liposuction that will remove many times the average amount of fat removed in a single surgery from a patient. Many doctors like to use the word when removing 8 or 10 liters of fat or more. By definition and by nature, "mega" sessions will almost always be performed on obese (severely overweight) patients. It is presently (1999) a relatively risky procedure. Maybe there will be some tremendous advance that will reduce these risks in the future.

Nurse Anesthetist - A nurse that is specially trained to anesthetize patients including general anesthesia and local anesthesia (see CRNA).

Large Volume Liposuction - volume or weight are used to measure the amount of fat removed. Different hospitals, states and authorities have different cut-off values for what constitutes a large volume of fat. Most will agree that 10 liters of fat or more is large volume liposuction.

Lipo - root word meaning "fat".

Lipoplasty - a euphemism (fancy term) for liposuction.

Liposuction - literally means sucking fat to remove it. The procedure is performed by cannulas through entrance wounds in the patient's skin. Fat is sucked through the cannulas into a container by the power of a vacuum pump (aspirator).

Liposculpture - a euphemism (fancy term) for liposuction which implies that the surgeon is acting as a sculptor. Of course, all surgeons performing liposuction are really also performing (or should be) sculpture (which is really art in 3-D). Therefore, the term is really a neologism (new term) that is a euphemism (nice or fancy way to say something).

Local Anesthesia - numbing confined to one part of the body. Local anesthetics percolate into nerves and prevent them from sending or transmitting their usual signals of pain or sensation in the case of "sensing nerves". The area injected that the nerve(s) passing through serve are "numbed" or "deadened". In the case of liposuction, local anesthesia (given by needle or probe) is used to numb the entrance wounds and makes-up a large part of the Klein tumescent solution. One might correctly say that having the tumescent method performed straight (without sedation or general anesthesia) is the same as having liposuction done totally by local anesthesia. In properly selected patients, the risk of a problem is extremely slight and lower than with sedation which is also lower than with general anesthesia. However, this may not be the case in many patients because before local anesthetics can numb an area the nerves "fire off" one last time which may be felt as pain or stinging. In patients with a low pain threshold, known or unknown heart disease, or nervousness (among many other common conditions) using straight tumescent or local anesthesia only can cause problems and lead to a less than optimum result. It is therefore usually advisable to offer patients the option of having an anesthesiologist or CRNA present for the liposuction, which does not mean that any drugs have to be given. Sedating drugs could then be given if requested by the patient to reduce the pain of the initial local anesthesia or Klein tumescent solution.

Problem risk (overall not high) but:

General>sedation>local anesthesia (straight tumescent method only)

Out-patient - a patient whose surgery is performed in a doctor's office or surgicenter with no intention to spend at least the night after surgery in the hospital.

Omentum and omental fat - Deep in the abdomen and protected by a muscle wall the bowel sits in a soft "cushiony" fatty layer called the omentum. The omental fat currently cannot be safely suctioned without risking severe life-threatening bowel problems. The omentum fat can become gigantic. It stores fat and calories as well as surrounds, protects and encases the all-important human bowel.

Physical Examination - to examine the physical nature of a patient, usually by sight and by hand. Regarding liposuction, a properly performed physical examination can showing the exact amount of fat that can be removed in a given area. A special physical examination method is used by the website author to demonstrate in minutes to patients the depth of fat able to be suctioned.

Plastic surgeon - See also Board certified and Plastic surgery. A doctor who will surgically change, mold or shape a portion of a human being. A plastic surgeon rarely uses plastic. Plastic surgery is practiced by many different branches of medicine including Ear, Nose and Throat Surgeons, General Surgeons, Dermatologists, Ophthalmologists, Oculoplastic (a branch of Ophthalmology) Surgeons and Plastic Surgeons (common, usual variety). Board certification of a Plastic and Reconstructive Surgeon means that an individual has passed a test given by a "board" of "authoritative" individuals. Some board-certification tests may examine only memory by a paper test or computer exam, some tests are oral and some tests are physical, involving the doctor's treatment or examination of a patient. Board examinations in plastic surgery were originally meant to restrict the practice of a certain portion of medicine to doctors who are qualified and have studied to perform plastic surgery. Unfortunately, these boards may be used as tools to restrain trade or limit other specialists. Some college students could pass the board-certification examination for various medical and surgical specialties if given the proper books. Two Board Certified Plastic Surgeons in Florida, who had obviously passed the board exam, had their practice of medicine and surgery restricted within three months of each other as punishment for unnecessarily harming or killing their patients. It is extremely difficult for board exam to completely test the abilities of the surgeon to cut or sew because so extensive a test would have examiner bias, and if enough doctors were to fail, they might complain or sue to pass. The same examiner simply cannot test all the applicants at one time under equal conditions to remove the bias of his/her individual prejudice. This explains the need for computer-graded, multiple-choice questions to determine who becomes your doctor. Moral: research and re-research your "plastic surgeon."

Plastic surgery - Surgery to change, mold or shape. It rarely has anything to do with the use of plastic. Plastic surgery is not confined to one specialty and is practiced by many different branches of medicine including Ear, Nose and Throat Surgeons, General Surgeons, Dermatologists, Ophthalmologists, Oculoplastic (a branch of Ophthalmology) Surgeons and Plastic Surgeons (common, usual variety). Plastic surgery is also used when doctors repair a defect. It should be performed in a meticulous and fine fashion by whatever type of doctor is doing the work. It was not until the year ..... that certain doctors felt that is would be desirable for them to break away as a group from other surgical specialties and form the American Society of Plastic and Reconstructive Surgeons with a TWO year training period (shorter than almost any other specialty). In the year ..... the American Board of Plastic and Reconstructive Surgery was formed by many of the same doctors and only allowed doctors who were "grandfathered-in" and doctors completing the TWO year training period just mentioned to sit the board. Unfortunately, passing a board examination does not guarantee that a doctor can cut a straight line with a scalpel or sew tissue with great accuracy or even remember the correct dosage of a drug to give. It is always best to see live results on many patients before selecting a cosmetic surgeon.

Risk - the chance something will go wrong during or after surgery (see complications). A risk is usually spoken of by surgeons in terms of percentage chance that a problem can happen.

Scar - Fibrous tissue, composed of collagen, formed by fibroblasts or other cells. Scars are usually the result of damage to the body and are readily visible on the skin. Collagen and scarring are the glue by which the human body heals wounds. Without the formation of deep scars, almost all skin wounds would split apart. Gland or surface tissue has little or no binding capability; therefore, scar tissue is important to all skin-surgery results. When sewing or closing wounds, the author prefers to create a deep, hidden, strong scar for permanent binding because the deep scar takes the pressure off the surface tissues. The surface scar can then be minimized by proper tension and stitch techniques. Any surgery or wounding of the skin results in some scar formation. The key to good surgical results is how easily the final scar can be seen or how well it is hidden in pre-existing wrinkle lines or natural anatomy lines.

Sedation - the production of a sedative (to reduce activity or excitement) effect; the act or process of calming. When referring to liposuction the term loosely implies the administration of a sedative/hypnotic drug however opiates and other medications are usually implied as well.

Skin - The largest organ of the body. Skin is composed of living and dead layers. The dead layers include the surface scale, outside hair and nail plate. The living layers include the epidermis, dermis, subcutaneous (fat, the area liposuction targets) and all of the structures found within those layers, including blood vessels, sweat glands, etc.

Specialists - A specialist (for our purposes) is a doctor who devotes him/herself to a special occupation or branch of learning (Webster). Most doctors performing liposuction belong to one of five principal specialties including (in alphabetical order): dermatology, ENT, general surgery, gynecology, plastic surgery. The American Board of Medical Specialties has a board for each of the specialties mentioned.

Specialty training:

Dermatologist - 1 year internal medicine, 3 years of dermatology and dermatologic surgery. Many dermatologic surgeons then take 1-2 years of a dermatologic surgery training.

General Surgery - 5 years of surgery, mostly internal on bowel etc.

ENT - 1 to 2 years of general surgery plus 3 years of ear, nose and throat surgery.

Gynecology - 1 year of general surgery plus 3 years of obstetric and gynecologic surgery.

Plastic Surgery - 5 years of general surgery (mostly bowel) and only 2 years of actual plastic surgery training.

Split-session liposuction - usually applies to liposuction in heavier or obese patients. As opposed to removing the available fat all in one day with a "mega" (giant) session (surgery), two or three smaller liposuctions are performed on separate days, usually a month or more apart to give the body time to heal and recuperate. Even when added together the risks are likely lower in split sessions when compared to a "mega".

Spinal Block - also known as an epidural when applied to the lower spine in order to numb the lower body.

Straight tumescent or straight local liposuction - the use and reliance upon, during liposuction, only upon local anesthetic for pain control. Although this practice may seem safe, a significant percentage of the public may not benefit from not having the option of an anesthetist, CRNA, or anesthesiologist available. Local anesthetic is numbing confined to one part of the body. Local anesthetics percolate into nerves and prevent them from sending or transmitting their usual signals of pain or sensation in the case of "sensing nerves". The area injected that the nerve(s) passing through serve are "numbed" or "deadened". In the case of liposuction, local anesthesia (given by needle or probe) is used to numb the entrance wounds and makes-up a large part of the Klein tumescent solution. One might correctly say that having the tumescent method performed straight (without sedation or general anesthesia) is the same as having liposuction done totally by local anesthesia. In properly selected patients, the risk of a problem is extremely slight and lower than with sedation which is also lower than with general anesthesia. However, this may not be the case in many patients because before local anesthetics can numb an area the nerves "fire off" one last time which may be felt as pain or stinging. In patients with a low pain threshold, known or unknown heart disease, or nervousness (among many other common conditions) using straight tumescent or local anesthesia only can cause problems and lead to a less than optimum result. It is therefore usually advisable to offer patients the option of having an anesthesiologist or CRNA present for the liposuction, which does not mean that any drugs have to be given. Sedating drugs could then be given if requested by the patient to reduce the pain of the initial local anesthesia or Klein tumescent solution.

Stitches - Most surgeons performing liposuction do not stitch (see section regarding). Stitching takes time. Stitches may be of many types and varying thickness. These factors greatly influence how good a stitching result will be. As well the surgeon's skill in placing the stitches is important. Stitches can be placed below the surface of the skin or in the surface of the skin as well as being placed in pairs or tightly or loosely. The website author has a special stitch that he believes improves entrance wounds by reducing the visibility from scarring or pigment changes.

Subcutaneous - Lying below or under the cutaneous (dermis, leather) tissue. This tissue is usually composed of fat cells and the structures that run through it, i.e., blood vessels, nerves, etc. Fat is a soft, shock-absorbing barrier that acts as a conduit for the nerves and blood vessels. As well, subcutaneous tissue is an energy-storage device. See Fat in the glossary. The sebaceous glands of the hair follicle arise in the subcutaneous layer and are in high concentration on the face and scalp. There are no sebaceous glands on the palms or soles.

Subcutaneous fat - (see subcutaneous) subcutaneous fat sits just below the skin's surface (or under the cutaneous = dermis = leathery tissues). This is as opposed to omental (deep abdominal) fat.

Supranatant - Supra means above or top. Supranatant refers to the layer of fat and oil that rises to the surface of the liposuction collection canister that usually sits on or next to the aspirator. Regarding liposuction, supranatant refers to floating fat or oil as opposed to the infranatant which sinks because it is more dense. Water-based fluids and blood (which sink) make up the infranatant and are more dense than oil and fat (which float).

Tumescent - means swollen or ballooned. In referring to liposuction the term tumescent refers to the ballooned look of the tissues just after large volumes of Klein solution fluids have been pumped into the target fat and just before (and sometimes during) the liposuction. See tumescent liposucton.

Tumescent Liposuction - now accepted as the safest and most effective form of liposucton by all surgical specialists (including plastic surgeons), was invented and developed by dermatologic surgeons. Tumescent liposuction implies use of the Klein tumescent solution in a fashion that greatly swells the target fat or tissues and enables passage of the liposuction instruments with less pain, trauma and bleeding.

Tumescent method - (also see Klein solution and method). With the tumescent method the amount of non-fatty fluid (infranatant) removed in the aspirate is usually greater than with the "wet method" and much greater than with the "dry method." With the tumescent method the relative amount of blood removed in the aspirate is usually less than with "wet method" and much less than with the "dry method". With the tumescent method the amount of fluid leakage following surgery is usually greater than with the "wet method" and much, much greater than the "dry method."

Tumescent Solution - see Klein solution and method.

Tummy - Words that usually mean the same thing regarding external appearance (looks) in liposuction are belly, and abdomen. Medically speaking the words gut and stomach really do not mean the same thing and represent the tubed-organs of digestion. It is best not to use the words gut and stomach to mean tummy, belly or abdomen.

Tummy Tuck - The surgery of the tummy tuck involves cutting and drawing together with stitches or staples at least one of the three following layers of the "tummy": skin, subcutaneous fat, and/or muscle. A tummy tuck that only involves skin and fat is defined here as a "surface tuck" and a tummy tuck that involves cutting and tightening the muscle (or its sheath or other associated components) is a "deep tuck."

Ultrasonic Liposuction - Ultrasonic literally means beyond a sound frequency that the human ear can hear. Ultrasonic liposuction is a form of liposuction in which high frequency vibrations created by an ultrasound generator shake a special liposuction cannula. The vibrating tip shakes fat cells from their attachments as well as breaks fat cells releasing fat and oil into the area surrounding the ultrasonic cannula tip into which they are sucked. The vibrating at the cannula tip causes heat that can damage nerves, vessels and organs if not properly controlled. Unfortunately, current methods to control the heat at the tips of ultrasonic cannulas are relatively crude and many patients have been injured using this method of liposucton as evidenced by lawsuits being filed.

Vacuum - the sucking force created by the aspirator as the aspirating machine removes air gas molecules from the hose and cannula. The vacuum draws fat cells and globules into the holes (ports) at the tip of the cannula.

Wet Method - The second oldest type of liposuction technique. The dry method of liposuction first type performed at the birth of the procedure and saw use in the early years. The wet method eventually took the place of the dry method. The wet method implies that fluids are first pumped into the tissues about to endure the liposuction. The wet method was performed under both general and local anesthesia. There was some pain control (but less effective when compared to the great pain control of today's tumescent method) since the fluids pumped into the target fat contained some adrenaline (small blood vessel constrictor to restrict bleeding) and lidocaine (a numbing medicine). The wet method helped to reduce bleeding into the suctioned areas and blood loss when compared with the dry method. Transfusions were reduced with this method as compared with the dry method. Patients could move after the liposuction better than with the dry method. The wet method does not imply the use of the special Klein Tumescent Solution and therefore is not as effective as the Klein Solution when used properly. The wet method also differs from the tumescent method in that the target fat is not filled-up with so much fluid that it becomes "tumesced" (ballooned, distorted with expansion). Plastic surgeons still widely practice the "wet method". With the "wet method" the amount of non-fatty fluid (infranatant) removed in the aspirate is usually less than with the tumescent method but greater than the "dry method." With the "wet method" the relative amount of blood removed in the aspirate is usually less than with the "dry method" but greater than the amount of blood removed in the tumescent method. With the "wet method" the amount of fluid leakage following surgery is usually less than with the tumescent method but greater than the "dry method."