What Lipo? -- Tumescent, Dry, Wet, Super Wet, PAL

• Wednesday October 25, 2006 | Posted in: Plastic Surgery Procedures

  There are various techniques for doing liposuction. Some techniques are now longer considered safe (Dry Technique), and some are recognized as worldwide standards of care (Tumescent Technique).

  Read on to check what all this famous “suction” is all about:  

  Tumescent Liposuction
  The word "tumescent" means swollen and firm. By injecting a large volume of very dilute lidocaine (local anesthetic) and epinephrine (capillary constrictor) into subcutaneous fat, the targeted tissue becomes swollen and firm, or tumescent. The tumescent technique is a method that provides local anesthesia to large volumes of subcutaneous fat and thus permits liposuction totally by local anesthesia.

  The tumescent technique eliminates both the need for general anesthesia and need for IV narcotics and sedatives. The tumescent technique for liposuction 1) provides local anesthesia, 2) constricts capillaries and prevents surgical blood loss 3) provides fluid to the body by subcutaneous injection so that no IV fluids are needed.

  Dry Technique
  Dry Technique Dry Technique (no longer used) required general anesthesia. The dry technique derived its name from the fact that it did not use injections of local anesthesia into the fat before liposuction. This technique was abandoned because of the excessive blood loss it caused.  Blood composed approximately thirty percent (30%) of the tissue that was removed by liposuction using the dry technique.

  Wet Technique
  Wet Technique also required general anesthesia. The wet technique required the injection of approximately 100 milliliters of local anesthesia containing epinephrine. Although the wet technique caused less blood loss than the dry technique, blood loss with the wet technique was still excessive and dangerous. Blood composed approximately 15% to 20% of the tissue removed by liposuction using the wet technique.

  Super Wet Technique
  Super Wet Technique also requires general anesthesia. The super wet technique requires the injection of a volume of dilute local anesthesia that is less than half the volume used for the tumescent technique. Surgical blood loss with the super wet technique is greater than the tumescent technique but significantly less than the wet technique. Approximately eight percent (8%) of the fluid removed by super wet liposuction is blood.

  Power Assisted Technique (PAL)
  Power Assisted Liposuction (PAL) devices have recently become available. PAL devices use power supplied by an electric motor or compressed air to produce either a rapid in-and-out movement or a spinning rotation of an attached liposuction cannula. Advocates of PAL assert that it makes liposuction easier for the surgeon.

  While some liposuction surgeons have expressed enthusiasm about PAL, many others remain skeptical about any advantages of PAL. There are no objective scientific publications to support the enthusiastic claims made by manufacturers of PAL devices.

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