Tumescence technique


Cosmetic surgery has experienced an unstoppable boom, especially since the turn of the millennium. The number of cosmetic surgeries in Germany in 2014 was around 287,000, and in the USA it was as much as 1.5 million. The USA leads this statistic ahead of Brazil and South Korea, while Germany ranks 6th. Ever better methods and ever cheaper offers entice many patients - and for some years now more and more patients - to make minor corrections to their bodies. One of the most popular is liposuction, which is supposed to make annoying love handles disappear. Liposuction operations are not new, and were first performed in the 1950s. While the operations back then still led, among other things, to a leg amputation and damage to various internal organs, the technology is now relatively sophisticated and, if used correctly, quite safe. The currently most common liposuction procedure is the so-called tumescent technique.


The tumescent technique is a method of liposuction

The tumescence technique derives its somewhat complicated name from the Latin "tumescere", which means to swell, or to inflate. This is due to the nature of the technique.

At the beginning of liposuction, the patient is injected with 0.5 to 1 liter of liquid mixture into the areas of fat to be suctioned off. The mixture contains, among other things, sterile water, sodium carbonate, cortisone, and an anesthetic - i.e. anesthetic. The purpose of this procedure is to be able to remove the fatty tissue better from the subcutaneous connective tissue later. It is firmly anchored there, after all, the connective tissue represents something like the scaffolding of the skin and subcutaneous tissue. After half an hour to a full hour of exposure, the anesthetic has developed its effect and the patient does not feel the further action at this point more. On the other hand, a kind of emulsion has now formed from the solution and fatty tissue, which can be suctioned off much more easily.

Now suction cannulas are pushed into the fatty tissue. As a rule, they have a diameter of 3-8 millimeters, or 1-2.5 mm when using microcannulas. The latter make the procedure a little more complex, as the smaller cannulas mean that suction can be performed less quickly and much. However, the use of such small cannulas makes sense in certain places where only a small amount of fatty tissue is to be removed.

In any case, however, there is no reason to fear that the longer the procedure will reduce the effectiveness of the anesthetic and result in pain. With the tumezence technique, if performed correctly, the anesthesia lasts up to 18 hours, which is enough time for the surgeon to perform the procedure. The long anesthetic time is not the result of the supposedly high dose of anesthetic. As in real life, fat cells react very slowly to changes and therefore store anesthetics for a particularly long time before they release them again - a fact that has given many anesthetists headaches during general anesthesia. When performed correctly, the tumescent technique is a very safe and complication-free procedure for liposuction and has meanwhile established itself as the gold standard.


After liposuction there is a follow-up treatment of at least 6 weeks necessary. During this time the patient must a Wear a support corset. This is necessary because the connective tissue has been damaged and the weight ratios in the treated area have been changed. A lack of follow-up treatment would result in unsightly dents and an inhomogeneous fat distribution pattern. The corset treatment can be omitted with the much gentler, but more complex and therefore more expensive microcannula technology. In both cases, after using the tumescence technique, it may be necessary toPuncture holes"Through which the instruments were inserted into the fatty tissue, to sew. However, the seams can usually be pulled again within 1 to 2 weeks. There may also be initial swelling and bruises, but these will also disappear after a week at the latest.


Like any other operation, the Tumezentechnik also carries a certain risk. In Germany, around 5 Deaths calculated on the basis of liposuction. However, this must be seen in relation to the number of interventions performed: 250,000 annually in Germany, and three quarters of a million annually in the USA. Every 50,000th operation ends fatally, which means a relatively low risk. The sheer number of interventions also gives a certain amount of experience. It is precisely this that should be taken into account when choosing the treating surgeon, since the number of interventions performed is the only measure by which a surgeon in this branch can be objectively measured. In Germany there are no further training regulations that make liposuction mandatory. So you will not checked in any specialist examination. The surgeon's experience is all the more crucial.


Liposuction is considered the gold standard when it comes to losing fat tissue quickly and in a targeted manner. With no other intervention method can fat tissue be lost as quickly as with the transcence technique.

However, there are other methods that should be considered for weight loss. First of all, it is not possible to lose weight on a specific part of the body. A widespread misconception, for example, is that you can burn belly fat through targeted abdominal muscle training. Fat burning occurs systemically when a calorie deficit is reached, but always follows human fat distribution patterns. Men usually gain weight on the stomach first (typical "beer belly"), women tend to gain weight on the buttocks and legs ("pear-shaped distribution pattern"). In the end, these are also the stubborn areas where the last bit of fat lingers. A healthy eating, with waiver of "processed food", and sufficient, daily exercise, are more useful than any weight loss tips in the world. However, this is of course the "hard" way that I don't want to raise at any time.

An alternative to the tumescent technique and natural weight loss is therefore the gastric band. Part of the stomach is constricted - the patient is full more quickly, eats less and quickly loses weight. Indeed this intervention is much more dangerous than the tumescent technique, expensive, and is only covered by the health insurance in exceptional cases. In addition, close medical follow-up care is necessary, since losing weight after Gastric band surgery contrary to popular opinion, is by no means a sure-fire success.


Various studies have shown that the body is careful to keep the total amount of fat the same. A removal of adipose tissue, for example by means of tumescence technique, caused the body in the studies to move the "lost" fatty tissue in other places within 12 weeks rebuild. Whether this trend continued after 12 weeks or was reversible was not investigated. However, it makes it clear that there is no panacea for combating unwanted fat deposits, and the only permanent measure for weight loss is a conscious lifestyle. Liposuction is not paid for by health insurances, or only in exceptional cases. Liposuction using the tumescent technique can cost up to € 2000, depending on the surgeon's experience and level of awareness. Of course, the region and the amount of tissue to be aspirated are also decisive.