Liposuction is the surgical removal of subcutaneous adipose tissue using aspiration cannulas introduced through small skin incisions. Tumescent liposuction refers to the technique of infiltrating the subcutaneous compartment with dilute concentrations of lidocaine and epinephrine as described by Klein . By definition tumescent liposuction excludes the use of additional anesthetics that have a risk of suppressing the respiratory system. It is done completely under local anesthesia. Prior to development of the tumescent technique, excess adipose had been removed by a combination of en bloc resection with skin excision or curettage through small incisions. Today, liposuction may be performed in the outpatient setting under local tumescent anesthesia, which allows for the removal of large volumes of fat with minimal blood loss, low postoperative morbidity, and excellent cosmesis. It has been used to successfully treat undesired adipose tissue from nearly all body sites (Table 21.1), and it is also an effective treatment for noncosmetic adipose collections including lipomas, gynecomastia, and hyperhidrosis.
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