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Upon arriving at Dr. Al Rustom's Skin and Laser Clinic you
will be greeted and asked to re-sign your surgical-consent forms. You will then
be escorted to the operating room. Pre-operative photographs will be taken and
the areas on your body that are to be treated with liposuction are marked with a
felt-tip pen. Photos will be taken of the markings and you will discuss these
and the plan for the treatment with the doctor. It usually takes about 30
minutes after arrival before the surgery begins.
Next, using extremely thin and short little needles, the doctor or the nurse
will anesthetize the skin at sites where the longer needles will be inserted to
anesthetize the subcutaneous fat. Patients usually experience a slight pricking
sensation as the skin becomes "numb".
Next, a volume of dilute tumescent anesthetic solution is carefully and gently
injected into the targeted fat. Once an area has been well infiltrated with the
anesthetic solution, the fat is usually completely numb. The infiltration of
the local anesthetic is a slow careful process that can take as long to
complete as the liposuction itself. After the infiltration of the anesthetic is
complete, but before beginning liposuction, you may go to the bathroom one more
time.
Experience has shown that giving a sedative by mouth often permits better local
anesthesia than when intravenous sedatives are used. This is because an alert
patient is more capable of detecting subtle areas of incomplete anesthesia. A
patient who is too sedated might easily ignore an incompletely anesthetized
area, and then feel more discomfort when liposuction is actually done.
Therefore minimizing sedation actually maximizes patient comfort.
After completing liposuction absorbent pads are placed over the incision. The
incisions are so small that no stitches are required. Finally, frequently the
Tumescent Liposuction Compression Garments are put on. Then you are ready to
get up and go home. Because of residual local anesthetic, it is several hours
after completing the liposuction before any significant soreness begins.
Although you will feel well enough after surgery to drive yourself home, you
must not do so, because large amounts of local anesthetic may cause some
drowsiness.
The tumescent technique minimizes postoperative discomfort. Because the
residual local anesthesia lasts for 18 to 36 hours, plain Tylenol is sufficient
to treat post-operative discomfort. With the Tumescent Technique there is no
post-surgical nausea, nor the unpleasant feeling of a "hang-over" usually
associated with general anesthesia.
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