Tumescent liposuction or liposculpture is the safest form of liposuction or body sculpting available. It is performed with only the use of local anesthesia in our office. Unlike traditional liposuction performed with general anesthesia, tumescent liposuction patients have faster recovery times, less bruising, less visible scars, and a dramatically lower risk of complications. Patients typically return to work in 2-3 days.

Tumescent liposuction is useful for the removal of unwanted fat deposits in the following areas: upper and lower abdomen; inner and outer thighs; hips; waist; back; arms; neck and jowls; and knees. Ideal candidates are close to their target weight, but have trouble spots or fatty deposits. After an initial consultation with Dr. Kayal, areas to be treated are decided. Photographs will be taken of the areas to be treated. You should bring a list of questions with you.

Risk of Liposuction Surgery

Any surgery involves the risk of infection, bleeding, scarring or serious injury, however tumescent liposuction has an amazingly good safety record. One of the reasons that tumescent liposuction is so safe is that neither general anesthesia nor IV sedation is required. A recent survey involving over 15,000 patients who had tumescent liposuction without general anesthesia revealed no serious complications, no serious infection, no hospitalizations, no blood transfusions, and no deaths. The greatest risks of liposuction are those associated with general anesthesia. By eliminating general anesthesia, the risks of liposuction are dramatically reduced.

Patients can minimize the risk of surgical complications by not taking medications or over-the-counter preparations that might adversely affect the surgery. Patients should inform Dr. Kayal of any medications being taken either regularly, or occasionally, including herbal remedies.

Risk of Irregularities of the Skin

Tumescent liposuction using microcannulas is the least likely to cause any significant or noticeable post-surgical irregularities of the skin. The tumescent anesthesia is placed in the fatty deposits. Then tiny cannula or tubes are placed below the skin and the fatty deposits are suctioned away. By magnifying the fatty compartment, the tumescent technique permits more accurate removal of fat, with greater assurance that the liposuction cannula will not inadvertently approach too near the undersurface of the skin, which would cause irregularities. Thus the tumescent technique helps to minimize the risk of post-surgical irregularities of rippling of the skin. Liposuction might improve pre-existing irregularities of the skin such as dimpling, but prospective patients should not assume that there would be significant improvement. It is unrealistic to expect perfectly smooth skin. Patients should expect that their skin would have approximately the same degree of dimpling and irregularities as existed before tumescent liposuction surgery. Ultimately, after liposuction the skin texture should be within normal limits. A casual observer should not notice any evidence of surgical irregularities of the skin. However, it is possible that a noticeable irregularity of skin may have a genetic predisposition for persistent discoloration at incision sites.


Liposuction of the thighs, while improving the silhouette, does not necessarily eliminate the subtle “puckering” of the skin often call “cellulite”. Cellulite results from the pull of fibrous tissue that connects skin to underlying muscle. While tumescent liposuction may reduce the degree of cellulite, it is unlikely to eliminate it. Liposuction should not worsen cellulite.

Liposuction and Obesity

Liposuction is not an appropriate treatment for obesity. Liposuction is not a substitute for a prudent diet, good nutrition, and regular exercise. Obese patients may be good candidates for limited liposuction if their goal is simply to improve the shape of certain limited areas of the body.

Pre-Operative Instructions

For the day of your procedure you should wear loose fitting clothing. A button down shirt is preferred. It is important to arrange for a ride to and from the office. Ideally, someone should stay with you for the first 24 hours. Dr. Kayal will mark the areas to be sculpted and review them with you. You will be given a mild sedative to help you relax. The procedure typically takes 2 to 3 hours, depending on what needs to be removed. You will leave the office wearing a compression garment, with pads to absorb the drainage. The excess fluid will drain out over the next 2 to 3 days. You should protect your car and your bed with protective pads.

Post-Operative Healing

Normal healing after tumescent liposuction involves a limited but definite degree of soreness, swelling, bruising, and lumpy firmness. A temporary mild numbness of the skin may persist for up to 4 months. Most patients can actually see some improvement of their silhouette within one week after surgery. However, because of the slow resolution of post-surgical swelling, the ultimate results following liposuction usually require 12 to 20 weeks to be achieved. Normal activity may recommence as soon as tolerated. Walking can be done the very next day and regular exercise in about a week. You will continue to wear the compression garment for 2 weeks. Some swelling and lumpiness will appear after the first few weeks. This is normal and part of the healing process. The end result will not be evident until the six week point, and areas continue to improve over the next six months. Diet and exercise play a crucial role in healing.

Realistic Expectations

Although the results of liposuction are often quite spectacular, it is not realistic to expect perfection. It is impossible to guarantee the precise amount of improvement that will result from liposuction. Patients should not have unrealistic expectations. Although patients can usually expect to achieve at least a 50% improvement, it is unreasonable to expect 95% improvement or near perfection. For the perfectionist, or for liposuction of a very large area, maximum improvement may require a second procedure for which there would be an additional fee.

Patients who would be satisfied with a 50% improvement would be reasonably good candidates for liposuction. The “50% improvement” is intentionally a vague measure. It indicates a definite perceptible improvement, but something short of perfection. If a 50% improvement would make a patient happy, then it is likely that these expectations will be met. Dr. Kayal’s patients generally achieve more than a 50% improvement.'

Longevity of Results

The fat cells that are removed by liposuction do not grow back. If the patient later gains or loses weight, the change tends to be distributed proportionately over the entire body. Although one can expect some changes with. aging, provided that the patient does not gain large amounts of weight, the patient’s new, more pleasing silhouette is relatively permanent.

Before and After

Before Liposuction
After Liposuction