Awake Liposuction

Awake Liposuction has historically been reserved for body contouring patients desiring only a modest reduction in fat pockets. As such, Awake Liposuction cases have involved conservative treatment of only localized or a few areas at a time. Liposuction modalities used for awake surgery have included:

• Tumescent liposuction (traditional)
• Power-assisted liposuction (PALS)
• Laser liposuction (Sonobello or Airsculpt)

Patients don’t know that these awake lipo modalities effectively remove fat only from the middle part of the fat layer. This fat compartment is the most generous of the three fat layers, which include:

• Superficial
• Middle
• Deep

The removal of fat from this middle "compartment" has been tolerated under local anesthetic because this layer of fat possesses a low density of pain fibers. Unfortunately, when fat removal is limited to the middle layer, it fails to attain high-definition results.

What Are High-Definition Results?

High-definition results allow for the creation of dramatic yet natural body contours. Recent advances in liposuction techniques using VASER technology have allowed specially trained surgeons to achieve incredible outcomes. High-definition results describe body contour outcomes following high-definition liposuction. High-definition liposuction requires the capacity to remove fat from all three compartments of the fat layer.

Only by removing fat from all three compartments is it possible to create more refined body contouring outcomes. In other words, superior high-definition outcomes are predicated on removing fat from the middle, superficial, and deep layers. In this manner, it is possible to create natural shadows and unveil muscle highlights not previously possible with traditional liposuction techniques.

This limitation of traditional liposuction techniques to access the superficial and deep layers is twofold:

1. Traditional and laser liposuction techniques provide poor access to two of the three layers.
2. Access to these layers of fat has been avoided due to significant discomfort with awake lipo, as there is a higher density of nerve fibers in the deep and superficial layers of fat.

A breakthrough technique now allows just a handful of surgeons to combine Awake Liposuction with high-definition results.

Advancement of Awake Liposuction Protocols Which Allow For High-Definition Liposuction

We proudly announce several advancements in awake liposuction protocols allowing high-definition results. Until recently, high-definition liposuction was reserved for the surgical suite, where general anesthesia could be administered to ensure you were completely asleep.

Traditional and laser liposuction have been popularized as procedures that can be performed while awake under local anesthesia.

Advanced surgical tools and a new methodology have been developed to achieve high-definition results with Awake Liposuction.

Why Has High-Definition Liposuction Eluded Awake Techniques?

Pain fibers are triggered by manipulating small spherical organelles, called corpuscles, that are in the highest density:

1. Directly underneath the skin in the superficial fat compartment
2. Overlying the muscle lining in the deep fat compartment

Since high-definition results are predicated on removing fat from both compartments, high-definition liposuction could not be performed under local anesthesia. However, several advancements in surgical tools and protocols have made high-definition liposuction a reality of awake lipo:

• The first is the advent of VASER liposuction to remove fat from all three layers.
• The second is developing a non-excisional skin tightening tool called the Renuvion J plasma.
• Third, another important advancement to local anesthesia is the addition of modified laughing gas (nitrous oxide) administration methods.
• A final advancement includes modification of the infiltration tumescent solution infiltration.

Doctors want their patients to be pain-free when they have cosmetic procedures; patients rely on them to keep them comfortable. Therefore, comprehensive high-definition liposuction with VASER technology was only done under general anesthesia...until now!

What Is VASER Technology?

A novel skin-tightening tool, Renuvion J plasma, has recently been introduced to counter the increased propensity of skin laxity observed following comprehensive fat removal. Renuvion J plasma reduces skin redundancy by thermally heating the collagen fibers on the undersurface of the skin and structural cables spanning from the skin to the underlying muscle lining.

This thermal heating results in the shortening of collagen fibers, best described by a shrink-wrap effect. However, the thermal heating of collagen molecules is also prone to triggering pain fibers, thus limiting the maximum capacity of the thermal application when you are wide awake.

How Laughing Gas Advances Have Advanced Awake Liposuction

Advancements in the administration of laughing gas have allowed for the completion of high-definition liposuction while you are awake. This advancement allows patients to reap the benefits of high-definition liposuction results while avoiding general anesthesia.

Laughing gas (nitrous oxide) provides aggressive global anesthesia and subsequent euphoria by stimulating your dopamine centers. However, the administration of pure nitrous may result in full sedation nearing general anesthesia. Recent advancements in nitrous administration have allowed for a lighter load of nitrous exposure as anesthesia yet provide controlled and effective pain control.

1. The first modification of nitrous administration includes mixing nitrous with oxygen at a 50% ratio to lower the potency of the administered nitrous gas such that you remain alert.
2. The second modification is the administration apparatus which uses a proprietary nozzle fitted into the patient's mouth.

The unique shape of the nozzle allows for a self-controlled administration of nitrous to the patient. The combination of these two advances has been coined as Pronox, a novel means of allowing patients to control the amount of sedation.

Oversedation is avoided, while immediate and continuous relief from discomfort or pain is a reality. When an increase in sedation is desired, the nozzle is held and sucked on by the patient; as sedation increases, the nozzle falls out of the mouth, resulting in self-controlled limitation of nitrous gas intake.

The supplement of local anesthesia with a modified tumescent solution is an advancement that provides the ability to complete high-definition awake liposuction.

Modified Tumescent Solution

The tumescent solution is injected into your soft tissues, providing two effective functions.

1. The tumescent solution numbs pain fibers using an anesthetic medication called Lidocaine. The percentage of Lidocaine used in the modified tumescent solution is increased from 500mg to 800mg per L of fluid to increase the numbing potency.
2. The second function involves the addition of antihypertensive medications that allow for constriction of vessels resulting in a decreased incidence of blood vessel injury and subsequent oozing of blood.

Minimizing the incidence of blood loss is critical since blood products can be inflammatory and irritate nerve fibers. Adding an anti-hypertensive medication to the tumescent cocktail provides additional protection from blood oozing and ensures comfort.

Awake Lipo With High-Definition Results - Conclusion

In summary, awake liposuction can be performed to remove all three fat compartments comprehensively. VASER offers some skin tightening effects, and more skin tightening can be achieved with Renuvion J plasma to avoid the rippled effect of excess skin when fat is removed. However, it must be noted that there is a limit to how much skin can retract, primarily due to age and the amount of fat removed. In this case, your surgeon will present the best way to deal with excess skin to avoid a disappointing result.

The advances, which include VASER liposuction, proprietary laughing gas protocols, and modified tumescent solution, provide the unique ability to perform high-definition liposuction while you are completely awake.

Patients may wish to take advantage of the cost savings of avoiding general anesthesia or feel safer knowing they do not lose conscientious.  anesthesiologist fees.

We offer you a unique opportunity if you want high-definition body contouring results but wish to avoid general anesthesia. Make a no-obligation consultation to determine if your body contouring goals can be met with awake liposuction.