We are independent & ad-supported. We may earn a commission for purchases made through our links.
Advertiser Disclosure
Our website is an independent, advertising-supported platform. We provide our content free of charge to our readers, and to keep it that way, we rely on revenue generated through advertisements and affiliate partnerships. This means that when you click on certain links on our site and make a purchase, we may earn a commission. Learn more.
How We Make Money
We sustain our operations through affiliate commissions and advertising. If you click on an affiliate link and make a purchase, we may receive a commission from the merchant at no additional cost to you. We also display advertisements on our website, which help generate revenue to support our work and keep our content free for readers. Our editorial team operates independently of our advertising and affiliate partnerships to ensure that our content remains unbiased and focused on providing you with the best information and recommendations based on thorough research and honest evaluations. To remain transparent, we’ve provided a list of our current affiliate partners here.

Our Promise to you

Founded in 2002, our company has been a trusted resource for readers seeking informative and engaging content. Our dedication to quality remains unwavering—and will never change. We follow a strict editorial policy, ensuring that our content is authored by highly qualified professionals and edited by subject matter experts. This guarantees that everything we publish is objective, accurate, and trustworthy.

Over the years, we've refined our approach to cover a wide range of topics, providing readers with reliable and practical advice to enhance their knowledge and skills. That's why millions of readers turn to us each year. Join us in celebrating the joy of learning, guided by standards you can trust.

What Is Tumescent Anesthesia?

By Maggie J. Hall
Updated: May 17, 2024

Plastic surgeon, Dr. Jeffrey Klein developed the local anesthesia delivery method of tumescent anesthesia in 1987. Tumescent means swelling, which describes the tissue response immediately after injecting the local anesthetic. This effect typically subsides with absorption. Benefits of the treatment include direct and rapid numbing of only the specific area of treatment. Physicians use tumescent anesthesia for cosmetic and non-cosmetic dermatological procedures, eliminating the necessity for general anesthesia.

Physicians discovered that by merely injecting an anesthetic solution into the dermal layer, or subcutaneous region, they achieved sufficient anesthetic results. Using only the tip of a small gauge needle and one injection site, surgeons infuse the solution, which usually contains lidocaine, epinephrine, and sodium bicarbonate dissolved in a saline solution. The tissue initially swells until the medication permeates and spreads. The amount of lidocaine injected depends on the size of the area requiring treatment. If anesthetized tissue over a larger area is required, physicians typically place additional needle sticks only into the areas of the dermis already anesthetized.

When the tissue swells, the action compresses the capillaries lying in the skin, which reduces bleeding. The epinephrine further constricts the vessels once the swelling subsides, ensuring minimal bleeding throughout the procedure. Surgeons are often able to complete dermatological procedures without using electrocautery, sutures, or staples because of the tissue compression and vasoconstriction effects. The sodium bicarbonate component of the solution minimizes the burning or stinging that patients often experience with injections, and some studies suggest the substance has antimicrobial properties as well.

Dr. Klein originally used tumescent anesthesia prior to liposuction procedures, injecting the solution directly into the fatty layer beneath the skin. Some surgeons suggest that dermal layer injections may provide adequate anesthesia of adipose tissue because of solution spreading and because the dermal layer contains a greater number of nerve endings. After the initial injection, surgeons may ensure deep tissue absorption by infusing additional solution. Dermatologists often use tumescent anesthesia prior to dermabrasion, removal of benign or malignant growths, or hair transplants.

Patients can minimize the risk of lidocaine toxicity by ensuring that physicians have a complete medical history containing all prescription and over-the-counter medications. Certain medications compete with lidocaine for the enzymes required to adequately metabolize the anesthetic agent. Blocking or enhancing the activities of these enzymes may lengthen the time in which the lidocaine remains in the body, producing toxic effects as the medication travels through the blood. Lidocaine and epinephrine both affect heart rhythm and rate and may not be suitable for some patients with heart disease. Tumescent anesthesia might also cause pulmonary edema or a pulmonary embolism.

WiseGeek is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Discussion Comments
WiseGeek, in your inbox

Our latest articles, guides, and more, delivered daily.

WiseGeek, in your inbox

Our latest articles, guides, and more, delivered daily.