What’s Tumescent Fluid?

Tumescent fluid is used in the vast majority of liposuction procedures in the United States, including Vibration Amplification of Sound Energy at Resonance, or VASER. First developed in the 1970s in France and Italy, it was further refined by Dr. Jeffrey A. Klein in 1985. The California dermatologist was the pioneer of liposuction procedures that did not require general anesthesia. (1)

The use of this enhanced technique has allowed surgeons to conduct liposuction procedures more safely and effectively, and allowed patients a more comfortable experience with limited blood loss. Though many conventional liposuction procedures still use general anesthesia, many surgeons prefer IV sedation as it allows patients a less complex recovery.

At Norcal Liposculpture, experienced cosmetic surgeon Dr. Jack Friedlader helps his patients attain the body silhouette of their dreams with tailored VASER liposuction procedures using tumescent fluid. For further information, and to discuss the benefits of a VASER procedure, please contact us to book a personal consultation. To speak to us directly, you can call Dr. Friedlander’s Roseville office at (916) 347-7755.

How Does Tumescent Fluid Work?

Tumescent lidocaine anesthesia (abbreviated to TLA) was developed for performing liposuction using local anesthesia. (2) The fluid itself is essentially a surgical wetting solution. The word “tumescent” comes from the Latin verb tumescere, which means to become firm or swell up. This is precisely what happens to the tissue in the targeted area of a liposuction treatment. This action makes it much easier for the surgeon to remove fat more accurately.

What is in Tumescent Fluid?

Tumescent fluid is a solution composed of:

  • Lidocaine – Lidocaine, sometimes known as lignocaine, is a local anesthetic that alters our pain perception, numbing the area of treatment. It does so by directly blocking nerve signals to the brain. Lidocaine is proven to be safe and effective, even at high doses. (3)
  • Epinephrine – Epinephrine is a hormone.  It constricts the blood vessels, allowing the lidocaine to stay in the treatment area and enabling it to last for a longer period of time.
  • Sodium Bicarbonate – Sodium bicarbonate is used in tumescent fluid as a “buffering” agent which neutralizes the acidic pH of the solution. This allows for less pain during administration.
  • Saline – Saline is a standard, non toxic isotonic solution. It is used in a wide range of surgical procedures because of its body compatibility and safety. The saline also causes the fatty tissue to swell, making it easier to extract. (1)

About VASER Liposuction

Dr. Friedlander uses tumescent fluid in every VASER liposuction procedure. The goal of  VASER liposuction is to sculpt the body to a slimmer, more desirable aesthetic precisely and comfortably. It’s a top cosmetic procedure that helps patients rid themselves of difficult-to-shed fat deposits, even though they may have tried exercise regimens and changes in diet. The most common areas of stubborn fat such as the abdomen, flanks and thighs. Also known as Klein’s fluid, the application of tumescent fluid alters tissues to allow for easier fat removal

VASER Lipo Treatment Areas

VASER is a versatile treatment that can be used in the following areas of the body:

  • Abdomen
  • Flanks
  • Armpits
  • Chin
  • Thighs
  • Back
  • Chest (Male Breasts)
  • Knees
  • Armpits
  • Upper Arms
  • Calves
  • Waist
  • Under Buttocks (Banana Rolls)

How is VASER Different?

Created by distinguished plastic surgeon Dr. Alfredo Hoyos, VASER is one of the world’s leading liposuction modalities. The biggest difference between VASER and standard liposuction is that it uses ultrasound technology to assist with the permanent removal of fat cells. 

Benefits of VASER Liposuction:

  • Slimmer Silhouette  – Previously unattainable looks can be achieved as VASER slims and smooths areas of stubborn fat to improve body silhouette.
  • Better Muscle Definition – The accuracy of VASER allows surgeons to sculpt a patient’s body to their desired aesthetic.
  • Effective Skin Tightening – High frequency ultrasound waves dislodge fat and simultaneously tighten skin to maximize results.
  • Reaches Deeper Tissues – VASER ultrasound-assisted liposuction makes deeper fat deposits accessible.
  •  Less Damaging – Targeted VASER can simultaneously extract fat and tighten skin with minimal damage to surrounding tissues.
  • Faster Recovery – Avoiding the use of general anesthesia, which can prolong postoperative pain, VASER allows a safer, speedier recovery for patients
  • Lasting Results – Patient results from liposuction last, as fat cells are permanently removed. With healthy lifestyle habits, patients can experience the contouring effects of their VASER procedure for many years!

With VASER, multiple areas of the body can be treated at the same time. Speak with Dr. Friedlander to create your personalized treatment plan!

Masters of VASER Liposculpture

To ensure the highest quality liposuction services at Norcal Liposculpture, Dr. Friedlander has personally trained with leading VASER pioneers from the United States and overseas who have learned from the creator of VASER himself; Dr. Alfredo Hoyos. 

Dr. Friedlander has had the honor of collaborating with VASER specialist John Millard, MD in Denver, Colorado and London cosmetic surgeon and VASER expert Dr. Grant Hamlet of Harley Street. These premier surgeons have worked together to provide their patients with some of the most effective VASER liposuction procedures in the United States!

Candidates for VASER Liposuction

Healthy men and women with localized fat deposits may be good candidates for VASER liposuction. As tumescent fluid is used throughout the procedure, patients should have no known allergies to any of the components of the wetting solution. VASER is not a weight loss procedure, so candidates should be at or near their goal weight before their surgery. Dr. Friedlander accepts patients on a case by case basis. The usual range is within 30 lb of the patient’s ideal weight.

The best candidates for liposuction are well informed about the possible outcomes of their treatment, understand the importance of following pre- and post- procedure instructions, and have realistic expectations of the scope of VASER liposuction.

Personal Consultation

Book a personal consultation with Dr. Jack Friedlander and find out how VASER liposuction could help you achieve a flatter abdomen, a more contoured waist, or slimmer thighs! He’ll explain how VASER uses ultrasound technology for more advanced fat removal and outline the benefits of IV anesthesia compared to general anesthesia. He will ask you to fill out some basic forms related to your health and perform a physical examination. If you have several aesthetic concerns, Dr. Friedlander may recommend treatment for multiple areas of your body.

Meet with Dr. Friedlander to discuss your VASER liposuction procedure at his Roseville office, conveniently located northwest of Sacramento on I-80.

Your VASER Liposuction Procedure

Norcal Liposculpture will cater to your individual needs to make your VASER experience as uncomplicated and effective as possible. Dr. Friedlander asks that you follow all medical directions carefully to optimize your results. 

Preparing for VASER

  • Maintain a stable weight, within 30 lb of your ideal weight.
  • Cease smoking and use of tobacco products 4-6 weeks beforehand.
  • Arrange for a trusted adult to provide transportation to and from your surgery.
  • Do not take any blood thinning medications (such as NSAIDs) for at least 3 weeks.
  • Avoid drinking alcohol the night before your procedure.

VASER Lipo Procedure

After administering IV sedation, Dr. Friedlander will make a small incision in the treatment areas. He will saturate the underlying layers of fat with specially formulated tumescent fluid to aid the suctioning of fat and to ensure your procedure is as comfortable as possible. He will then insert the VASER probe under the skin to target the troublesome fat. The VASER device emits ultrasound waves which agitate the tumescent fluid to break down tissue and dislodge it, before it is suctioned away with a small cannula. Dr. Friedlander will skillfully work to remove the necessary amount of fat in the area until he has achieved the desired contour. Once this process is complete, he will suture the incision point. After a short monitoring period, patients can leave our care and spend some well-earned time relaxing and recovering at home.

After Your VASER Procedure

Depending on your area of treatment, you may be required to wear a compression garment. Dr. Friedlander will provide detailed individualized instructions for you to follow. You will have some residual bruising and swelling, but these are temporary and will diminish in a few days. The long-lasting effects of local IV anesthesia will continue to subdue discomfort, decreasing the need for immediate pain relief. After this stage, Dr. Friedlander will provide adequate pain medication to help make your recovery process more comfortable. Patients should avoid strenuous activities and continue to avoid smoking until otherwise directed. He will advise you to stay home from work until you feel ready to return. Usually patients are back in the office after around a week.

Dr. Friedlander will use light lymphatic massage and external ultrasound at your follow-up appointments to promote healing and better results.

Most patients see the incision site scars fade in just a few months. Dr. Friedlander will schedule a follow-up appointment to assess your progress two weeks after your VASER procedure. Depending on the patient and the location of your liposuction, your results may be permanent!

Cost of Liposuction in Sacramento

Every VASER liposuction treatment plan is based on the individual needs of each patient. Therefore, costs will vary. To get in touch with Norcal Liposculpture, arrange a consultation , and get a quote, please call  (916) 347-7755 or contact us via our simple online inquiry form.

Find more information about VASER liposuction and other cosmetic procedures on Dr. Friedlander’s blog.


  1. Venkataram, J. (2008). Tumescent liposuction: A review. Journal of Cutaneous and Aesthetic Surgery, 1(2), 49. https://doi.org/10.4103/0974-2077.44159 
  2. Klein, J. A., & Jeske, D. R. (2016). Estimated Maximal Safe Dosages of Tumescent Lidocaine. Anesthesia & Analgesia, 122(5), 1350–1359. https://doi.org/10.1213/ane.0000000000001119 

Hatef, D. A., Brown, S. A., Lipschitz, A. H., & Kenkel, J. M. (2009). Efficacy of Lidocaine for Pain Control in Subcutaneous Infiltration During Liposuction. Aesthetic Surgery Journal, 29(2), 122–128. https://doi.org/10.1016/j.asj.2009.01.014

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