Tumescence in surgical hair restoration is a state of temporary swelling and fattening of the skin created by injections of anesthetic fluid and epinephrine into the fat layer of the scalp. The fluid being injected therefore, has been coined "Tumescent Anesthesia".
Tumescence minimizes blood loss and can help the anesthesia last longer. It also makes it easier for doctors to see between the follicles and harvest the donor strip without cutting hair follicles by making expanding the tissue and making the skin firm. It also helps the doctor avoid damaging deep seated blood vessels.
The aim of this technique is to distribute very dilute solutions of local anesthetic and vasoconstrictor evenly throughout the donor and recipient sites. At the donor area this results in a bloodless, firm cutting surface and for the recipient site, the dermis is thickened so that one is less likely to strike the larger blood vessels .
Operative blood loss may be greatly reduced with this technique with beneficial effects for patient and surgeon. The operation proceeds much more smoothly without the operative site obscured by blood and recently inserted rafts continually "popping". For the patient there is the advantage of less total blood-loss and decreased postoperative swelling and bruising around the forehead and eyelids.
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