Accutane is a wonderful medication, but it can be pretty hard on the liver.  In fact, one of the main side effects seen in many people who take the medication is alteration of liver function enzymes.  We check these regularly when someone is taking Accutane.

The safest way to perform liposuction is to use the tumescent technique, or injection of large amounts of dilute local anesthetic solution.  Lidocaine is the anesthetic used.  Lidocaine can be toxic if  high amounts are in the body.  The liver has the job of clearing lidocaine from the bloodstream.

If the liver is irritated, damaged, or not working properly as a result of a medication such as Accutane, toxic amounts of lidocaine can build up in the body and lead to very serious complications.

I would advise any patient to wait until they were off Accutane, even if the liver appears to be working properly on the medication.  It is simply not worth the risk.

Accutane affects every organ in the body, especially the liver. The lidocaine tumescent solution injected during the liposuction to numb up the fat layer is filtered threw the liver as well as any IV sedation meds given during the surgery. Even tho the risk of problems is very little when either accutane is prescribed or liposuction is done alone, the combined effect could be dangerous. I would wait 2-3 months after off accutane to do the liposuction and get a blood test to make sure the liver enzymes are normal. There also is a little more risk of scarring from wounds while on accutane but this is minimal.

David Hansen, MD

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