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Is Lidocaine a Limiting Factor for Liposuction?

asked 2 years ago by bodyjoy in WDC
Latest answer by Armando Soto, MD
Question viewed 647 times
Tags: lidocaine, limit, second opinion

I've met with 3 of the five doctors I've researched and selected to consult with for tumescent (both Vaser ultrasonic and laser technologies) liposuction surgery on my abdomen and flanks. The first 2 doctors perform the procedure on both areas using Vaser. The 3rd doctor I met with will do the upper abs in one procedure and the lower abs and flanks in a 2nd surgery because of a limit on the amount of lidocaine that can be used under general anesthesia. So they won't run out they will do two surgeries. NO ONE ELSE MENTIONED THIS!!! Why is this?

17 answers to Is Lidocaine a Limiting Factor for Liposuction?

Lidocaine limits and liposuction

From the photos shown, you could have the liposuction on the full abdomen and sides/hips done all at once very easily. Expect to pay around $5-7,000. The tumescent technique of injecting local anesthesia to numb up the areas (rather than gen anesthesia) is the safest and done the most often now by most docs who concentrate their practices on liposuctions. Many add a little IV sedation to make you more comfortable but you are awake and talking the whole way through. The limit of 55... more

David Hansen, MD
Beverly Hills Dermatologic Surgeon

www.DrDavidHansen.com

Lidocaine and liposuction

Hi there- It sounds like one of the doctors you saw is not a real plastic surgeon.... It is definitely true that there is a limit to how much lidocaine a person can safely receive- and in fact, it is very true that the risk to your health and safety if you get too much is a risk most women wouldn't want to take- There have been more than a few DEATHS in the US from patients having liposuction by non-plastic surgeons- in every case that I know of, the death was caused by lidocaine toxicity. These more

Armando Soto, MD
Orlando Plastic Surgeon

Lidocaine for liposuction has limits for the amount that you can get

Hello - Lidocaine toxicity is a real concern when it comes to any surgery, especially liposuction. if you're requesting the removal of a significant amount of fat, you may want to consider general anesthesia in order to lower the risk of lidocaine toxicity. From your photos, it appears as though you may want general anesthesia with standard liposuction or ultrasound liposuction. This way, you can improve the safety of your liposuction and have it performed in a hospital setting as... more

Jeffrey E. Schreiber, MD
Baltimore Plastic Surgeon

Liposuction of the abdomen and flanks can be done in the same operation

There is a limit to how much lidocaine can be given in a single operation. However, the amount of liposuction you need based on your photograph should be safe to do with standard tumescent technique without worrying about lidocaine toxicity.

Elizabeth Lee, MD
Bay Area Plastic Surgeon

Look for another surgeon

Looking at your picture ( thanks for including it, it is a lot easier to give you a better advise) you are a good candidate for liposuction, if you are considering general anesthesia and liposuction, then you can get that done without any concern about the lidocaine toxicity, you will probably need about 4 L of traditional tumescent solution, which will be way below the recommended limits. However you may be a candidate for tumescent anesthesia, only. With PO sedation this is very tolerable... more

Victor Manuel Perez, MD
Kansas City Plastic Surgeon

Lidocaine and Liposuction

It has been known since the mid 1980's that much higher doses of Lidocaine can be placed in our fatty tissues (as a dilute solution mixed with Epinephrine - IE the TUMESCENT solution you hear repeatedly) than can be injected into our veins. That being said, there are limits to how much lidocaine CAN be infused at any one time and how much fluid can be safely removed in one setting. I cannot understand the opinion of the third surgeon you saw. I routinely liposuction larger areas than you... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Liposuction and limiting amounts of lidocaine anesthetic

In order for you to be comfortable during the liposuction procedure, some doctors will give you sedation. The amount of local anesthetic that is used may not be as much as when done with pure tumescent local anesthesia without sedation because you won't feel the pain as you are sedated. If you only have tumescent anesthesia, the surgeon will need to leave some reserve of local anesthetic in case there is pain during the procedure and will want to have enough to cover all the areas... more

Ronald Shelton, MD
Manhattan Dermatologist

Lidocaine and liposuction

While the quantity of lidocaine used in liposuction solution is important, it can be adjusted to accomodate for larger volume removal. In my mind, the critical criteria relates to the amount of fat removed and the overall health of the patient.

Steven Wallach, MD
Manhattan Plastic Surgeon

Lidocaine toxicity

Lidocaine is part of the tumescent fluid injected during liposuction. A concentration of 35mg/Kg body weight is considered safe with lipo. Looking at your pictures,i think that your areas could be done in the same settings. In certain situations the laser lipo could be done under local. When it is done under local,some physiscians divide the areas to avoid lenghty procedures.

Hisham Seify, MD, PhD
Los Angeles Plastic Surgeon

Lidocaine toxicity and liposuction

Lidocaine toxicity has again become a problem. If it or epinephrine (adrenaline), the other drug injected to fill the tissues before liposuction, is used in too high an amount, heart or brain disfunction and even death can occur. Many, particularly non-surgeons, are using large quantities of fluid containing these drugs, but there is no real need to. Though the new laser liposuction machines need a fluid filled area in which to work, one can vary the amounts of the drugs used, and it is not... more

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Liposuction risk factors

I would generally agree with Dr. Baxter's response except that it's not quite clear what the various risk factors are and how they are mitigated. I would also add that it is not necessary to use 3 to 1 injection of tumescent fluid for liposuction done under local-only or oral sedation type procedures. My own experience even back in the 90's was that the average for tumescent injection volume to aspirate was 1.25 to 1 even in procures done without IV sedation. Lidocaine is indeed toxic if the... more

Scott L. Replogle, MD
Denver Plastic Surgeon

Liposuction and lidocaine

From your photos, you could do all areas at once and be well below the 5000 cc per day limit of fat removed. If your doctor is a real plastic surgeon and can use a physician anesthesiologist, you can keep the lidocaine well below toxic levels and safely do all of the areas of concern to you. Non-plastic surgeons typically cannot get MD anesthesiologists to work with them so they rely entirely on the lidocaine for numbness and may need to separate the areas out in order to avoid toxicity. ... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

One can have liposuction of all 3 areas at one time.

We routinely do liposuction, using lidocaine, on the 3 area you mentioned in one surgery. I have no idea why he told you this. Remember it is not the machine that is important in doing liposuction, it is the surgeon's experience.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

This is exactly why one gets more than one consultation!

Liposuction is limited by lidocaine. The exact limits depends on a number of factors. When liposuction is performed under local anesthesia, called pure tumescent liposuction, atypical safe dose would 35mg/Kg. However it may be safe to use larger doses with some investigator suggesting doses above 50 mg/Kg and higher. However the risk of lidocaine toxicity increases and the effect of mild lidocaine toxcity may not be life threatening but they are definitely unpleasant. Note that pure... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Lidocaine toxicity and the limits of liposuction

It's a confusing world out there when it comes to liposuction options. A few basics: First, there are 3 options for anesthesia. One is tumescent, in which a fluid containing the numbing agent lidocaine and epinephrine is injected into the fat compartment until it swells up enough to become firm. Typically the amount of fluid is about 3 times the amount of fat. This method is most often promoted as a safer alternative to general anesthesia because the patient is wide awake. The second method,... more

Richard Baxter, MD
Seattle Plastic Surgeon

Lidocaine a limiting factor for liposuction

Either the third DOCTOR was not a plastic surgeon or he is being VERY conservative. My bet is the first, but you did not mention their training. Yes there is a maxium loading dose of lidocaine but if done with count measuring and IV sedation of Face Mask gases this should not be an issue. Best of LUCK FROM Miami Dr. B

Darryl J. Blinski, MD
Miami Plastic Surgeon

Lidocaine limit in liposuction

Lidocaine can cause toxicity in large doses, but for the areas of lipo you want done, (and judging form your photos) this would likely not be a problem in your case. I think that most plastic surgeons would not hesitate to perform the areas of lipo that you are wanting in one procedure in an accredited facility.