How much tumescent fluid should be injected for liposuction of the abdomen?

     I perform liposuction of the abdomen and flanks and several other areas in one surgery, but there may be a reason to do less.Kenneth Hughes, MDLos Angeles, CA

Only so much local anesthetic can be given at one time.  Every physician uses a little different recipe for tumescent.  If your doctor can only uses a certain amount, please listen to him.  He is trying to do your surgery as safely as possible.  If you choose general anesthesia, he can do more areas with less tumescent fluid.

When using tumescent local anesthesia for liposuction, trust what your doc tells you since he has your best interest at heart and knows your extenuating circumstances. Usually you can have roughly 6 liters of tumescent fluid injected at 1 procedure. 2% lidocaine comes as 20mg/ml.  We add 25 ml of this 2% lido to each liter of solution to make a 0.05% concentration which has 500mg lido per liter. The upper limit of safety for the lidocaine is 55mg/kg. You weigh 130 lbs which is 59 kg.  For extra safety, if we use 45mg/kg limit and take this times 59 kg, therefore we come up with 2655 mg of lido. Each liter of solution has 500mg of lido in it therefore 2655 divided by 500 mg/liter = 5.3 liters of solution. If you dilute the lido by 20 % further then you have 400 mg/liter lido which then 2655 mg divided by 400mg/liter comes out to 6.6 liter of solution you can get injected to cover more territory. All this depends on you having a normal liver functioning and not on any meds that affect the liver or other body lab abnormalities. IV sedation often accompanies the local tumescent anesthesia to make you more comfortable. This is only a brief explanation of tumescent fluids for lipo. Sincerely, David Hansen,MD