Amount of Lidocaine in Tumescent Liposuction Based on Body Weight?

I'm having tumescent liposuction on the large surface area of my inner and outer thighs and knees, and the dr said he may be able to do my hips as well depending on how much lidocaine he has ro use for my legs. I only weigh 100 lbs and am concerned that the standard of 55 "units" of lidocaine (mg?) may be too much for me. Needless to say I don't want to risk toxicity, but am also afraid of having him spread the lidocaine too thin and feeling pain during the procedure.

Doctor Answers 7

A little IV sedation always helps any anxiety or pain during liposuction but don't be foolish enough to consider gen anesthesia.

Many plastic surgeons are still practicing liposuction in the dark ages such as using general anesthesia, huge canulas, minimal or no tumescent infiltration, not standing patients up during surgery to assess results and the same old "see a board cert. plastic surgeon" when they typically have the most complications, most law suits and less than great results when it comes to liposuction. To be fair, some can do a decent job but Derm Surgeons invented the tumescent liposuction technique and tend to give the best results and have advanced liposuction the most of any specialty. Of coarse, there are limits to how much fat can be removed by any method of liposuction. It is easy to adjust the tumescent solution dosage of lidocaine to accommodate larger areas without adding pain to the equation or even adding a little IV sedation which still allows you to be totally awake and comfortable. 35mg/kg lidocaine is the concentration that some docs who don't understand or know how to use tumescent lidocaine solutions hide behind. They used to say 5mg/kg for yrs until they were laughed at for their ignorance (anesthesiologist were partly to blame for this as well).  There is nothing more risky than general anesthesia when it comes to liposuction now a days and gimmicky procedures such as lasers or ultrasound machines or various detergent injections to dissolve fat, etc... are right up there causing many problems which should be avoided at all costs. When you want to get liposuction done, see several docs who specialize in liposuction where they have many yrs experience, have great before and after photos, have an accredited operating room, is knowledgeable and understands what you want, and will be there through the whole process holding your hand. We all want this to be a great experience for you. Sincerely,

David Hansen,MD

Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 42 reviews

Amount of Lidocaine in Tumescent Liposuction Based on Body Weight?

       I can calculate these totals in my head based upon concentration and volume of tumescent solution and determine the mg and then compare 35 mg/kg x your weight in kg.  Find a plastic surgeon with ELITE credentials who performs hundreds of liposuction procedures each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Simple Math But Also Read Further

The answer is 35mg/kg of body weight.  On another note.  You want to see a Surgeon who is experience with liposuction and managing the complications of liposuction. Any procedure or technique when applied inappropriately can cause harm.  Liposuction can be performed effectively either with local anesthesia (tumescent fluid only), with the addition of IV sedation or with General Anesthesia. It is up to the surgeon to choose the most appropriate method of treatment that would be safest for that particular patient and complexity of the procedure.  Typical if a surgeon performs liposuction that surgeon should perform this procedure in an accredited outpatient surgical facility AND credentialed at the hospital a nearby hospital as well have the ability to admit patients to the hospital if serious complications should arise. Typically a plastic surgeon fits that criteria.  There are other specialties that perform liposuction and do a great job but WHERE THE RUBBER MEETS THE ROAD is if there is a problem that requires hospitalization can they admit you, diagnosis and treat your issue.  Ultimately, it your choice of the provider you choose but arm yourself with all the important information.

Dr. ES

Tumescent liposuction

If your surgeon is experienced, they know how much lidocaine can be used for your procedure as well as how much can be done at one setting.  The liposuction will remove a lot of the lidocaine along with the fat so not all of it gets absorbed into your system.  The amount of lidocaine that can be used has been studied extensively in liposuction cases and it sounds like your procedure will be well within that safety range.  Good luck!

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Generally Accepted Tumescent Lidocaine Dose is 35 mg/Kg

The generally accepted safe dose of lidocaine when performing tumescent liposuction is 35 mg/kg. Studies have shown that you can use doses from 55-90 mg/kg, but the risk of toxicity goes up.  One of the key issues is that even though the procedure is safely performed with these high doses, the peak blood levels of lidocaine after tumescent liposuction does not occur until 18 hours of that time you are at home.  If you have a blood level that is too high and you are at home, then you risk a potentially catastrophic complication.  If your safety and comfort are your primary concerns, you should consider having the procedure under general anesthesia.  In this situation, it can be done either without lidocaine or with a lower dose.  If you do not exceed 5 liters of aspirate, which is unlikely in your case, you can still go home the same day...but with peace of mind.  A board certified Plastic Surgeon should be open to either approach.  Best wishes.

Robert F. Centeno, MD, FACS
Columbus Plastic Surgeon
4.9 out of 5 stars 77 reviews

Liposuction and lidocaine toxicity

When I perform liposuction I mix a tumescent solution so that the lidocaine level is no more than 35mg/kg total.  I dilute the tuemescnet fluid accordingly.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

You should have this done under IV sedation

If you have this procedure done under IV sedation, than your surgeon can decrease the amount of lidocaine without fear that you will feel discomfort. Many surgeons do not even use lidocaine in tumescent fluid because of fear of toxicity - but this requires sedation or general anesthesia. Make sure this is with a board certified plastic surgeon. Don't do this with a "cosmetic surgeon" who is unable to administer general anesthesia.

Matthew Schulman, MD
New York Plastic Surgeon
4.9 out of 5 stars 324 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.