You are correct and that we use very large doses of both lidocaine and epinephrine when we do liposuction especially if large areas are being treated and if the patient is awake for the procedure. I personally use as much as 50 mg per kilogram of lidocaine. Most people will use 1 mL of epinephrine in a concentration of one to 1000 per liter of numbing solution. When injected in a dilute solution into the fat, the absorption is much slower than for example, injections at the dentist. Symptoms from epinephrine are usually manifested by people having tremors or shaking, but we do not see noticeable tachycardia. I’ve done over 8000 Liposuction procedures, including using large amounts of numbing solution and have never had a patient develop significant tachycardia. It’s just not what happens from these drugs during these procedures. Patients shake, they feel anxious, but they don’t get tachycardia, regardless of what you believe or have read. If there is tachycardia, it is very slight and at most 10% of baseline. This would the heart rate would go from 80 to 88, which is not enough for anyone to even notice. For most patients, the side effects of epinephrine typically settle down after a couple of hours. Most people go home and sleep, and by the next day I’ll side effects of epinephrine are gone and patient are left sore. Your concern is not something you should be concerned with. The two most important issues patient should be concerned with when it comes to getting Liposuction is first understanding your candidacy for the procedure and secondly finding the right provider. Things go wrong with Liposuction all the time. Lots of people are left disappointed, and worse. All of these negative outcomes are almost all related to patient candidacy and provider selection. Lots of people want to get Liposuction, but they don’t understand they’re not good candidates for the procedure. People who are not good candidates for Liposuction cannot have quality results, regardless of who does the procedure. Patient who are excellent candidates for Liposuction have the potential of having high-quality outcomes if they find the right provider. In the hands of the wrong provider they can be left disfigured. Delivering consistent quality Liposuction is far more difficult than most people realize the number of plastic surgeons who have mastered this procedure is pretty small. I would say 5% of plastic surgeons are good to excellent and one percent of plastic surgeon are Approaching mastering the procedure. To find the right provider, I generally recommend people have multiple consultations at which point it is the patient’s responsibility to vet providers. Ask providers to open up their portfolio and show you at least 50 patients worth of before and after pictures. Being shown a handful of pre-selected images representing the best results is not sufficient to verify your provider has the skills necessary to deliver consistent quality outcomes. I cannot emphasize these points enough. Of all the things to be concerned about you should be worried about being left With bad outcomes. This is common, this happens regularly and is 100% avoidable. Best, Mats Hagstrom MD