Is Lidocaine a Limiting Factor for Liposuction?

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?

Doctor Answers 18

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 mg/kg of lidocaine is pretty universal now and you are well under that limit with the areas you are concerned about. General anesthesia greatly increases the risks and problems and should be avoided if at all possible. Finding a doc with a lot of experience and one you trust and have a great rapport with is the most important thing rather than cost or type of anesthesia he uses.

Good Luck.

Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 43 reviews

Lidocaine limit and liposuction

The standard Klein formula for tumescent liposuction included lidocaine because the procedure was being done with the patient awake. Lidocaine can be toxic if overdosed, so the it limits how much lipo you can do.   If you are getting general anesthesia, lidocaine is not necessary and therefore is not a limiting factor for liposuction ,vaser or otherwise.

Mark A. Schusterman, MD
Houston Plastic Surgeon
4.9 out of 5 stars 77 reviews

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 non-plastic surgeons use lidocaine as the exclusive methid of anesthesia because they do not have privileges to do surgery under anesthesia in a real OR- so they do liposuction in their offices under local...

Because liposuction hurts when awake, they keep giving more until the patient is more comfortable- but at risk....

A true plastic surgeon is one certified by The American Board of Plastic Surgery.

As long as you have your surgery performed by a real plastic surgeon, you should be able to have all areas treated effectively and safely in one comfortable procedure.

Armando Soto, MD, FACS
Orlando Plastic Surgeon
4.8 out of 5 stars 159 reviews

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 well. Good luck!

Jeffrey E. Schreiber, MD, FACS
Baltimore Plastic Surgeon
5.0 out of 5 stars 202 reviews

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 Slass Lee, MD
Bay Area Plastic Surgeon
4.9 out of 5 stars 54 reviews

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, with minimal discomfort and without the associated complications of general anesthesia (i.e. cardiac or pulmonary embolism (P.E) problems). When this tecnique is used, the patient usually tolerates up to 3 hours of surgery easily. This is usually the time needed for Laser liposculpturing of the anterior abdomen and anterior flanks, if posterior back and flanks liposuction is needed, this will have to be addressed at a different session.

The most important factor in obtaining good results is the selection of your surgeon, you should consult Board certified Plastic surgeons ( American Board of Plastic Surgery, the only board in plastic surgery recognized by the american board of medical specialties), this will guarantee the proper training of your surgeon, (which is not a weekend course).

Good luck in finding a good surgeon

Victor M. Perez, MD, FACS
Kansas City Plastic Surgeon
5.0 out of 5 stars 29 reviews

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 have demonstrated in the photo above safely in one setting.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 109 reviews

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 undergoing the surgery that day. The amount of lidocaine that can be safely used is well-reported and is based on your body weight, and the doctor considers daily medications that are prescribed by your other doctors for you, as they may create a higher amount of lidocaine in your blood if they affect its metabolism.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

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
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

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, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 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.