Is Lidocaine Poisoning During Conscious Liposuction a Large Risk Factor?

I am having multiple areas liposuctioned,i.e. lower abdomen, love handles and saddlebags. I'm not overweight at all, just have some problem areas. Is lidocaine poisoning a concern?

Doctor Answers 9

Lidocaine with Liposuction

Lidocaine is used with tumescent liposuction to numb the areas being treated.  If you are being treated in an accredited facility by a board certified surgeon, then they should be following all safety guidelines.  Additionally, lidocaine with used in appropriate doses is a very safe medication.  That said, since a higher concentration of Lidocaine is required for conscious liposuction, you may need to limited the areas that you want treated to prevent reaching toxic doses.  Good luck.  

New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

Lidocaine poisoning during conscious liposuction a large risk factor

YEA! Dr Aldea's hit it out of the ball park!!!! In Ft Lauderdale, Fl. there was a lidocaine overdose with conscious patient in liposuction death last year. I have been for over 10 years warning doctors and patients this would happen someday. And it DID! Non trained liposuctionists who are not plastic surgeons have not had the training in medication use. Be Careful out there.

From MIAMI DR. Blinski

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Lidocaine toxicity during liposuction

When used appropriately by a Plastic Surgeon properly trained in its use, Lidocaine (the injectable that does the numbing of the area) is quite safe. However, if too much is used, it does become toxic and can even cause death. There are a group of surgeons (most with little surgical training) using a tumescent anesthetic formula containing more lidocaine than many of us are comfortable with. My advice is to talk to your surgeon carefully about his/her qualifications and the safety precautions used. I believe that, when suctioning more than a small area (such as what you are contemplating), the procedure should be done in a certified facility with full safety precautions available.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Lidocaine toxicity with lipo due to having too much done under local (tumescent)

Lidocaine is not a particularly toxic drug, and has even saved many lives when used for cardiac resuscitation. However, in large doses it can cause significant problems, and when used with the tumescent technique for wide-awake lipo, the blood levels peak about 8-12 hours later, long after the patient has left the clinic. The question has come up more often lately because of a death that occurred after tumescent lipo at a "lipo clinic" in the Seattle area that is known for heavy advertising and forceful sales. For small areas in a healthy patient, you should have no worries, and for larger areas the addition of intravenous sedation or general anesthesia by a qualified anesthesia provider may provide comfort while minimizing the lidocaine dose for your safety. Most important of all is to select an experienced liposuction doctor, meet with the surgeon (not just a salesperson) as part of the consultation, and make sure the procedure will be done in an accredited surgical facility. Many try to downplay the fact that liposuction is surgery.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Lidocaine toxicity is very uncommon with liposuction

Your surgeon should review all your medications you consume and discuss with you if any need to be stopped prior to the procedure as some will interfere with the metabolism of the lidocaine and the level of the anesthetic in the blood can be elevated.  Do not take a new over-the-counter medicine without speaking to  your doctor prior to the procedure, as many of those, without prescription, can also affect the anesthetic.  Your surgeon also calculates the safe limit of lidocaine for your weight and depending on the concentration of the lidocaine used, they will know how many liters of fluid to safely give you and how many areas of liposuction for your body's shape can be given. That will dictate if you can safely undergo liposuction on all the areas you wish at the same time or if you need to have multiple procedures.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Lidocaine toxicity during liposuction

When Iperfrom liposuction I think of the amount of fluid that I will need to inject and then I dose my lidocaine in each bag to keep the concentration well below toxic levels. I assume your surgeon would do the same.

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

LIdocaine Toxicity with tumescent liposuction

The administration of a toxic dose of Lidocaine, the commonly used local anesthetic in Tumescent Liposuction, is a known complication which is uncommon when the procedure is done by experienced plastic surgeons. All of us who perform this procedure know how to avoid it and should it happen, how to quickly treat it. If you chose an experienced Plastic surgeon who operates on a Medicare or AAAASF facility I would not stress over it. Good luck with your procedure.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

While all drugs can have ill effects, lidocaine is used routinely and successfully with liposuction

When a patient undergoes liposuction of one or many areas either under general anesthesia or iv sedation, ringers lactate with lidocaine is routinely used to distend the tissue to make the procedure less bloody, smoother and less painful. The amount of lidocaine use at any one time has been very carefully evaluated and determined. If the physician stays under 35 mg of lidocaine per kilogram weight, you should have a safe effective procedure. 

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 15 reviews

Tumescent Lidocaine anesthesia is 100 times safer than general anesthesia for Liposuctions if kept under 55mg/kg in healthy pt.

I am making up the 100 X value to get across the point that lidocaine toxicity from tumescent anesthesia is only a minimal risk when compared to the huge risk of general anesthesia when doing liposuctions.  In a healthy patient, the lidocaine dose should be kept below 55 mg/kg for the tumescent local anesthesia. The majority of liposuction are no longer being done under general anesthesia for not only safety reasons but also that you get better results when the patients are able to be put in all different positions because they are awake to allow the doc to assess how the lipo is coming along and to fine tune the results to get the smoothest results.

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 42 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.