The use of Eppinette friend and Liposuction is key and standard for a few reasons. It does two things making this a much better and safer procedure. The first is vasoconstricting the blood vessels running through the fat layers which greatly diminishes bleeding and blood loss during the procedure. The second is that an analysis to use substantially higher doses of lidocaine which is necessary to keep patients comfortable for an awake procedure. Without epinephrine the safe dose of lidocaine is only a tiny fraction of what it is when used as numbing solution which contains epinephrine. Lots of people have side effects to epinephrine but these are not dangerous and Epping Efron used in cosmetic surgery is safe for the vast majority of people unless someone has underlying medical conditions that are quite serious. I suggest having a few in person consultations with local board certified plastic surgeons to discuss your liposuction needs, get a quality assessment and hear each providers view on various options for treating you. If you have concerns about upper difference affect on your heart then you should talk to your cardiologist or your internist about if it’s safe to have this medication during cosmetic surgery. Best, Mats Hagstrom MD