Is there a lipo procedure without epinephrine?

Question

I habe POTS postural othostatic tachycardia syndrome. My heart races. I was interested in some producures but wondering if there's numbing that doesnt make your heart race. Denist uses Carbocaine.

Semih Yildiz, MD, FEPOBRAS · Answer

Liposuction can sometimes be modified for patients who are sensitive to epinephrine, but it is not as simple as choosing a different numbing medicine. Standard tumescent liposuction commonly uses very dilute epinephrine because it reduces bleeding, bruising, and lidocaine absorption; removing it can change the safety profile and may limit how much can be done.

With POTS and episodes of racing heart, you should have the plan reviewed by your cardiologist and an anesthesiologist before scheduling. Options may include minimizing epinephrine, using an alternative local anesthetic in selected areas, doing a smaller procedure, or performing the surgery with monitored anesthesia in a setting prepared to manage heart rate, fluids, blood pressure, and medications. Carbocaine/mepivacaine is used in dentistry, but large-area liposuction is very different from dental numbing, so the safest answer depends on your POTS severity, medications, procedure size, and the surgeon’s anesthesia setup.

Camille Cash, MD · Answer

Epinephrine is used during surgery to constrict blood vessels which in turn helps with bleeding.  It doesn't numb you but is often mixed with the numbing medication such as lidocaine to improve pain management and the numbing effect.  You can discuss your concerns with your surgeon who may be able to minimize the use of epinephrine based on the procedures that interest you.

Manuel Diaz, MD · Answer

Hello dear. Yes, liposuction without epinephrine exists, although it's not common. Carbocaine (mepivacaine) or other anesthetics without epinephrine can be used to prevent increased heart rate, but there's more bleeding and less pain control.

Is there a lipo procedure without epinephrine?

Answers (3)

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