I was supposed to do tumescent lipo of the abdomen and flanks, but my doctor said that for my weight 130 pounds they can use only 2.5 liter of the tumescent fluid so it won't be enough to do the flanks at the same time. I read a lot about the lipo but I could not find any information, I feel ver disappointed because I really wanted to do everything at once and I didn't know that will be a problem.
Answer: Milligrams versus liters The usual limitation with tumescent liposuction is not the total volume but rather the number of milligrams of lidocaine used.Most people use the Klein formula, which is 50 mL of 1% lidocaine for every liter of saline.There are also other additives such as epinephrine and sodium bicarbonate.Most plastic surgeons will use a maximum of 35 mg of lidocaine per kilogram of weight of the patient.For example, a 100 kg person could tolerate 3,500 mg of lidocaine. Using the Klein formula, this would be seven liters. In your case, based on the Klein formula, weighing 130 pounds combined with the 35 mg per kilogram, the maximum volume would be just over 4 L.There have been published studies showing it is safe to use as much as 50 mg per kilogram. That is an added 40% of local anesthesia. In your case, this would be 5.6 L.Some surgeons use a higher concentration of lidocaine in their tumescent solution. In those cases, lesser volumes are used.Every surgeon is different.Based on the above formulas, treating the full abdomen, including flanks, hips and waist, upper and lower abdomen, is done routinely.A typical 130 lbs patient in my practice would need 1-1.5 liters of tumescent solution for the upper and lower abdomen. Typically, I would use an additional liter for flanks, hips and waist for both sides. It is possible to remove as much as 5 L of fat while staying within safe parameters.Most patients need some level of sedation.Perhaps your surgeon was planning on not using any type of sedation, in which case he or she may have felt the need to use more lidocaine.I'm curious if your surgeon is a board-certified plastic surgeon.Your stated limitations seem rather timid.At the same time, safety is always number one.Best of luck,Mats Hagstrom, M.D.
Helpful
Answer: Milligrams versus liters The usual limitation with tumescent liposuction is not the total volume but rather the number of milligrams of lidocaine used.Most people use the Klein formula, which is 50 mL of 1% lidocaine for every liter of saline.There are also other additives such as epinephrine and sodium bicarbonate.Most plastic surgeons will use a maximum of 35 mg of lidocaine per kilogram of weight of the patient.For example, a 100 kg person could tolerate 3,500 mg of lidocaine. Using the Klein formula, this would be seven liters. In your case, based on the Klein formula, weighing 130 pounds combined with the 35 mg per kilogram, the maximum volume would be just over 4 L.There have been published studies showing it is safe to use as much as 50 mg per kilogram. That is an added 40% of local anesthesia. In your case, this would be 5.6 L.Some surgeons use a higher concentration of lidocaine in their tumescent solution. In those cases, lesser volumes are used.Every surgeon is different.Based on the above formulas, treating the full abdomen, including flanks, hips and waist, upper and lower abdomen, is done routinely.A typical 130 lbs patient in my practice would need 1-1.5 liters of tumescent solution for the upper and lower abdomen. Typically, I would use an additional liter for flanks, hips and waist for both sides. It is possible to remove as much as 5 L of fat while staying within safe parameters.Most patients need some level of sedation.Perhaps your surgeon was planning on not using any type of sedation, in which case he or she may have felt the need to use more lidocaine.I'm curious if your surgeon is a board-certified plastic surgeon.Your stated limitations seem rather timid.At the same time, safety is always number one.Best of luck,Mats Hagstrom, M.D.
Helpful
