My practice is almost exclusively devoted to body contouring using liposuction and fat transfer. Almost all my procedures are done with my patients awake. In order to do this and obtain the advantages of avoiding general anesthesia, very high doses of lidocaine are used. Even though there are good safety guidelines in regards to how much lidocaine can be used, the chance is always there that a patient can develop lidocaine toxicity or a lidocaine overdose. The lidocaine injected during the procedure is absorbed slowly over time after the procedure. The highest blood levels are seen typically 12 hours after the procedure. Should someone develop an overdose of lidocaine, it will typically be seen around that time. If someone's surgery finishes at noon time, that means they are at highest risk at midnight. When large areas or multiple areas are treated, we typically use higher doses of lidocaine, though always within the safety guidelines. With a single area, the chance of your surgeon using very high doses of lidocaine is unlikely. Of the reported fatal lidocaine toxicity cases reported in the United States, most of the patients were alone the night after the procedure. Surgeons who perform liposuction with general anesthesia typically use much lower doses of lidocaine. Just one note on your chosen area to be treated: it is rare, if ever, that I treat the lower abdomen only with liposuction. Patients almost universally need their upper and lower abdomen treated as well as their waist and hips. We typically sell this as an anatomic unit called the full abdomen. Most patients' fat distribution will be grossly abnormal if a single area is treated without treating the surrounding areas. This has been my experience over the last five years and having performed well over 2,000 liposuction procedures.Of course, blanket statements cannot be made in regards to a single patient without sufficient information. The recovery itself of a single area after liposuction is quite well tolerated and not really a big deal. If your procedure is scheduled to be done using general anesthesia, then there may be side effects of the anesthesia that may last many hours. The most common one is postoperative nausea and vomiting.Best of luck,Mats Hagstrom, M.D.
