What is another alternative to epinephrine during a tummy tuck and liposuction?

The alternative is not have liposuction.  The epinephrine in the tumescent fluid is critical to the safe performance of this procedure.

Epinephrine has 2 purposes during the procedure. The first is that it causes the lidocaine, which is the local anesthesia, to last longer. Secondly, it causes vasoconstriction which reduces the risk of bleeding and bruising. You can certainly use the lidocaine without the epinephrine. I would not be concerned about doing the tummy tuck, but I would not be aggressive with the liposuction. I would tell you that I would do as much as I could, but once you started oozing during the liposuction, I would need to stop to be safe. Good luck with your procedure!

Although a local anesthetic with epinephrine is commonly used to inject the skin prior to incisions to minimize oozing, as in a tummy tuck, the procedure can certainly be done without epinephrine too. The bigger issue is avoiding epinephrine during liposuction. It is possible to do some liposuction without the epinephrine as well, but there will be more bleeding and bruising. If the liposuction is gentle (not too aggressive), and the treated area is small, then avoiding epinephrine could be an option too. If more extensive liposuction is needed, then you and your doctors will need to weigh the risks vs. the benefits.

It's not necessary to use epinephrine for an tummy tuck but it is needed to do any but the most minimal amount of liposuction. The doses are small but might have some systemic effects as well. Best is to have your plastic surgeon discuss the procedure and your particular medical issues with your cardiologist. Insist on having your procedure performed in a certified facility and have your anesthesia performed under the direct supervision of a board certified anesthesiologist.Finally, for the best results seek the consultation of a plastic
surgeon certified by the American Board of Plastic Surgery. They have a website
listing all the certified plastic surgeons. Members of the American Society of
Aesthetic Plastic Surgery will all be board certified in plastic surgery and
have demonstrated an interest and special skill in cosmetic plastic surgery as
well.

A small amount of very dilute epinephrine is unlikely to have effects on your entire body but liposuction cannot be done without it. Discuss this with your surgeon and anesthesiologist and have your surgeon talk with the cardiologists.

The epinephrine is very important in liposuction as it minimizes bleeding>  My suggestion is that you have your plastic surgeon and your cardiologist talk to each other as there may be a medication or a strategy to block some of the effects of the epinephrine on you palpitations.  

Thanks for the question.  Epinephrine is a normal substance that is released in all of us for neuroregulatory control in everything that we do, but I can appreciate that too much of it released at one time may cause heart palpitations as you described.  This product is central to our reducing bleeding during any type of cosmetic surgery for the most part, however.  I would make a point of having your Plastic Surgeon consult with your Cardiologist before any surgery is contemplated to see what might be the best solution to this problem.Good luck to you.Frank Rieger M.D. Tampa Plastic Surgeon