Pharmacology

Overall, liposuction results in very few problems from the use of medications during the procedure. It is, therefore, one of the safest cosmetic surgical procedures performed under the hands of a well-trained, skilled and experienced cosmetic surgeon. The following is a description of the medications used and their roles during the procedure.

Lidocaine

Liposuction fluid anesthetizes the skin, which allows the procedure to be performed while the patient is awake and within an office-based setting. The primary active ingredient of this fluid is lidocaine. This type of anesthesia is very safe if given in moderate dosages.

Lidocaine is metabolized by a specific pathway within the liver after being administered in a standard liposuction procedure. Many other medications are also metabolized via this pathway. If both are in the body at the same time, the two medications can compete for the liver's pathway, resulting in higher blood levels of lidocaine. This could result in a toxic dose of lidocaine.

Patients should notify their physicians of the medications they are taking before their liposuction surgery. If any medications are on the list of similarly metabolized medications as lidocaine, then it is advisable to discontinue them one to two weeks prior to surgery to decrease this potential problematic interaction.

Medications that could interact with the Lidocaine unfavorably include antidepressants such as Prozac and Zoloft; antibiotics such as Biaxin and Zithromax; high blood pressure medicines such as Inderol and Procardia; and many more. Check with your physician for a complete list.

A unique effect of lidocaine is it decreases the chance of infection through a type of bacteriostatic effect. Thus, infections rarely occur after liposuction procedures.

Epinephrine

Another key ingredient of the liposuction fluid is epinephrine, which constricts the blood vessels within the fatty areas resulting in minimal blood loss and a safer procedure. It also decreases the absorption of the lidocaine into the blood stream, which results in longer lasting anesthetic effects.

Sodium Bicarbonate

Finally, sodium bicarbonate is added to the tumescent fluid in a liposuction procedure to decrease the stinging that so often accompanies injection of straight lidocaine into the skin. This results in improved comfort of the patient during the procedure.