Pharmacology

SmartLipo Laser Liposculpture utilizes tumescent liposuction fluid to anesthetize 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. Lidocaine is a very safe medication if given in correct dosages.

Properly trained physicians who perform liposuction surgery are very careful of the dosage of lidocaine that is given to the patient for the procedure. There is a maximum dose allowed per treatment day and strict guidelines are utilized to make sure that the patient does not receive excessive amounts of this medicine.

Lidocaine is metabolized by a specific pathway within the liver. There are many other medications that are also metabolized via this pathway. When given together, the two medications compete for this liver pathway resulting in higher blood levels of lidocaine. This could result in a toxic dose of lidocaine.

Therefore it is imperative that patients notify their physicians of the medications they are taking. If any of these medications are on the list of similarly metabolized medications as lidocaine, then it is advisable to discontinue these medications one to two weeks prior to the procedure to decrease this potential problematic interaction.

Some of the medications that could potentially interact with the lidocaine in such a fashion include certain antidepressants such as Prozac and Zoloft, certain antibiotics such as Biaxin and Zithromax, certain high blood pressure medicines such as Inderol and Procardia, and many more. Check with your physician for a complete list.

Other medications to avoid before and after liposuction procedures of any type include those medications that “thin” the blood and decrease the ability of your blood to clot. These include many anti-inflammatory medications such as Aspirin, Motrin, and Aleve. Moreover, liposuction should not be performed on patients on strong blood thinners such as Coumadin, Heparin or Plavix.

Lidocaine may produce drowsiness as the blood level increases and this can progress into worsening mental states and other untoward reactions. However, studies have shown that injection of dilute solutions of the tumescent fluid into the fatty layer below the skin almost always achieves very safe blood levels of lidocaine that cause no harm. Indeed injected in this area allows the lidocaine to be absorbed into the fatty tissue like a “sponge”. This results in longer anesthesia in the area which can continue for hours after the procedure has ended.

A unique effect of the lidocaine is that it decreases the chance of infection through a type of bacteriostatic effect of the lidocaine per se. Thus rarely do infections occur after tumescent liposuction techniques and this includes the SmartLipo Laser Lipolysis technique. This improves the safety profile of the procedure which results in improved recovery and results after the procedure.

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

Finally sodium bicarb is added to the tumescent fluid 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.

Overall, SmartLipo and Tumescent Liposuction result in very few problems from the use of the medications utilized for the procedure. They are therefore some of the safest cosmetic surgical procedures performed under the hands of a well trained, skilled and experienced cosmetic surgeon.