High-Definition Liposculpture in Males Using Power-Assisted Liposuction and Local Anesthesia

Abstract

In high-definition liposculpture, the body is being shaped in a manner that it creates an athletic appearance and defined, contoured look. Typical areas in the male patient include arms, pectoralis, the area over the serratus muscle, lower back, as well as lateral and medial abdomen. This is sometimes combined with fat grafting to areas over the deltoid muscle and/or pectorals. High-definition liposculpture poses a new challenge to local anesthesia using lidocaine alone. Sufficient analgesia has to be achieved in multiple areas, without reaching systemic toxic levels of lidocaine. To reduce the risk of systemic side effects, we added prilocaine to the tumescent solution. Prilocaine differs from lidocaine in its metabolizing pathway, and combining both anesthetics therefore allows for higher tumescent volumes. In a prospective study, 48 male patients underwent high-definition liposculpture. The mean injected volume was 9.4 L. There were no side effects resulting from the high volumes of tumescent solution. Minor complications included seroma (2); 3 patients required touch-up. To conclude, a combination of lidocaine and prilocaine enables treatment of the entire torso and arms in a single session. Potential systemic effects of each anesthetic, lidocaine and prilocaine, need to be known to the user.