A large volume of lidocaine with epinephrine can be administered in dilute concentrations into the subcutaneous space, resulting in minimal blood lidocaine levels. This allows large-volume, multiple-area liposuction to be done painlessly under local anesthesia with only oral and intramuscular sedation and analgesia. Other advantages include minimal blood loss, decreased patient morbidity and expense, and elimination of the risks of general anesthesia and intravenous anesthesia/sedation.

Dermatologic liposuction education has emphasized small volume cases performed under local anesthesia using the tumescent technique. The safety of this approach appears to be validated in terms of decreased malpractice settlements.

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