**4.1 Infiltration**

• It is of great importance and practice to apply infiltration solution before starting the liposuction procedure. The tumescent technique containing diluted epinephrine and lidocaine, which is frequently used in liposuction practice today, was described by Jeffrey Klein [5]. Reasons and advantages beyond application of infiltration solutions are a few. Epinephrine and lidocaine in the solution have two basic roles: anesthesia and vasoconstriction. Thanks to the vasoconstrictor effect, bleeding during the procedure and bruising in the postoperative period are reduced considerably. For patients whom general anesthesia is not preferred, liposuction can be performed with infiltration thanks to its anesthetic effect. For patients undergoing general anesthesia, intraoperative anesthesia is supported and patient comfort is increased in the post-operative period thanks to this anesthetic effect. It is not an obligation to use lidocaine in the infiltration solution in patients undergoing general anesthesia. However it is generally preferred because of these secondary effects. In order to reduce the risk of toxicity, the amount of lidocaine dosage should not exceed 35 mg/ kg [6]. The infiltration solution commonly used today is a mixture of 1 ml of epinephrin (1:1000) and 50 ml of 1% lidocaine for 1 liter of Ringer lactate solution [7]. While the ratio of infiltration solution to aspirate volume is approximately 2–3:1 in the tumescent technique, which is one of the most widely used infitration technique, this ratio is approximately 1:1 in the super wet technique. Application of infiltration solution facilitates the movement of the cannula by providing tissue expansion and decreasing friction forces during the liposuction procedure. The infiltration solution should be evenly distributed to the area of liposuction. Over-infiltration (more than 3:1 ratio) should be avoided as it may cause the surgeon to judge falsely.
