Exposure to Tumescent Solution Significantly Increases Phosphorylation of Perilipin in Adipocytes

Aesthet Surg J. 2017 Feb;37(2):239-245. doi: 10.1093/asj/sjw156. Epub 2016 Sep 2.


Background: Lidocaine and epinephrine could potentially decrease adipocyte viability, but these effects have not been substantiated. The phosphorylation status of perilipin in adipocytes may be predictive of cell viability. Perilipin coats lipid droplets and restricts access of lipases; phospho-perilipin lacks this protective function.

Objectives: The authors investigated the effects of tumescent solution containing lidocaine and epinephrine on the phosphorylation status of perilipin in adipocytes.

Methods: In this in vitro study, lipoaspirates were collected before and after tumescence from 15 women who underwent abdominoplasty. Fat samples were fixed, sectioned, and stained for histologic and immunohistochemical analyses. Relative phosphorylation of perilipin was inferred from pixel intensities of immunostained adipocytes observed with confocal microscopy.

Results: For adipocytes collected before tumescent infiltration, 10.08% of total perilipin was phosphorylated. In contrast, 30.62% of total perilipin was phosphorylated for adipocytes collected from tumescent tissue (P < .01).

Conclusions: The tumescent technique increases the relative phosphorylation of perilipin in adipocytes, making these cells more vulnerable to lipolysis. Tumescent solution applied for analgesia or hemostasis of the donor site should contain the lowest possible concentrations of lidocaine and epinephrine. LEVEL OF EVIDENCE 5.

MeSH terms

  • Adipocytes / drug effects*
  • Adipocytes / metabolism
  • Adult
  • Anesthesia, Local* / adverse effects
  • Anesthetics, Local / pharmacology*
  • Anesthetics, Local / toxicity
  • Female
  • Fluorescent Antibody Technique
  • Humans
  • Lidocaine / pharmacology*
  • Lidocaine / toxicity
  • Lipolysis / drug effects
  • Microscopy, Confocal
  • Middle Aged
  • Norepinephrine / pharmacology*
  • Norepinephrine / toxicity
  • Perilipin-1 / metabolism*
  • Phosphorylation


  • Anesthetics, Local
  • Perilipin-1
  • Lidocaine
  • Norepinephrine