Aim: It is desirable to have a safe estimate of the maximum recommended mg/kg dosage of lidocaine (MaxD) for tumescent local anesthesia (TLA). Current estimates of MaxD are based on data obtained from liposuction patients. One cannot assume all patients will have liposuction after infiltration of TLA. For technical or medical reasons it is possible that liposuction surgery might have to be cancelled after a patient has been given a complete dosage of TLA but before liposuction can be initiated. Furthermore, there are a number of surgical procedures which rely on TLA but do not involve liposuction. Thus estimates of MaxD for tumescent liposuction should be based on patients who have not had liposuction. Background: For tumescent local anesthesia (TLA), the peak serum concentration lidocaine (P) is a function of the mg/kg dosage of lidocaine, and the concentration of lidocaine and epinephrine in the solution of TLA. Liposuction removes lidocaine before it can be absorbed into the systemic circulation and thereby reduces P. P is correlated with the risk lidocaine toxicity. Methods: Six adult female volunteers received dilute lidocaine and epinephrine injected by the Monty infiltration technique for TLA. P was determined from sequential serum samples which were taken at times = 0, 1, 4, 6, 8, 10, 12, 14, 18, 24 and 30 hours after completion of infiltration. After the infiltration there was no liposuction. The mg/kg dosage and concentrations of lidocaine and epinephrine in the TLA solution varied between patients. Results: The maximum of all the peak lidocaine concentrations was 2.9 micrograms/ml. The ranges of dosages of tumescent lidocaine was 30 to 40.4 mg/kg. The mean time of the peak serum concentration of lidocaine was 13.2 hours, range 10 to 18 hours. Conclusion: A tentative estimate for maximum recommended dosage (MaxD) of tumescent lidocaine is approximately 45 mg/kg without or with liposuction.