Jeffrey Klein, MD, who is in the private practice of dermatology, dermatologic surgery and cosmetic surgery in San Juan Capistrano, Calif., is a pioneer in the research of tumescent local anesthesia with subcutaneous tissue.

Dr. Klein made two presentations in April to the Brazilian Society for Dermatologic Surgery – one on tumescent liposuction and the other on the interaction of tumescent local anesthesia with subcutaneous tissue. He also presented his research on the subject April 19 at the Sixth International Vein Congress in Miami.

“I have recently concluded an IRB-approved clinical trial that included 39 patient-studies involving tumescent infiltration of lidocaine with sequential HPLC measurements of serum lidocaine concentration over 24 hours,” said Dr. Klein, whose first liposuction case was 23 years ago.

“My statistical analysis [from the IRB trial] indicates that 45 mg/kg is an appropriate estimate of the maximum safe dosage of tumescent lidocaine without liposuction, and the probability of lidocaine toxicity less than 0.0004 or less than 1 per 2500.  In contrast, based on a linear regression analysis,  a dosage of 55 mg/kg without liposuction is associated with a probability of toxicity equal to 0.01 or 1 chance in 100.”  (See an article by Dr. Klein detailing this research in the June/July issue of Vein Therapy News).
    
Education
Dr. Klein got undergraduate degrees in mathematics from the University of California at Riverside and the Université de Paris, and a masters from University of California at San Digeo, also in mathematics. His degree in medicine is from the University of California at San Francisco (UCSF) and his master of public health degree in biostatistics epidmiology is from the University of California at Berkeley. He also held a National Institutes of Health (NIH) research fellowship in clinical pharmacology.

He has specializations in dermatology from the University of London’s Institute of Dermatology and the All India Institute of Medical Sciences in New Delhi; a specialization in clinical pharmacology from UCSF; and a specialization in pharmacology and a dermatology residency from the University of California at Irvine (UCI). Dr. Klein also did a residency in internal medicine at UCLA.

That Which Makes You Happy
“An interest in public health and in particular epidemiology and biostatistics was my original motivation for going into medicine,” Dr. Klein explained. “Immediately after medical school I finished an MPH degree in biostatics at U.C. Berkeley, and then completed an internal medicine residency at UCLA.”  
He said he had become somewhat disillusioned by primary care internal medicine, so he began to consider all the available options for sub-specialization.  
“Thus I asked every professor that I knew from my UCLA program the following three questions: ‘Are you happy with the specialty you have chosen; would you choose it again; and would you recommend it to someone else?’

“As it turned out, the only specialty in which all the specialists said yes, yes and yes was dermatology. And I have to agree, I am very happy being a dermatologist.”

Board Certifications
Dr. Klein is an associate clinical professor in dermatology at the University of California in Irvine, and he earned board certifications from the American Board of Internal Medicine in 1980, American Board of Dermatology in 1984 and American Board of Cosmetic Surgery in 1989. His other certifications include Advanced Cardiac Life Support and Advanced Trauma Life Support.

He holds hospital affiliations at Hoag Hospital, Irvine Medical Center, Mission Hospital Medical Center, South Coast Medical Center and the University of California Irvine Medical Center.

Honors, Memberships and Scholarship
The American Society for Dermatologic Surgery presented Dr. Klein with the President’s Award in 2004 for “Outstanding & Unique Contributions to Dermatologic Surgery and The American Society for Dermatologic Surgery.”

He is a member of the American Academy of Dermatology, American Society for Mohs Surgery, American Society for Dermatologic Surgery, Dermatology Foundation, American Society of Anesthesiologists, California Society of Anesthesiologists, International Anesthesiology Research Society, Orange County Medical Association (OCMA), California Medical Association, American Medical Association and the Indian Association of Dermatologists Venereologists Leprologists.

In addition to his Brazilian Society for Dermatologic Surgery lectures in 2008 and 2005, Dr. Klein lectured at the British Association of Aesthetic Plastic Surgeons in 2004; in 2005 at the California Congress of Dermatology and Dermatologic Surgery, the Italian Society for Aesthetic Surgery and Mass General Hospital’s Wellman Institute in Laser Medicine. He was also popular on television in 1995 with interviews on ABC’s “20/20” and “Larry King Live.”
He writes extensively – from 1979 through 2006, he has penned 40 articles for a variety of textbooks and peer-reviewed scientific journals.

Patent Holdings and Other Businesses
Dr. Klein holds nine patents, and has financial interests in three companies: HK Surgical Inc., Liposuction.com and Liposuction 101.
His patents include a method of forming absorbent pad using precut overlay, liposuction cannula with abrading apertures, compression sponge for wound care, a positioning pillow for approximating anatomic position in lateral decubitus position, a post-liposuction breast compression garment and method for edema reduction,  liposuction cannula, liposuction patient positioning support, skin applique to provide protection from ultraviolet light, and a liposuction method and apparatus.

HK Surgical markets a number of surgical devices and supplies, including the Klein Infiltration Pump, which is an electric powered peristaltic pump that is now an indispensable tool for optimal tumescent anesthesia.

“The most interesting aspect of tumescent local anesthesia from an academic perspective is a discussion about the maximum safe tumescent dosage of lidocaine,” Dr. Klein said. “However from a practical perspective, the task of getting the tumescent solution from the IV bag into the patient in a fashion that is painless, gentle and time-efficient is a prime concern.

“Originally I infiltrated the solution using a hand-held 60 ml syringe placed inside a special stainless steel handle attached to the IV bag-reservoir of the tumescent solution of local anesthetic by an IV tube. The syringe was refilled with tumescent solution simply by retracting the syringe plunger. Even today some surgeons still use a technique of repeatedly refilling syringes with a tumescent solution contained in an IV Bag or within a sterile basin.”  

But he said using an infiltration pump is far more efficient, and considerably less painful for the patient, as well as for the surgeon’s fingers and thumb.
Liposuction.com is an educational site that provides all information needed for an individual to make an informed decision about the procedure. It includes a list of doctors with links to their pages, photographs, articles, links and FAQs.

Liposuction 101 is a site for doctors and nurses, offering a hands-on Tumescent Liposuction course that has been approved for 27 CME hours from the University of California Irvine School of Medicine.

Looking to the Future
In the future, Dr. Klein said he would like to see a greater effort to encourage better, more objective and scientifically sound clinical research.  
“I hope to see more IRB-approved studies. I would like to see not only the American Society for Dermatologic Surgery (ASDS) but also plastic surgery, cosmetic surgery and vein surgery develop guidelines and simple templates for clinical experimental designs that could easily be applied to many types of clinical research projects in these fields.  

“There too many anecdotal reports of improved results, and too few studies with subjective outcomes that are designed with side-by-side intra-patient controls and too few studies that are adequately blinded.

 
“In a word, I would like to see less anecdotal and more objective rigorously controlled studies when the outcome variable is a subjective cosmetic result.” VTN