Liposuction, Awake or Asleep?

     Larger volume liposuction or liposuction of multiple areas performed with general anesthesia I feel allows me to get the best results.  If a patient experiences pain or is uncomfortable, the surgery is made more difficult for the patient and the surgeon alike.  In addition, when or if you are flipped to a prone position (on your stomach), having a secure airway is important.  This is difficult to achieve with sedation and local.  Every plastic surgeon has his or her own thoughts on this issue.

I perform almost all liposuction procedures under general anesthesia, as do all of the board-certified plastic surgeons that I know (unless the area to be treated is fairly small). It's far more comfortable for the patient, and easier for the surgeon to be aggressive where necessary and delicate if needed as well. If you are in reasonably good health, general anesthesia for liposuction is extremely safe when performed in an accredited operating room by a board-certified anesthesiologist. Some doctors who perform liposuction but are not surgeons are not able to obtain approval to work in an operating room with general anesthesia, so they use an awake technique in an office setting by necessity. This can at times be a reasonable option too, but I personally would choose general anesthesia for myself or a member of my family.

It can be done safely either way.  Usually, we use general anesthesia for the larger lipo cases, and local / IV sedation for the smaller ones.  There are pros and cons for both methods, but the results are comparable, and depend more on the surgeon's skill / proficiency rather than the type of anesthesia.

Both are fine and depend on what your doctor prefers. I do smaller cases awake and larger cases asleep. I like the vaser system and think it can be done on awake or asleep patients. Good Luck!

Liposuction can safely be performed either with general anesthesia (totally asleep) or with local anesthesia and sedation (not totally asleep).  When large volumes or many areas of liposuction are to be performed, I find that it is more comfortable and safer to have my patients asleep. 

I personally do not find it helpful for patients to stand during the procedure.  If I feel that I need the patient to sit for any reason to look at the areas, this can easily be accomplished while the patient is asleep using the specialized operating room tables available in our operating room.

 

Best of luck with your surgery.

The length of time doing the procedure for five areas; if these are true areas and not those called areas by some offices, would require that the procedure would be better done with intravenous sedation or a general anesthetic in my office. It is too long under just tumescent. I hear about complaints from patients from offices that do this regarding the very uncomfortable nature of these. There are also risks or lidocaine toxicity due to the need to use a more highly concentrated and and a lot of tumescent local in that many areas. The issue of surgeon fatigue is a factor too and deeper anesthetic techniques allow for a more efficient and thorough result. A skilled and experienced surgeon does not need to have you stand up for this. 

The type of anaesthesia will not in any way determine the final outcome of the liposuction procedure, rest assured.

Local anesthesia with sedation is preferred by us when we need to address a small areas with the patient preferably supine. Considering that you are having 5 separate areas done along with VASER Hi-Def, i would definitely recommend general anesthesia. It would make it pain free intra-op, your surgeon would be able to concentrate better on the procedure at hand with your personality out off it, and i am sure you will have a great result.

All the best!

I would offer you the procedure that you are contemplating to be performed under general anesthesia. This ensures me that you will be comfortable while allowing me to concentrate on achieving your goals.  You mentioned 5 areas which means that it may take a long time to do all of it under local in single setting. Most of my patients start getting anxious after about 3 to 4 hours of lipocontouring under local anesthesia. Doing the procedure longer is possible, but becomes quite unpleasant for the patient.  Follow the advice of your surgeon, and have the liposuction procedure under general anesthesia. This is better for you, as it is for your surgeon. Prior to your surgery, it is very reasonable to seek a second opinion to be confident in your decision.

There are many reasons for choosing one way vs. the other. You mentioned several issues that I think it's important to consider. In general, tumescent liposuction is performed whether you are under local or general anesthesia. There are several different modalities to are used in addition to tumescent liposuction. You mentioned 5 areas which means that it may take a long time to do all of it under local in single setting. Most of my patients start getting anxious after about 3 to 4 hours of lipocontouring under local anesthesia. Doing the procedure longer is possible, but becomes quite unpleasant for the patient. You mentioned using Vaser which is one of the several modalities currently available for lipocontouring. Excellent contouring and shaping, including "hi def" can be achieved with many of the modalities currently available in the hands of excellent plastic surgeon. Find a plastic surgeon that will perform lipocontouring under both conditions and discuss pros and cons with you so you can decide which route is most suitable for you.

Best Wishes

There is no doubt that you get the best results when your surgeon can fine-tune the results by standing and sitting you up and turning you in all positions during the procedure. It just makes sense. He/she is able to see and feel exactly what needs to be further smoothed out and refined to give you what you want. You and the doc do this together. Being awake and comfortable is so much safer as well and you have a good experience and get what you want. A lot of docs don't use the tumescent liposuction with the smaller cannulas because it takes twice as long to do the procedure and is more work but the results are so much better. To be fair, you still can get a decent result under gen. anesthesia but why take the risk. Other factors such as the doc's experience in lipo, doing it in an accredited op room, trusting him, feeling comfortable with your doc, great before/after photos, etc...all contribute to your end results as well. Sincerely,

David Hansen,MD