Ask a doctor

Liposuction, Awake or Asleep?

Hi doctors, i'd just like to know, does it matter if i'm asleep or awake for the lipo? - will it affect my result? i'm having 5 areas done so i've been recomended to be asleep but i'm afraid that some fat may be missed as i won't be able to stand/sit up during the lipo, im also having hi def vaser done on my abs. (i've been reading so much and hear so many different opinions on google and would just like to know the honest truth).

Doctor Answers 25

Anesthesia for Liposuction

Thank you for your question. I agree with your surgeon and would recommend parenteral or IV sedation, at a minimum, for five areas of treatment. If you were having 1-2 areas treated, then local anesthesia would likely be adequate for you to be comfortable during the procedure. I would not worry about not being able to stand during the procedure. An experienced surgeon will be able to perform the procedure without you being able to stand, and if you needed a minor revision at a later time, local anesthesia would most likely be adequate for that.   Hope this helps you make your decision. Good Luck!

Large Volume Liposuction under General Anesthesia

     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.

Liposuction awake vs. asleep?

Thanks for your question.  I know how nerve racking it can be to some patients to have general anesthesia and go fully to sleep.  However, general anesthesia is a very safe procedure (as long as you are a healthy person).  It is very difficult to remove as much liposuction material on someone who is awake compared to someone who is asleep.  You can't make the person as comfortable and therefore tend to not be nearly as aggressive with removal of the fat.  Hope this helps.

Shaun Parson, MD
Phoenix Plastic Surgeon
4.5 out of 5 stars 36 reviews

Awake or asleep for lipo

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.

Liposuction awake or asleep

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!

Gregory T. Lynam, MD
Richmond Plastic Surgeon
5.0 out of 5 stars 35 reviews


With 5 areas planned for lipo, I usually use "twilight" sleep sedation and combine it with local anesthesia.  The procedure does require sterile technique and once the patient is prepped with the surgical soap and sterile drapes are placed, position changes must be carefully done.  I do not have the patients stand for this reason.  I hope this information is helpful.

Ronald H. Stefani Jr, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 2 reviews

Type of Anesthesia during Liposuction

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.

Anesthesia During Liposuction

This decision is best left to your surgeon and your anesthesiologist. However, I would say that in your case, five areas is a long time to lay on the table awake. Even the most quick and efficient surgeons cannot complete this in less than a few hours if they are thorough. I would recommend that if your'e going to have this many areas done you find someone who can take you to an outpatient surgery center for anesthesia. It doesn't mean you'll have to be completely asleep, you can be sedated but still alert and able to help your surgeon by moving into certain positions etc. 

Cameron Rokhsar, MD
New York Dermatologic Surgeon
4.5 out of 5 stars 33 reviews

Awake for liposuction

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. 


I generally prefer general anesthesia for all but the most minimal liposuction procedures. The reasons are simple:

1. It is difficult to adequately anesthetize large areas without sedation and there is a higher likelihood of patient movement and recollection of the procedure

2. It is difficult to be very aggressive with the suctioning process when you are concerned that the patient may begin to feel discomfort if the cannula enters an area not fully numbed, or if the patient may become anxious with the activity.

3. Many of the cases of liposuction-related deaths reported in the media relate to overdosing of local anesthetics, often occuring at the hands of practitioners who are not board-certified plastic surgeons, at facilities that seek to cut costs for higher profit margins. If you are not sedating the patient or putting her under general anesthesia with a qualified anesthesiologist or CRNA, you may be taking inordinate risks with patient safety if you attempt liposuction of large areas under routine local anesthesia. I restrict lipo under local to limited submental fat excess, axillary rolls, minor cases of gynecomastia, touch-up revisions after more comprehensive lipo, and small love handles. I never do multiple zones under local at once.

Tim A. Sayed, MD, FACS
Boca Raton Plastic Surgeon
5.0 out of 5 stars 15 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.