Painful Tumescent Liposuction Procedure - Is This Normal?

I had a lipo procedure done 2 days ago. It was tumescent/smartlipo/PAS. I was very nervous before the procedure but kept telling myself, the dread of something is always worse than going through....WELL, it wasn't. The first stage of him putting in the tumescent fluid was excruciatingly painful, I felt like I was on that table of torture and awake for every gory detail of it. He seemed to be very aggressive during this part. Is this normal to feel this kind of pain?

Doctor Answers 13

Local anesthesia during liposuction

There are many variables that might explain why some patients feel more pain than others during the anesthetic delivery prior to liposuction. If an area is being redone, if there was prior surgery there or trauma, then scar tissue has been built up and that is more painful to numb. If the anesthetic fluid is not buffered, the pH may be such that it can burn a little more. The local anesthetic is delivered by me very, very slowly which helps minimize the pain. Some medication can be given to help minimize the pain felt, but many times this is not even necessary with the above techniques. There are some patients whose pain threshold is so low that what isn't felt as painful by most people is excruciatingly painful to them. There may be a biochemical reason for this in how their neurologic pathways are constructed. The overwhelming majority of my patients do not feel that the anesthetic delivery is painful.

Manhattan Dermatologic Surgeon
5.0 out of 5 stars 34 reviews

Anesthesia for Liposuction

                                    Tumescent liposuction represents a significant advance in the management of localized fat collections. When this technique is utilized with local anesthesia alone the response varies from patient to patient.  The majority of patients appear to do well and have good results especially when smaller amounts of fat are removed.  Unfortunately, we frequently see patients who have had similar experiences and are less than happy with their procedure.

                  For this reason, many surgeons supplement local anesthesia with I.V. sedation or general anesthesia to minimize pain and discomfort during the procedure.  When utilizing this approach, patients can have more fat removed and avoid multiple procedures.  The procedure is more comfortable and avoids break through pain which can occasionally occur with local anesthesia alone.

                  It’s important to realize that all surgical procedures and anesthetic techniques have risk.  This is true whether local anesthesia, I.V. sedation or general anesthesia are utilized.  Most surgeons who perform tumescent liposuction agree that the anesthetic technique utilized is less important than the use of certified operating room and the presence of an anesthesiologist.  In other words you don’t want your surgeon to be your anesthesiologist. 

Tumescent Lipo

The infiltration of fluid is not usually painful, but can on occasion cause a little pressured feeling.  There may be a feeling of stretching or fullness, but that should resolve quickly. Thank you for your question and good luck with everything.

Vivek Bansal, MD
Danville Plastic Surgeon
5.0 out of 5 stars 13 reviews

Proper meds for tumescent liposuction

Here is my recipe that has changed very little and been very successful for over ten years:

  • Lorazepam 1 mg the night before (keeps one from tossing and turning all night thinking about the next day's procedure.
  • Celebrex 400 mg one hour before the procedure.
  • Lorazepam 1-2 mg one hour before the procedure.
  • We start the procedure with a warmed bed, relaxing music, and whatever else might be calming to that person.
  • If there is anything more than minimal discomfort, we give Versed 5 mg. This is a pretty stong sedative and makes one drowsy for the rest of the day, but makes all the difference for the one out of ten who need it.

T. Wayne Day, MD
Nashville Dermatologic Surgeon
5.0 out of 5 stars 1 review

Tumescent liposuction

Most painful part of liposuction is initial injection at the site of incision and initial part of infiltration particularly in the superficial plane. I prefer to go very slowly using very fine needle to minimize the pain. Starting with deep infiltration first, ensures good anaesthesia for superficial infiltration. Adding sodium bicarbonate to the solution reduces pain of the anaesthetic. Bottom line is surgeon needs to be very gentle and patient to minimize the discomfort.

Sanjay Parashar, MD
Dubai Plastic Surgeon
4.5 out of 5 stars 12 reviews

Painful Tumescent Liposuction Procedure

There is pain associated with liposuction. I usually perform liposuction under general anesthesia or under local with IV sedation, so I will be able to take out as much fat as I can while making it a comfortable experience for the patient.

Kenneth Bermudez, MD
San Francisco Plastic Surgeon
5.0 out of 5 stars 11 reviews

Anesthesia and liposuction

Liposuction can be very painful; unfortunately, this is not advertised.  Some sort of medication must be given for it to be tolerated in most patients.  Oral valium and narcotics will work or IV sedation or general anesthesia.

Samer W. Cabbabe, MD, FACS
Saint Louis Plastic Surgeon
4.5 out of 5 stars 22 reviews

Lipsuction and pain

Your experience sounds like you had liposuction under local anesthesia only.  This is one reason why I use sedation being performed by a board certified anesthesiologist.  I want my patients as comfortable as possible.  Then I can do my best work knowing that my patient is comfortable.

Steven Wallach, MD
New York Plastic Surgeon
4.0 out of 5 stars 22 reviews

Liposcution is usually done under general anesthesia

Liposuction under local anesthesia is not for everyone.  Some patients are able to relax and get thru it while others are much better under general anesthesia.  The tumescent solution does have some of the numbing medication in it, but it is still uncomfortable for most unless asleep.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 60 reviews

Local Anesthesia For Liposuction Is Not For Everyone

While many surgeons tout the advantages and ease of liposuction under local anesthesia, it is not for everyone. Your experience is not a rare one. This is why I prefer my patients to have general anesthesia or some form of sedation for most liposuction procedures. This is particularly important in a patient who has any form of anxiety about undering this type of operation.

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.