Brain-dead from Laser Lipo Under Local Anesthesia?

Hi there-
Without knowing more details about the patient and surgery you refer to, it is very difficult to know exactly what might have happened... I can tell you that there was recently a patient death here in Florida during Smart Lipo under local anesthesia (possible we're talking about the same case)....
This patient died as a result of Lidocaine toxicity- a situation in which she was administered excessive amounts of numbing medicine during the procedure in an attempt to make her comfortable. Complicating the situation (and in my opinion contributing heavily to the risk) was the fact that she was having the procedure performed by a physician whose primary training (his residency training) had been in rehabilitation medicine (the type of doctor that might help you recovery from hip replacement or a stroke... these doctors most certainly do not receive liposuction training in residency), and was being done in his office, not an accredited OR...
There are several issues here.... First of all, it is imperative to understand the difference between saying that something "can" be done, and whether or not it is actually in the best interests of the patient.... If you asked me, "Can liposuction be done on an awake patient with local anesthesia?", I would answer yes, but unless it is the SMALLEST of areas, you are exceptionally tough, and you don't mind possibly compromising the outcome a bit, you should not have it awake...
Regardless of technology, the truth is that liposuction (again, unless it is the smallest of areas) hurts. Period.
Sculpting a lovely outcome for a patient is very difficult when they are in pain (even if they are a bit sedated and might not remember it) because I (being a nice guy) worry about their pain and the trauma they are experiencing, and become a bit distracted from the job they paid me to do- to give them the best outcome possible. The possible scenario here is that you end up having a terrible, painful experience, and don't even get the desired outcome because instead of focusing on doing their best work for you, your surgeon is preoccupied with your pain.
I suspect that this is what got the doctor in the situation above into trouble and led to the unfortunate death of his patient- she experienced pain, and he treated the pain with the only option available to him (since he was not doing it in an OR with an anesthesiologist available)... and ended up giving her so much numbing medicine that it caused her death.
So in my opinion, just because in some cases liposuction CAN be done with only local anesthesia doesn't mean that it is in the best interests of the average patient.
The second big issue is that the symptoms of lidocaine toxicity usually are not manifested for many hours after the drug is administered (up to 16 hours later!). This means that by the time you begin to have a problem from receiving so much lidocaine, you are probably no longer at the doctor's office, but at home, where you may not realize you have a problem until it is a big one....
Finally, it cannot be emphasized enough that liposuction (ANY liposuction, whether it is with Smartlipo, the VASER, or any other machine) IS SURGERY. No surgery should be entered into lightly. You should absolutely research the surgeon's credentials, but also those of the facility and the anesthesia provider. Be sure your surgeon is certified by The American Board of Plastic Surgery.... You would never let a doctor perform heart surgery on your mother if you knew his residency training had been in pediatrics, would you? Letting a doctor who did not receive training in plastic surgery as a resident do liposuction on you is not much different.
Be careful- safe and effective liposuction exists- but you have to do your homework.

For any surgical procedure it is important that your Plastic Surgeon has your safety as priority #1.  Make sure that your surgeon is Board Certified and practices at an accredited facility.  Fortunately liposuction and Smartlipo done by a reputable and safe surgeon on an appropriate patient is a very safe procedure. 

Without knowing all of the details, there is no way to speculate about what transpired. More detailed information is needed to begin to understand what happened.