Percocet and Xanax for Smart Lipo? I recently went for a consultation for Smart Lipo for the thighs.

Question

I was told besides lidocaine, percocet and xanax are taken before the Smartlipo to put me at ease and for pain management. I thought a person is awake during Smartlipo doest those pills combination knock a person to sleep? Also I am VERY NERVOUS to take it will I feel or go into panic once ingested? Will I become dependent on these drugs after? I need honest feedback on this and are there other options besides taken those 2 drugs.

William J. Hall, MD · Answer

Hi Thunderthighs,
 Yes, there is typically a combination of three drugs given before local anesthesia liposuction. The drugs are as follows: Xanax, Lortab, and Zofran. The Xanax is given to help relax the patient, the Lortab is for pain, and Zofran is for nausea. The drugs aren't a high enough strength to knock a patient out, it generally just makes the patient very comfortable and relaxed throughout the procedure. Taking the medication once isn't enough to become dependent upon them, it generally happens over several months to several years with daily use. I wouldn't over think it too much, as you will just work yourself up over something so minor. Best of luck to you!

Mark Edward Hennessy, MD · Answer

I understand your concerns regarding addiction (given almost daily reports of  opioid addiction in the news). However, you do not have to worry: 1) the dosing of the medications is low 2)number of pills is limited to a low number 3)you have no prior history of addiction. This is an ideal combination of medications to help you relax and management the initial pinches and pressure associated with infusing the numbing medications under your skin. A few of my patients have briefly fallen asleep during Lipo, but they always wake up when it is time for them to roll onto their sides. You will walk out of the office after lipo under your own power. A friend/family member will have to drive you home. I recommend that you seek out a Cosmetic Surgeon whom offers cost effective liposuction.

Harry T. Haramis, MD, FACS · Answer

If you are very nervous to be awake, this could limit your procedure and results.IV sedation (twilight) may be a better option and should be discussed with your plastic surgeon.

Jason Emer, MD · Answer

Awake liposuction for small areas can be performed using injectable and oral medications.  I suggest however seeing a full body contouring expert to get an even better outcome.  Smart lipo is also outdated and VASER + Jplasma/Renuvion/Inmode BodyTite do best. Best, Dr. Emer.

Marco A. Pelosi III, MD, FACOG, FACS · Answer

Your choices are no meds, meds, and IV sedation. It's common to be given a single dose of percocet and an anxiety pill before lipo done awake. They take at least 30 minutes to kick in on an empty stomach, but they will not put you to sleep. You will not become addicted to anything from a single dose, but someone will need to take you home. From the tone of your question, it appears that you are anxious to begin with and would benefit from an anxiety pill. However, without these meds, your chance of a panic attack is higher. Since you are nervous, you should consider going to sleep for your procedure with the aid of an anesthesiologist to provide intravenous sedation and complete peace of mind.

Calvin Jung, MD · Answer

Yes this is considered "awake" lipo because you will still be able to talk, breath and will make you comfortable prior to the procedure.  The tumescent solution will numb up the areas of interest and is the key to a pain free procedure.  You could opt not to have any oral medication, however, the numbing portion may feel slightly uncomfortable.  If you have never had an addicitive personality to medications or alcohol etc it is unlikely that you will become addicted to these medications after only one dose.

Ryan Neinstein, MD, FRCSC · Answer

Thanks for the question and this is become more and more of an issue with the recent concerns over our nations opioid crisis. I like valium and percocet to help make patients comfortable before lipo, they are talking and breathing on their own and typically very comfortable. For patients who prefer not to have any opioid we can use valium with toradol and gabapentin. The key is the lidocaine which is weight based and should be done by the surgeon themselves. Many patients now just use the lidocaine and are totally fine

Scott C. Lindsay, DO · Answer

Hello and thank you for your question.These medications are used to make  you feel more comfortable and at ease. You won't become dependent or have a  panic attack on them. It is a one time use. Contact your surgeon to discuss your concerns. Best of luck!

Connie Hiers, MD, FACS · Answer

Most people need more than just Percocet and Xanax be put to sleep. Both are given to relax you so you can tolerate the numbing process easier and relax for the procedure. If you are prone to panic attacks, you might consider general anesthesia instead. It is very unlikely that you will become addicted to narcotics after this elective surgery. Most patients only need one prescription of pain medication for the recovery after liposuction, and most surgeons only give one prescription. If you would prefer no narcotics, nonnarcotics may be given instead.

David E. Berman, MD (retired) · Answer

you will not become addicted to these medication since you are only taking them for the procedure. also these medications will not render you unconscious. They will simply make you more relaxed. you will not go into a panic. you need to trust your dr and be more relaxed.I have done over 600 Smartlipo cases in the office and i give almost all of my patients oral sedation before the procedure. david berman md

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