Can fat injections be done under local anesthesia?

Question

I have read on this site that many doctors perform facial fat injections under local anesthesia. Is there swelling after a local is administered? If yes, does this affect the doctor's ability to judge the appropriate amount of fat to inject?

Larry S. Nichter, MD, MS, FACS · Answer

The type of anesthesia recommended for #FatTransferToBreast is dependent on several factors all which center around your safety and comfort level. In my practice we often use oral sedation with local anesthesia for many types of cases including the one you mentioned. However, we generally do not use this technique if you have sleep apnea, anxiety attacks, claustrophobic, or if the procedure will take more than 3 hours. This is a decision that will be made after consultation with your plastic surgeon. If you are in good health, then general anesthesia and IV sedation are also good options. Swelling occurs regardless of the technique and goes away progressively. The amount of fat available and the best amount to inject is determined by your surgeon not the technique. Dr. Nichter

Konstantin Vasyukevich, MD · Answer

Fat grafting is commonly performed under local anesthesia.  The injection of fat is not much different from the injection of other fillers that are used to improve the contour of the face.  To numb up the face most doctors inject local anesthetic into the are of sensory nerve to "block" the sensation of pain.  Some local can also be injected directly into the area of fat transfer, but the amount is usually very small and does not cause significant tissue distortion.

John J. Martin, Jr., MD · Answer

Fat transfer is done easily with local anesthesia.  There is very little discomfort involved with the procedure, so many patients opt to do this with straight local.  If you are anxious it can also be done with IV sedation.  While anesthesia is injected into the face, it is not enough to create distortion of the shape of the face.  We also usually have mapped out about how much will be going into distinct areas of the face.

Jamil Asaria, MD · Answer

Fat grafting can quite easily be performed to limited areas of the face under a local anesthetic. If you are considering larger areas to be treated, or fat grafting under the eyes, I find that patients are much more comfortable under intravenous sedation.

Stephen J. Ronan, MD, FACS · Answer

Small areas and micro grafting can be grafted under local anesthesia (i.e. lips, etc).  But if any significant amount of fat is to be grafted, you should have sedation at least.  Your comfort is important.  The more comfortable you are, the better the job we can do.  It is hard to place micro amounts of fat and see perfect contours while you are wincing.Some doctors try and do everything under local anesthesia because they cannot get privileges at a hospital due to lack of training.  Procedures under local in the office are not regulated as they are in a hospital.  If a hospital doesn't allow a physician to do a procedure on you due to lack of training, why would you want it from them?  Make sure whoever you let do any procedure on you is fully trained and can do that procedure at a hospital or accredited surgery center.  This advice alone will keep many people out of trouble.Good luck.

Michael Law, MD · Answer

Fat Grafting is an artistic endeavor that requires extreme training, expertise, and patience, Before selecting a surgeon, view many, many before and after images   Fat grafting involves both harvesting and placement of fat as there are two surgical sites, I think it is best performed under some form of sedation in addition to local anesthesia.  The exception would be very low volume grafting in very focal areas. I would stress that fat grafting is a surgical procedure. It is not like temporary fillers. patients do better with surgery when they are relaxed and surgeons can achieve the best results when patients are relaxed.

C. Bob Basu, MD, MPH, FACS · Answer

Fat micro grafting is commonly performed under local anesthesia.Dr. Basuhouston, tx

Omeed Memar, MD, PhD (license suspended) · Answer

Yes, fat transfer can be done under local anesthesia. I do fat transfer to the face, breast, and buttocks under local anesthesia. You need to go to a surgeon trained in tumescent anasthesia and has the artistic eye along with enough experience to judge the appropriate amount of fat to inject.

Vincent D. Lepore, MD (retired) · Answer

Smaller amounts of fat transfer, particularly in the face, can be performed under local anesthesia.  You are correct that the swelling associated with the local anesthetic must be taken into account when determining how much fat should be transferred.  Also, it is known that a percentage of the fat does resorb and this volume must also be taken into account when performing the procedure.  Seek out a board certified plastic surgeon with extensive experience in fat transfer surgery.  Best wishes, Dr Lepore.

Can fat injections be done under local anesthesia?

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