I have a very low pain tolerance - is AirSculpt for me?

Question

I recently had a consultation with the Boston office. I’m looking at getting multiple areas done (abdomen, bra roll, chin + bbl). I have a very low pain tolerance. For reference, I had coolsculpting on my chin in the past + I found the massage to break up the frozen tissue EXTREMELY painful. Airsculpt claims to be painless, however the surgeon said it was 100times more painful than coolscupting. He said I wasn’t a good candidate + should consider traditional lipo with general A. Thoughts?

Mats Hagstrom, MD (license on probation) · Answer

Liposuction can be done with general anesthesia, deep sedation, moderate sedation, light sedation or with only local anesthesia.
There are safety limits regarding how much lidocaine can be used so the more areas that are being treated could potentially make the procedure more uncomfortable. There is a substantial learning curve to doing full body liposuction and fat grafting with patients awake without causing excessive pain.
This is not something most residents learn during their training.
There’s a big difference depending on who does the procedure and patients vary substantially based on their ability to tolerate pain.
I’ve personally had both patients who claim to be very sensitive and those who claim to have a high pain threshold find the procedure easy and difficult.
I to get a quality result and not induce excessive pain surgeons need to be extremely flexible and never be in a hurry. Awake procedures often require adding more local anesthesia and the times adjusting pain medications appropriately.
There is without a question some discomfort with having awake body contoring. most patients find it tolerable but not pleasant. Perhaps a bit like getting a tattoo or having a major dental procedure.
One option may be to ask the provider you’ve consulted with how long he’s been doing awake procedures. The first few hundred cases done without general anesthesia can definitely be a bit trying. Like I said there is a learning curve for getting patients through these procedures without excessive discomfort.
I have no idea how much massage after coolsculpting hurts but I’ve heard that cool sculpting can be quite uncomfortable.
 There certainly nothing wrong with going back and talking to the provider again or asking for a second opinion.
My practice has been devoted exclusively to doing liposuction and fat transfer procedures for the last 10 years. During that time almost every single case was done with patients awake using mild sedation with local anesthesia exactly or similar to how air sculpt is performed. During the first 15 years of practice I typically used general anesthesia for any major Liposuction work.
Having done the procedures both ways I have a fairly strong belief that keeping patients awake for liposuction and fat transfer has enough advantages that it is a much better way to do the procedure.
It does require the surgeon to have this skill and experience to put patients through the procedure comfortably and this simply takes practice and being patient.
The primary advantage to avoiding general anesthesia is the ability to have the patient moved during the procedure and hold multiple different positions allowing us to contour the body in a more expert manner.
Avoiding general anesthesia typically also reduces blood loss, decreases postoperative bruising and improves the safety profile to some degree.
This is not to say that all plastic surgeons should stop using general anesthesia for liposuction. Unless a surgeon is willing to take the time to learn how to do procedures without general anesthesia in a comfortable humane manner it’s probably better to have an anesthesiologist on hand to make sure patients do not experience excess of pain.
Most likely you’ll be able to tolerate the procedure well but anticipate there will be some discomfort. The most important aspect is to have open communication with your surgeon and the nursing staff continuously throughout the procedure and let them know what you can tolerate and if it gets uncomfortable to the point where you cannot tolerate it.
Often adding adjuvants like breathing nitrous oxide can help patients through certain parts of the procedure that may be more uncomfortable.
In the end each patient needs to make their own decision for what seems appropriate and what they feel comfortable with.
Best of luck in your decisions.
Mats Hagstrom MD

I have a very low pain tolerance - is AirSculpt for me?

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I have a very low pain tolerance - is AirSculpt for me?

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