Local anesthesia for Liposuction?

Question

Hello, As the title states I'm looking to have Liposuction performed in the next few weeks. Areas of concern: Flanks, stomach, & thighs. What has been your experience with doing Liposuction with local anesthesia? Can multiple areas be done? I found a few plastic surgeons out of state that perform high volume liposuction with local anesthesia. I've also saw a few surgeons offer the ability to split the procedure up over the course of a few days. General anesthesia isn't a option, would there be any other alternatives to having this procedure performed? I greatly appreciate any guidance and assistance you can provide.

Jose Telich, MD · Answer

Dear Kristina0929,

Thank you for your question. While small-volume liposuction under local anesthesia can be safely performed in select cases, removing larger amounts of fat or addressing multiple areas under local anesthesia carries significant risks, including lidocaine toxicity and even death. These risks increase with prolonged procedures or when multiple areas are treated simultaneously.

For safety, major liposuction procedures should be performed in an accredited operating room under the care of an anesthesiologist. Alternative anesthesia options, such as regional anesthesia or epidural blocks, may provide effective pain management while avoiding general anesthesia. These options should be discussed with your plastic surgeon and anesthesiologist to ensure a safe and tailored approach to your procedure.

Splitting procedures over several sessions could be a safer alternative if you're averse to general anesthesia, but each case requires careful evaluation. Your safety should always be the top priority.

Daniel Barrett, MD · Answer

Dear kristina0929,
it is hard to tell for sure without an examination. Generally speaking, it is possible to perform liposuction under local anesthesia. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Jonghyun Hong, MD · Answer

Hello it is Dr. Hong from Fresh Clinic, South Korea. In Korean it is very common to perform liposuction under local (sleeping sedation) anesthesia .

Emmanuel De La Cruz, MD · Answer

Local anesthesia is commonly used for liposuction procedures. It involves injecting a solution (often containing lidocaine and epinephrine) directly into the area where the fat will be removed. This solution helps numb the area and constrict blood vessels, reducing bleeding and making the procedure safer.

Here are some key points about local anesthesia for liposuction:

Procedure: The surgeon injects the anesthesia solution into the targeted areas using small needles. This numbs the area and prepares the fat for extraction.

Advantages: Local anesthesia is preferred because it allows the patient to remain awake during the procedure. This reduces risks associated with general anesthesia and typically leads to faster recovery times.

Safety: The dosage of lidocaine in the solution is carefully controlled to ensure safety. Surgeons follow guidelines to limit the amount of lidocaine administered per session to avoid toxicity.

Comfort: Although the patient is awake, they typically do not feel pain during the procedure due to the numbing effect of the local anesthesia.

Applicability: Local anesthesia is suitable for most liposuction procedures, including those targeting smaller areas or larger areas where the patient prefers not to undergo general anesthesia.

Overall, local anesthesia has become a standard choice for liposuction procedures due to its safety, effectiveness, and reduced recovery times compared to general anesthesia. However, the specific type of anesthesia used may vary depending on the extent and location of the liposuction being performed.

Ajaya Kashyap, MD · Answer

Thank you for your query. Small areas, even if multiple, can be treated with liposuction under local anesthesia. There are safety issues if too much of liposuction fluid is injected. It is safer to split the sessions over a few days if you are looking for multiple areas to be treated, i have found Waterjet liposuction more comfortable than Vaser liposuction, under local anesthesia. Please find an experienced board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

George Marosan, MD · Answer

Thank you for your question. Liposuction can be done under local anesthesia, general anesthesia or deep intravenous sedation. I have done over 500 cases of liposuction under local anesthesia with minimal oral sedation +/- intramuscular narcotic anesthesia. I prefer to do all my liposuction procedures under deep intravenous sedation. Besides the anesthesia factor, there are two kinds of liposuction: 1. fat reduction, which 99% of surgeons and non-surgeons do and 2. sculpting, which only highly trained surgeons do well. The first one can be done under local. Why the multiple days of surgery under local? It is to avoid lidocaine toxicity, seizures, coma and death. Under intravenous sedation, way less lidocaine is used in the tumescent solution and will never reach toxic levels. So, local is not always the safest as some practitioners want you to believe. Although the type of anesthesia is a concern for most patients (heard many horror stories), the fact is that all have a very low risk if done by the appropriate professionals (anesthesiologists or certified registered nurse anesthetists) and not by the surgeon who also does your surgery. See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

Joel Patrick Maier, MD · Answer

It is common and preferable to perform liposuction with light oral sedation and local tumescent anesthesia. Depending on the BMI and how many areas are treated, 1 or more stages may be needed. Thank you.

David Hansen, MD · Answer

You are smart to get your lipo under local. Usually you would do the full  abdomen and flanks in 1 procedure and come back the very next day and get the thighs and knees done. That way you recover all at once and it is the safest way to do it with the best results. You can go back  to work in 2 days and be back to the gym in 1  week.

Camille Cash, MD · Answer

Safety is the number one priority in surgery.  Having large areas addressed with liposuction is best done under general anesthesia.  This is for your safety, comfort, and to maximize your results.  Smaller areas can often be safely performed with local anesthesia.  I've included a video on this that I hope you find helpful.

Connie Hiers, MD, FACS · Answer

I have done "awake" liposuction for many years, and it can be very safe if done correctly. There is a limit on how many areas can be treated at one time because of the limit of local anesthesia that can be used at one time. Typically, the abdomen and flanks can be done in one setting, or arms with thighs. I suggest going in for a consultation and discussing your concerns and areas to be treated.

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