I Dont Understand the Difference? (Narrowing in on the Doctor to Use for Liposuction)

I am considering two doctors for liposuction of the flanks. Both use tumescent, but only one uses anesthesia? How does work? Does that mean that the doctor that uses anestesia uses a bigge canule?

Doctor Answers 7

Docs who still use gen. anesthesia tend to use bigger canulas.

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Most lipo docs who do the best work tend to use micro canulas and do it under local anesthesia. The smaller the canulas, then the smoother the results. Docs who still use gen. anesthesia (which we all did 28 yrs ago) tend to still use the larger canulas and tend to not get the best results because of it. It only makes sense. Trust your doc because even the gen. plastic surgeons who typically still do a little lipo on the side can do a decent job with their old methods but if you have a choice and you like both docs, then the choice is easy. Sincerely,

David Hansen,MD 

Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

Narrowing on the Doctor to use for lipo

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I do all but chins and small touchups under general anesthesia as I find that patients are uncomfortable without it and surgery takes much longer. The risk with general anesthesia are very small.

Liposuction Anesthesia

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  The use of tumescence is helpful with pain control.  However, I don't believe tumescence eliminates all pain during liposuction.  I believe that additional anesthesia ensures that the patient is as comfortable as possible. 


Clifford King, MD
Middleton Plastic Surgeon

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Both Doctors may do a great job. General anesthesia increases your risk of complications.

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General anesthesia increases your risk of serious complications.  This is the reason that I do all of my cases using only oral sedation and tumescent anesthesia.

Mark Taylor, MD
Salt Lake City Dermatologic Surgeon
4.2 out of 5 stars 18 reviews

If it were me, I'd want anesthesia and a board-certified plastic surgeon

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There are many people out there who absolutely CANNOT tolerate liposuction under straight tumescent anesthesia. It is either just too difficult to get the area anesthetized or they are too anxious about the procedure. We do all types of anesthesia, but patients are by far the most comfortable with monitored anesthesia (MAC).


One reason you may see some people not offer IV sedation has to do with state regulations re. the procedure in an office setting. In some states you are required to have hospital admitting privileges and/or required to show operating privileges at a hospital for similar procedures. This is a simple and common sense rule and should be part of your interview with your surgeon. If they cannot answer YES to both of those privilege questions then you need to look elsewhere.


When looking at your surgery you need to look for 4 indicators of quality and safety

  1. Board certification by the American Board of Plastic Surgery
  2. accreditation of their office operating room by AAAASF or JAHCO
  3. admitting privileges at a hospital
  4. hospital privileges for the same surgery

Liposuction and anesthesia

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I prefer to perform liposuction using an anesthesiologist to sedate my patients and make them more comfortable. I do not think that patients are as comfortable under straight local.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews


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As for the details of the anesthesia, you need to discuss this with the doctors. It seems you had a very limited discussion regarding the surgery or you forgot.

As for the size of the cannula, most of us use 3 and 4 mm cannula. occaisionaly on the very abundant fat may start with 5 mm cannula

Samir Shureih, MD
Baltimore Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.