Hi thanks for your question. The decision to use local anaesthesia, twilight sedation, or general anaesthesia during a Vaser liposuction procedure is a personal one, and this decision should be made between the patient and the surgeon based on several factors, such as the the complexity and extent of the procedure (number of areas treated), the patient's medical history and medications, and their level of anxiety or discomfort. In my clinical practice, I use local anaesthesia for Vaser liposuction in limited areas such as the neck, arms, and flanks. However, I commonly use sedation or general anaesthesia when I perform Vaser liposuction in several areas of the body, especially the upper/lower abdomen, flanks, and back (known as the 360-degree approach). In my opinion and experience, when a surgeon uses local anaesthesia, they can remove fat but cannot perform body contouring very well due to the level of discomfort for the patient during the procedure. Vaser liposuction with twilight sedation or general anaesthesia, allows the surgeon to perform fat removal and also body contouring and middle to high definition Vaser, as the patient is completely sleep, and the consultant anaesthetist looks after the patient's vital signs and respiratory support. It is important to discuss the anaesthesia options with the surgeon and anaesthetist and ask any questions you may have to ensure you understand the risks and benefits of the different options. It is also important to have aftercare and follow-up visits with the surgeon after 1 week, 6-8 weeks, 3 months, and 6 months. I hope this helps. Best wishes, Dr Giuseppe Fiore