Will general anesthesia allow for more drastic submental lipo results than local?

Question

Hello, I recently had a consultation for submental liposuction and was told I would need to be put under general. To my understanding the amount of fat to be removed will require a toxic level of local anesthesia, requiring general instead. Is this realistic? Will general anesthesia allow for more drastic results than local anesthesia will (i.e will they be more aggressive/take more fat out this way)? I did not get any red flags from this surgeon, I am just wondering. Thanks!

Irena Karanetz, MD · Answer

Hello,
It is difficult to answer you question without seeing photos, but typically small amount of neck and chin liposuction can be safely performed under local anesthesia. However, this also depends on individual patient's pain threshold and tolerance. Performing liposuction under general anesthesia typically allows for more aggressive and precise liposuction, and improvement of chin and neck contour.
I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon in order to discuss your goals and concerns for the best cosmetic results. 
I hope this helps.Best regards, Dr. Karanetz
Dr. Irena KaranetzFellowship-TrainedBoard Certified Plastic Surgeon

Jason Emer, MD · Answer

It's difficult to say without the benefit of an in-person evaluation. Perhaps get a second opinion from another physician to discuss what next steps you are most comfortable with. ​I find that VASER liposuction in combination with Renuvion or ThermiRF are best for contouring the chin in those who are candidates, but Kybella can be used as an alternative and gets better results when combined with Thermage/Ultherapy/Exilis, TruSculpt iD, or Coolsculpting. I recommend getting a formal evaluation with an expert. Best, Dr. Emer​

Michael P. Morrissette, DDS, FACS · Answer

The use of general anesthesia for submental liposuction is usually unnecessary. . There are some aspects of the procedure that are a bit uncomfortable (the injection of local anesthesia or tumescent anesthesia) so I prefer to perform the procedure with intravenous sedation. A light amount of intravenous anesthesia allows me to to inject local anesthesia and perform the liposuction with no discomfort whatsoever. We perform the procedure in the office which generally takes an hour.

Tanveer Janjua, MD · Answer

Chin liposuction can be done under local anesthesia effectively and safely. The use of general anesthesia could be related to a surgeon's comfort level with the whole procedure. You have to decide for yourself as to which anesthesia you prefer. In my practice I always do it under local anesthesia unless  I am doing it as part of a necklift or facelift that might require general anesthesia.
Regards
Dr. J

Daniel Barrett, MD · Answer

Dear jrdntndy,
it is hard to tell for sure without an examination. Generally speaking, local anesthesia can be used for major surgeries. In most cases submental liposuction can be done under local anesthesia. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

William Portuese, MD · Answer

A full set of the facial and neck photographs from all angles are required to make a determination about how best to proceed. It's very important understand that there are Two compartments of fat in the neck, one is located above the platysma muscle, and the other one is located below the platysma muscle. Liposuction can only accomplish removal of the fat deposits above the muscle,  while a surgical neck lift accomplishes removal of the fat deposits above AND below the platysma muscle which also includes a platysma plasty to significantly improve the jaw line. Liposuction can be performed under local anesthesia, however a neck lift is performed under general anesthesia.

Darryl J. Blinski, MD · Answer

This is a real issue especially if given poor reasoning! If doing lipo under 1 liter in volume, whch most sub mental lipo is under 50cc's!, local anesthesia is the standard of care. If doing lipo over 2 to a max of 4 liters general anesthesia allows better removal of the fat with so much less pain during surgery. Please ask the surgeon the real reason for general anesthesia in a small lipo under the chin....???

Mats Hagstrom, MD (license on probation) · Answer

Each plastic surgeon will have their own preference in regards to anesthesia. Much of this is based on how are the provider learn from their training and how they have evolved their practice during their career.

Personally I do all liposuction procedures with patients awake using local anesthesia with mild sedation. Of all anatomic areas treated the chin and neck is one of the easier to perform avoiding general anesthesia.

The area does not require aggressive Liposuction and doing aggressive Liposuction can lead to catastrophic irreversible disfiguring results.

Plastic surgeons will recommend the type of anesthesia they are accustomed to using. Each one of us has evolved our styles the way we think serve our patients needs the best.

Personally I think general anesthesia is overkill for what is a fairly simple procedure that can easily be done in an office setting with patients awake using locally and seizure with or without mild sedation.

If you feel like the surgeon you met with is the right doctor for you then you should follow his or her recommendations.

If not I recommend scheduling multiple in person consultations with other providers.

Best,

Mats Hagstrom MD

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