Should I get BBL done with general anesthesia or local? (Photo)

Question

I do not have a lot of fat and thus wondering if local will suffice. 2 Doctors I am interested in & have also checked their pix. 1 of the 2 docs costs less and is a derm/cosmetic surgeon whom performs local. The 2nd doc is a ASPS certified, general anesthesia & costs $2K MORE!! I am so confused. I like the ref pix from both docs. I must add that this would be my 2nd plastic surgery as I have had breast implants done 5 yrs ago. I'm 5'9", 184lbs. ANY INFORMATION WOULD BE GREAT!! HELP!!

Ricardo L. Rodriguez, MD · Answer

Neither.The various types of anesthesia plastic surgeons use include local anesthesia, various types of IV sedation (where you breath on your own), and general anesthesia (assisted breathing with a tube).I perform all of my major procedures, including multiple procedure makeovers with IV sedation. A Brazilian Butt lift is a major procedure as it involves liposuction, fat processing, and reinjection of the fat (the process of fat reinjection involves scores of injections).While looking at before and after photos is a good way to get a general idea of a doctor's Brazilian Butt lift results, there are several other factors to consider both while looking at the photos, and in general.With photos, you want to be sure you're looking at patients with similar body types and you'll want to have additional information such as when the "after" photo was taken in relation to the surgery. You'll also want to know what percentage of your surgeon's patients end up having a follow up or "touch-up" procedure.In general, you want to be sure your plastic surgeon is board certified by the American Board of Plastic Surgery and has extensive experience in performing this specific procedure. The technique that your surgeon uses will affect not only your surgical result, but will also influence how long your results last.You should also be able to get a clear explanation of how the surgeon performs lipo, how he processes the fat, how he reinjects the fat, exactly what his operative technique is, and what his surgical goals are.Also know that when you price shopping the Brazilian Butt lift you'll need to ensure you're comparing apples to apples. How many areas of liposuction will be performed? What, exactly, is included in the quoted price? Physician's fee, anesthesia, operating room costs, post operative office visits?Best wishes!

David Shifrin, MD · Answer

I would be concerned if my family member was getting large volume liposuction under local by a dermatologist in their office. The potential for complications or less than satisfactory results is high.There are more than enough American board of plastic surgery certified surgeons in Chicago who do good work in safe controlled environments.Best

Luis Macias, MD, FACS · Answer

I only perform a BBL under general anesthesia, if performed correctly, it is entirely too much surgery to do while awake.  Does the first doctor you mention do any surgery under general anesthesia?  Is his/her practice limited to doing only cases under local anesthesia?   Do not choose your surgeon based on price as it may cost you in the long run. Make sure your surgeon specializes in gluteal shaping and look at before and after photos. Hope this helps and best of wishes.

Kenneth Hughes, MD · Answer

This procedure involves multiple facets and it takes an expert to give you the best result and avoid complications that can be avoided.  I would not recommend local anesthesia.  I would search for the surgeon who you feel is most likely to give you
the best results. Look at reviews and before and after pictures on that
surgeon's website. Kenneth Hughes, MDLos Angeles, CA

Andrew Jimerson, MD · Answer

You raise 2 good questions: local vs general anesthesia for BBL and dermatologist vs plastic surgeon for BBL.I am a board certified plastic surgeon with my own certified surgery center.  I recommend general anesthesia.  Liposuction is painful.  While I have performed it under local in the past, I find that my patients are uncomfortable this way and it limits the amount of liposuction I am able to perform.  The liposculpture is critical to the outcome of your BBL and in my opinion, it is best done under general anesthesia. Anytime you are considering surgery, I would ask the performing doctor if they have credentials to perform this procedure in the hospital and how they would handle any complications that may arise.  As a board certified plastic surgeon, I have the expertise to handle any surgical complications that may arise and the credentials to operate in a hospital if necessary.  I would ask ANY provider who is offering liposuction under local anesthesia if they have the credentials to do it under general anesthesia and if they have hospital privileges to perform the procedure in the hospital.  If they don't, I would recommend doing research into whether or not this is a surgeon.  Surgical and Medical training programs differ greatly.  There are a lot of doctors who perform cosmetic procedures but not all are surgeons.  Surgeons often cost more, but in my opinion, the expertise is worth it.

Barry L. Eppley, MD, DMD · Answer

Be wary of compromising your result by limiting what can be done with inadequate anesthesia. The most effective BBLs in most patients require through fat harvesting and deep as well as superficial fat injections. This requires general anesthesia to get the best (maximal) results.

Steven Wallach, MD · Answer

I perform a lot of liposuction under local only but I will say that it can be very uncomfortable to inject the fat back under local only. I would prefer with general or deep sedation.

Ofer Rodriguez, DO · Answer

beware of charlatans, trust only a plastic surgerybbl is no what you need, you have plenty of fatyou need a total liposculpture of torso with fat to buttlocal anesthesia only if you want crappy results.what makes the butt is not the butt per set but is done around it.

Michael Salzhauer, MD · Answer

I perform all of my BBLs under general
anesthesia. Trust me; you do not want to be awake during this surgery.
Liposuction is a very aggressive procedure and I have a lot of patients who
have had previous liposuction with other surgeons/Doctors under local and come to me
because they are not satisfied and are complaining of residual fat. It is
hard to be aggressive and fully sculpture the body under local. To get the best result do it under general. I also strongly
recommend having this procedure done with a board certified plastic surgeon that
constantly does this surgery and can provide you with a large gallery of before and
after pictures and reviews. 
Best Wishes,

Dr Miami :)

George Lefkovits, MD - Account Suspended · Answer

The BBL is the number one procedure I perform in my office. I always do it under general anesthesia. It is difficult to aspirate the fat and transfer it under local anesthesia. You should have your surgery by the Board Certified PS whom you consulted with. He has the proper training to perform the procedure, and by being able to do it under general anesthesia , you have a higher chance of getting a satidfactory result. The 2K extra is well worth it. Good luck!

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