Liposuction Local anesthesia not possible? (Photo)

Different plastic surgeons will have different levels of comfort and experience doing procedures using local anesthesia. earlier in my career I would not attempt to do full abdominal or torso liposuction without general anesthesia. 10 years ago I began specializing exclusively in liposuction and fat transfer procedures and now do all of my liposuction regardless of area or amount with my patients awake using local anesthesia with mild sedation. without sufficient experience and attempt at doing the procedure using only local anesthesia could result in a non-tolerably painful experience that is undesirable.
If done by someone who has experience and routinely does awake liposuction it’s fine to do the procedure without general anesthesia. it simply depends which doctor and put their experience is.
In regards to your results you have a substantial amount of visceral fat and this will not be treated with Liposuction so your results will not look like when you suck in your abdomen. in your case you simply need to lose weight and that is the best and most appropriate option to get a better looking torso. Weight loss is primarily related to what, how and when we eat as well as obviously how much.
A 20 pound weight loss program will get you where you want to be.
Liposuction is unlikely to deliver the results you’re interested in.
Surgery cannot correct for excess visceral fat.
Weight loss is the only and most appropriate solution in your case.
Best,
Mats Hagstrom MD

Based on your pictures, the decision on muscle repair vs lipo rests on careful in person examination.
then the question of lipo under local vs general anesthesia could be answered easily.