Awake lipo: I was told that this procedure is pointless and sucks out no fat.

Question

Anesthesia and more invasive is worth it. Can professionals elaborate on this concept? I don't have much fat to remove,...

Austin Hayes, MD · Answer

I use general anesthesia for my liposuction procedures, but there are many surgeons who perform awake lipo. This means that they use local anesthetic to make sure that you are numb before doing a liposuction procedure. Whether you are awake or asleep does not affect your surgeon's ability to remove the necessary amount of fat. I would trust in your surgeon's recommendations, as long as you feel that they are experience and that they have photos that demonstrate the results that you desire.

David Hansen, MD · Answer

Liposuction under local is the only way to go. You get all the fat you want removed and it is done safely and you actually get a better result since your doc can stand you up and turn you in all positions for the best touching up results.

Afshin Farzadmehr, MD · Answer

the safest lipo is one without unnecessary general anesthesia.  Tumescent lipo and appropriate sedation is gold standard and safest allowing for best results.  Based on my 19 years of performing lipo and over 10,000 patients in UCLA UCI Brazil and Beverly Hills I have not had even one patient go through the risk associated with un needed general anesthesia.   The risk of any procedure after considering a surgeon is experienced and qualified is the general anesthesia that Is not necessary particularly for this procedure.

Daniel Barrett, MD · Answer

Dear yoyo216,it depends on the area which should be liposuctioned. If it is only small area, then a local anesthesia can be an option. If you want a more extensive liposuction, then a general anesthesia is a better solution.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Kenneth Hughes, MD · Answer

Liposuction of smaller areas can certainly be performed under local.  For larger areas or for more removal, additional anesthetic options should be considered.

Justin West, MD · Answer

Hi and thank you for the question. The point of liposuction is to remove volume. This can absolutely be done in an awake patient. The keys are managing discomfort and choosing patients who are comfortable with it. I think it can be a great option for the right patient who has a small amount of fat to treat as you described. Good luck. 
Dr West

Tim Sayed, MD, MBA, FACS · Answer

Here's the deal:
Liposuction under local has severe limitations in most surgeons' hands. The amount of fat that can be removed under local is more limited as there are boundaries on how much local anesthesia can safely be injected before you reach a toxicity risk. General anesthesia allows the surgeon to move more efficiently, take out more fat, be more aggressive with tissue handling (like maneuvers to smooth the result and improve skin retraction), and treat more areas. A situation where the patient has very little fat to remove in a small area is paradoxically both a better scenario for lipo under local (small areas, limited need for lidocaine) and a worse one (may be harder to do subtle correction and results may be less noticeable). Not sure if  the person told you it is pointless because (s)he could not offer enough expectation of improvement because of your limited fat, or because (s)he does not think that surgery under local would allow enough aggressive technique to give you value. In-person exam is the best way for anyone here to better counsel you on your options, of course!

Robert M. Kachenmeister, MD · Answer

Thank you for reaching out. Being awake or asleep does not affect the ability to remove fat. Generally if you go under general anesthesia it can be more aggressive, but if you do not have much fat to remove, local anesthesia might be an option. I would suggest you go on a few in person consultations with board certified surgeons to learn about all options. Best of luck! Dr. Kachenmeister

Johnson C. Lee, MD · Answer

Generally speaking, liposuction results are based on the technique and ability of the surgeon and not the type of anesthesia. The anesthesia's purpose is to make the patient comfortable. As long as a patient can be made comfortable during awake liposuction, it should not affect results. Many surgeons, however, feel that they can be more aggressive with liposuction and their technique if the patient is asleep so they do not feel any discomfort from the more aggressive manuevers. Also, the larger the area, the more chances the patient has to feel the poking and prodding from the liposuction and the patient may want to more seriously consider general anesthesia as an option. Since anesthesia has its own risks, it is important to have an in-office history and physical to determine the best treatment plan together with your surgeon. Hope this helps!Johnson C. Lee, MD Plastic Surgery@drjohnsonlee

Milan Doshi, MS, MCh · Answer

Hello and thanks for your question.
 Single area or Small area  liposuction and one is not anxious liposuction can be done  under local  anesthesia.
If large area  or multiple area liposuction to be done it is better to do under general anesthesia to have pain free better experience.  And result will be better because surgeon is able to do through job.
Best of  luck
 Dr Milan Doshi

Awake lipo: I was told that this procedure is pointless and sucks out no fat.

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