Is Smart Lipo painful under local anesthesia?

Smart Lipo is similar in pain to traditional liposuction. Most forms of liposuction involve injecting fluid into the area that contains a local anesthetic. In my San Francisco area practice, we perform lipo in our office and in the operating room.
The location depends on several factors including issues of safety (how much tissue is being removed, patient health issues, etc.) as well as patient comfort. Many patients can tolerate smaller areas of liposuction under local anesthesia and oral sedation. Some require the additional support of either IV sedation or general anesthesia. It depends purely on the patient.
For my patients who have strong fears of needles, we usually prefer to do this procedure under stronger forms of anesthesia. Talk to your physician and communicate your concerns. The best pathway to a successful procedure is good communication.
I hope this helps.

Any surgical procedure can be painful. The Smartlipo people try to convince everyone to have liposuction under local. Yes, it can hurt. Eventhough local is infiltrated, the injection can be uncomfortable, and even after the local is infused, the liposuction can be a bit painful. Most of the time this is not the case. That is why I prefer to give some sedation so patients are more comfortable. This also helps the doctor do a better job when he/she is more relaxed as well.

Smartlipo, like liposuction is not meant to be a painful procedure. In most cases, it is done using local anesthesia with a small amount of sedative to help the patient relax. This works perfectly well for most patients.
In your case, and you are not alone, the anxiety and fear of needles and having a procedure done can be very stressful. This situation is best dealt with using extra sedation, additional pain medications or even having an anesthesiologist do IV sedation or what some call twilight sedation.
Talk to your physician and see what options are available for you.