Is IV Sedation Safer Than General Anesthesia During Smart Lipo MPX?

I am considering Smart Lipo MPX on my lower abs. I was reluctant to have Traditional Liposuction previously because I didn't want to have General Anesthesia.

Everything I've read on Smart Lipo showed that it's generally done under local anesthesia so I was surprised when the Plastic Surgery Department told me that they use IV sedation (It was described to me as the same sedation that is used for Gastric procedures).

The procedure will be done at a well known teaching hospital. Is IV sedation safer than General Anesthesia? Why would he insist on sedation when most doctors are using local?

Doctor Answers 4

Local not safer than general anesthesia for Smart Lipo MPX

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You are incorrect, MOST EXTENSIVE Smart Lipos are done under IV sedation and/or light general anesthesia. This allows the operating surgeon to deliver more joules of energy to obtain a better result. Also the length of surgery time becomes shorter while under. Also, local only can cause major complications from overdosing on lidocaine, just like here in Florida. There was a death of a 30 year old mother of three from lidocaine toxicity during liposuction. My point is be careful out there. Regards.

Sedation, local or general anesthesia for smart liposuction

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Both smart liposuction and traditional liposuction can be done under either local or general anesthesia. Most local  procedures also have the patient take medications that are sedatives, however, according to the patient's preference. Regarding safety, local with sedation or just local is not necessarily safer than general anesthesia. It may be necessary to use much more local anesthesia with the tumescent fluid than with general anesthesia, and this has cased some problems and even deaths. With general anesthesia, pain tolerance is much improved, as expected, and less local is needed. Also, your airway and oxygen supply is much more controlled with general anesthesia. It becomes a matter of how much needs to be liposuctioned and the patient's and doctor's preference. 

Smart lipo requires no difference in anesthesia than tradition liposuction. In my opinion, traditional liposuction is still the gold standard for most areas.

General Anesthesia is never needed for liposuction

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General anesthesia is never needed for liposuction. General anesthesia adds unneeded risk to liposuction. GA (general anesthesia) increases the risk of post op nausea and vomiting. You don't want to be throwing up for 24 hours after your Lipo.

Most extensive lipos require either placing the patient face down on their stomach and/or turning the patient from side to side. There is more risk when patients are moved when they are asleep under GA than when they are awake.

Tumescent anesthesia is a specialized local anesthesia that was developed in the 1980's to allow surgeons to perform lipo without the risks of GA. A very dilute solution of local anesthetic and adrenaline is injected into the fat. This accomplishes two things; you feel no pain and there is almost no bleeding. Every lipo should have Tumescent fluid injected into the fat! Even when general anesthesia is used! The adrenaline prevents excessive blood loss and is one of the reasons Lipo has such a great safety record.

Why IV Sedation?

Unless the Tumescent (local anesthesia) is injected very, very slowly, it burns and hurts when it goes in. The sedation is used so that the patient won't feel the discomfort associated with injecting the local. The downside is some doctors give so much IV sedation, the patient is really getting GA (general anesthesia) through their vein. That is a dangerous situation if not monitored by an anesthesiologist or a CRNA (certified registered nurse anesthetist).

Very few facilities use pure local without some sedation.

For more than 20 years, we have combined epidural anesthesia ( the very safe anesthesia used for child birth ), Tumescent local, and light sedation.

Be sure any cosmetic surgery that you undergo is performed in a state licensed and national accredited facility under the supervision of an anesthesiologist or a nurse anesthetist.

Safety is your prime concern!

Richard L. Dolsky, MD (retired)
Philadelphia Plastic Surgeon

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IV sedation versus general anesthesia

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Which is safer? I think that general anesthesia may be safer in the sense that the airway is protected during the procedure. But there will be people that say IV sedation is better. A good anesthesiologist can do both.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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