Hello sgarner29, I appreciate your questions! Depending on the volume of fat to be removed, cosmetic surgeons may performed liposuction with either local or general anesthesia. I typically use general anesthesia when performing large volume liposuction procedures (beyond 4-5 Liters). When the lipoaspirate surpasses the 5 Liters, patients are admitted overnight in the hospital. Overall, general anesthesia is very safe for most patients. Under general anesthesia, the anesthesiologist or nurse anesthetist remains with the patient throughout the procedure and carefully checks the patient's heart rate, electrocardiogram, blood pressure and oxygen delivery (pulse oximetry) at a minimum of five-minute intervals. On the other hand, limited volume liposuction can be performed local using tumescent anesthesia. I would recommend you getting a VASER Liposuction as opposed to other liposuction methods for the significant skin retraction that occurs after this advanced body contouring procedure. VASER Lipo has been clinically proven to cause a 53% improvement in skin retraction relative to the standard liposuction procedures. Request an in-person consultation with an experienced plastic surgeon to assess your candidacy for VASER Liposuction based on your age, skin laxity, and health status, among other factors. Best wishes! Dr. De La Cruz.