What are the pros and cons of general or local anesthesia? I'm 5'3 and 185 lbs. Most of the weight is in my abdomen.

Question

I have no stretch marks. My doctor said that he could use either a general, or a local with a sedative. This would be considered large volume liposuction.

Gerald Minniti, MD, FACS · Answer

Hello,Be sure you go to an ABPS certified/ASAPS member surgeon who specializes in body contouring and has hospital privileges to perform liposuction in a hospital (this can be independently verified by you by calling the hospital he is on staff at). General anesthesia is always safest and most comfortable. Best of luck!

Michael Baumholtz, MD, FACS · Answer

Most of the major societies agree that any liposuction volume over 5 liters is considered high volume and post procedure - the patient should be admitted overnight to a facility that can monitor vital signs for fluid shifts, etc. Some centers of liposuction will only perform the procedure with an awake patient and tumescent fluid. Seek out a board certified member of ASPS/ ASAPS for your consultation and work. The only "benefit" in the scenario you present would be cost and I would strongly encourage you to not base a decision such as this on cost alone.

Jason Emer, MD · Answer

When you do body contouring and you want significant outcomes you need general anesthesia to get maximum results -- skin tightening, full fat removal, body lifting, fat grafting, cellulite improvement. You are limited by doing awake liposuction which is why I rarely do that procedure anymore except in specializes cases. I suggest a formal consult with a body contouring physician who does VASER and J PLASMA to get the best results.  Best, Dr. Emer.

Emmanuel De La Cruz, MD · Answer

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.

Ryan Neinstein, MD, FRCSC · Answer

Thanks for the question, I perform almost liposuction exclusively and about half awake and half under general. Firstly, if the patient is very anxious we just go straight to general as it is important to have a great experience because the journey is as important as the destination. For smaller areas patients like not going all the way under because they recover faster, have less risks of complications, and can just get up and walk out at the end of a case. Its an individual process and if you are having surgery under local make sure your doctor does a lot as there is a lot of finesse to this

Jonathan Berman, MD · Answer

Thank you for your question!Both general and local anesthesia can make your treatment process more comfortable. Many patients prefer general anesthesia because they are completely asleep and will not remember anything from their procedure. It also allows the surgeon to do the necessary work since the patient is “feeling no pain”. Personally, it is uncomfortable for me as a surgeon to perform surgery under local anesthesia when a patient is anxious or uncomfortable even given all the appropriate medicines to numb an area and comfort a patient. So, I find that having a patient asleep is often times safer than performing the procedure under local anesthesia. Surgeons sometimes prefer the method with the least anesthesia and not putting a patient to sleep. More often, the patient ends up receiving more rather than less anesthesia because the patient needs more medicine to be comfortable. With gas anesthesia, the gases go into the system and out of the system rapidly. The type of anesthesia is best discussed with your surgeon and what is most comfortable for he/she. As a patient you want the BEST result from your surgeon. Don’t select a surgeon because one performs the surgery under local and the other has you sedated. After all, you want the best result, in the hands of the best surgeon. Please remember how important it is to find a well-qualified plastic surgeon. All plastic surgeons should have the proper training and perform surgeries every day either using local anesthesia, sedation anesthesia or general anesthesia. Many of them have their own accredited operating rooms and will perform what they think is the SAFEST and BEST way for them and you the patient. So, remember when you go to a non-board certified, cosmetic surgeon and not a plastic surgeon, there are risks involved!

David Finkle, MD · Answer

For longer procedures, the patients are more comfortable and the surgeon can work quicker and more efficiently when the patient is fully asleep and does feel any discomfort during the procedure.  Do your research and determine if the surgical facility is nationally accredited and the anesthesia is provided by a board certified anesthesia personal.  If that is the case then any type of anesthesia is safe.  I personally am a chicken and when I had my liposuction, I elected to go to sleep, it was easy and the recovery was a piece of cake!Good Luck!

Robert H. Hunsaker, MD · Answer

I have a lot of experience with liposuction done both ways. In my opinion, it is not which is better, it is which is the surgeon AND anesthesia provider most comfortable with. Done well they are both excellent choices. Done "not so well', neither is. When there is an option I ALWAYS tell my patients to choose whatever the anesthesia provider is most comfortable with.

Nick Masri, MD, FACS · Answer

Thanks for your question, sgarner29.
Personally, I go for general anesthesia when doing large volume liposuction. Some people still experience significant pain and discomfort when only local anesthesia is used for aggressive liposuction.
However, there are side effects to general anesthesia, like nausea, vomiting, and grogginess afterward. If you’re going to choose general anesthesia, make sure that you have someone to drive you home as it would be unsafe to do that yourself.
You can still choose local anesthesia with sedative, but it’s best paired with low volume liposuction.
Better ask your reputable and board-certified plastic surgeon’s recommendation and stick with it.
Good luck!

What are the pros and cons of general or local anesthesia? I'm 5'3 and 185 lbs. Most of the weight is in my abdomen.

Answers (9)

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