Which Kind of Liposuction is Safest? I Just Want my Saddlebags Done?

I've tried to research the safest, best type of liposuction, but can't seem to find whihc option is safest. My husband does not want me to undergo general anesthesia and is most worried about the safety of the procedure. He is an anesthesiologist and has seen the dangers. I just want my saddlebags done, I am pleased with the rest of my body. And, if a procedure is safer, does that mean it will be less effective?

Doctor Answers 14

Which Kind of Liposuction is Safest?

I believe the safest kind of liposuction is done with local anesthesia. The published evidence in the medical literature is clear that liposuction is very safe when performed with local anesthesia. Here are the important points:

  • The safe dose of lidocaine, the local anesthesia, is well established, and there is a wide margin between the safe dose and an overdose. 
  • An allergic reaction to lidocaine is so rare, that it's considered something that just doesn't happen.
  • General anesthesia medications are associated with adverse events that aren't always predictable; patients do have unexpected adverse events that can be life-threatening.
  • When a person is "out" under general anesthesia, they're unable to communicate with the surgeon if they're feeling something they shouldn't be feeling. For example, a patient who is "out" may not feel the surgeon straying from the fat space and invading a part of the body where the surgeon shouldn't be. Local anesthesia makes only the fat numb and comfortable, but not the other parts of the body; it's another safety feature.
When an anesthesiologist is concerned about his wife undergoing general anesthesia, that's pretty telling. 

San Antonio Dermatologic Surgeon
4.7 out of 5 stars 62 reviews

Safe Anesthesia for Liposuction

If your husband is an Anesthesiologist and he does not want you to have Liposuction under general anesthesia, I can only assume that he has very little experience with the various types of Liposuction anesthesia and what is done by many practitioners. In my view, General Anesthesia with minimal wetting solution (using no Xylocaine) is by far the safest method. Not only do you receive minimal drugs, but you have an experienced professional watching you constantly. Also, most general anesthesia is done only in certified facilities. Many of the other wetting agents that also provide anesthesia can be safe if the amount of drug injected is kept low. Unfortunately, many of the people doing the most advertising about their local anesthesia being the safest, are doing the procedures in non certified facilities under the local anesthesia because they do not have privileges to do them in a certified facility under other types of anesthesia. Also, many are learning the procedures from non-core physicians and being taught to use what the American Society of Plastic Surgeons thinks is toxic levels of drugs in their wetting solution. These physicians are also pushing the limits of state rules about anesthesia, since they are classifying use of these wetting solutions as level 1 anesthesia. I personally believe use of any wetting solution should automatically make this anesthesia a Level 2. Select the person to do the procedure very carefully, have it done only in a certified facility, and rethink the type of anesthesia.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Tumescent local anesthesia is safest for liposuction

From the patient's perspective, local anesthesia for liposuction is a much better choice than general anesthesia. General anesthesia may be more convenient for the surgeon because it reduces the time needed to inject the necessary local anesthetic that is essential to performing liposuction safely. In tumescent local anesthesia relatively large volumes of saline solution containing dilute amounts of the anesthetic (lidocaine) and epinephrine (a drug that constricts the tiny blood vessels within the fat tissue), is injected throughout the volume of fat that is to be treated by liposuction. If correctly administered the anesthetic usually numbs the area completely (making the actual liposuction painless) and eliminates any appreciable bleeding (which greatly reduces post-operative bruising). I wrote the linked article (see below) in an effort to help surgeons maximize patient comfort during tumescent liposuction.

If general anesthesia is not used (and local anesthesia alone is used) it takes more time and effort on the part of the surgeon to thoroughly numb the fat tissue while maintaining maximum comfort for the patient. The usual result is greater (frequently 100%) numbing of the area to be treated, making the liposuction itself painless or nearly so. Also the constriction of tiny blood vessels is more complete, resulting in much less bruising and a faster post-operative recovery. Because such meticulous use of the tumescent local anesthetic is less likely to be done in the setting of general anesthesia, more extensive bruising and a longer recovery is often seen after the use of general anesthesia.



In addition to the advantages mentioned above, local anesthesia is nearly 100% safe, whereas general anesthesia is much more dangerous and can even be fatal. The safety difference is best illustrated by the fact that nearly all serious complications associated with liposuction have occurred in the setting of general anesthesia; virtually none have been seen when proper tumescent local anesthesia is used exclusively.

Robert C. Langdon, MD
Guilford Dermatologic Surgeon
4.7 out of 5 stars 24 reviews

Tumescent liposuction without sedation is the safest liposuction

Dr. Jeffrey Klein, a dermatologist, researched the metabolism of local anesthetic thoroughly and clincially, when discovering tumescent liposuction.  There can be interactions with current medications that you take, as well as sedation were it to be given to you.  I exclusively perform tumescent liposuction without sedation and this provides the greatest safety possible. There are risks with any surgery so discuss this with your surgeon. Then, whether the surgeon uses power liposuction, smart liposuction, ultrasonic liposuction vs. conventional microcannulae liposuction, the different procedures and the risks of contour irregularities and thermal injury must be reviewed.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

What type of liposuction is the safest?

Liposuction safety and efficacy is dictated by the surgeon and not the device. What type of surgeon you choose and their level of experience and expertise is the most important factor in achieving a desirable, long term result.

Jeffrey Kenkel, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 6 reviews

Liposuction under local anesthesia is the safest approach.

Liposuction under local anesthesia is the safest approach. There are numeous studies confirming this. There is now 20 years of literature on this subject. The most important thing is to see the most experienced liposuction expert you can find in your part of the country.

William P. Coleman III, MD
Metairie Dermatologic Surgeon
3.5 out of 5 stars 2 reviews

Which Kind of Liposuction is Safest? I Just Want my Saddlebags Done?

I understan the fear associated with general anesthesia but depending upon the amounts of fat to be removed would need to be considered in my choice of methods of anesthesia. For me I use local tumescence + face mask or IV sedation. I also preform ALL the types of liposuction methods. Without an examination my guess of type is the combination of Smart Lipo Triplex+traditional lipo. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Liposuction questions

Liposuction is a safe procedure when performed on a patient who is in good health by a board-certified plastic surgeon in an accredited surgery facility.  Although liposuction can be performed using only local anesthesia or local anesthesia with IV sedation, I prefer general anesthesia for most cases.

Andrew P. Giacobbe, MD
Buffalo Plastic Surgeon
4.9 out of 5 stars 23 reviews

Liposuction and anesthesia

Well since your husband is an anesthesiologist, he can certainly attest to the safety of sedation for lipousction.  Find a good surgeon and then let them decide on the type of liposuction to perform.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

For the safest liposuction and great results, tumescent local anesthesia with micro canulas are your answer.

You are smart to eliminate the docs who still do the old method of general anesthesia and traditional liposuction.  Pure local tumescent anesthesia with the micro canulas are the way to go when you want great results and the safest liposuction.  Board certified dermatologists are one of  the the groups  who will have the most experience in this technique and is so worth it .  Sincerely,

David Hansen,MD

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 42 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.