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

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. 

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.