Liposuction under local anesthesia, is this an option?

Question

Hello im planning to do lopo with local anesthesia, i saw one doctor who didn't recommend it he said sometimes its more dangerous bcz dome patients have allergy from the sedative.. i really dont want to go with general Im planning to do my armd abdominal and sides

Donovan Rosas, MD · Answer

Liposuction can be performed under general, MAC, or local anesthesia. The choice is based upon the procedure, patient, facility and surgeon preference.Liposuction can safely be performed under tumescent anesthesia alone. There are, however, limits to what can be accomplished. There is a max dose of tumescent for every patient (based upon weight). When a patient is awake, in order to ensure maximal comfort, the tumescent must be concentrated into a smaller area. This limits the amount of work which can be done.MAC and General anesthesia affords a greater margin of error allowing the tumescent to be spread over a wider area or multiple areas.Surgeons will have their preferences, larger cases may demand a higher level of anesthesia, and not all facilities are capable of delivering every level of anesthesia. All of these factors play a role.As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Otto Joseph Placik, MD · Answer

Check out this video!!!where I explain that liposuction can be done under local anesthesia.You don't have to be put asleep if you don't want too.

Jeffrey A. Klein, MD · Answer

Tumescent Liposuction without general anesthesia or IV sedation is the safest option. True tumescent liposuction involves injection of large volumes (1-2 liters per area, up to 4-5 liters in a large abdomen) of dilute local anesthetic solution into the targeted area, while the patient is awake. The patient may receive an oral sedative to take the edge off their nerves, but IV or IM sedation is not usually given. Additionally, in true tumescent liposuction, multiple very small 1-2 mm adits (incisions) are made and used for liposuction using micro-cannulas. Multiple small tunnels of fat are removed from several different incisions, making it easier to get smoother results. These cannula incisions are left open so the tumescent fluid drains out over the next couple days (up to about 6 days a larger patient that received greater volumes of local anesthesia). Once healed, the incisions are virtually invisible on most skin types. The procedure is limited to one-three areas in a surgical day, as there is a maximum safe dosage of tumescent lidocaine that may be injected. For several reasons, the risks of complications with true tumescent liposuction is greatly reduced. IV sedation and general anesthesia have inherent associated risks. With true tumescent liposuction, because there is a maximum amount of tumescent lidocaine that can be safely given, surgical trauma is self-limiting, and problems with DIC (inability to clot) are not seen. Bruising and soreness are minimized, as are complications with deep vein thrombosis or infection. Tumescent liposuction with general anesthesia, in an attempted to increase the number of liposuction areas or to increase the number of procedures (as in liposuction, breast augmentation and face lift) performed at one time, can result in complications and death, and certainly one can have a reaction to the medications used in either general anesthesia or IV sedation. “Normal” liposuction often involves general anesthesia. Most surgeons do inject a solution containing, at minimum, some epinephrine so as to minimize bleeding. Usually, the insertion sites are limited to just a few larger incisions, and the cannulas are much larger, resulting in larger tunnels of fat removal, and an increased risk of irregularities. Postoperative garments must often be worn up to 6 weeks. Patients are able to return to normal activities and exercise more quickly following tumescent liposuction.

David Hansen, MD · Answer

For both safety reasons and quality reasons, Liposuction should only be done under tum. local with or without a little iv sedation. By eliminating general anesthesia, you have eliminated by far one of the biggest risks involved in liposuctions! Under local, your doc can have you in all positions and even stand you up for the best fine tuning of the results.

Connie Hiers, MD, FACS · Answer

Liposuction with local anesthesia is very safe, however, not all surgeons are comfortable with doing it under local anesthesia. It does require more time and the surgeon must pay close attention to the amount of fluid used. Also, fewer areas may be treated at one time due to the amount of anesthesia that can be safely given. Fewer drugs are usually given with awake liposuction than with general anesthesia. Allergic reactions may occur with any drug. I have done awake liposuction for many years now, and it works well for many patients. I'm sure you can find a surgeon in your area who is experienced with awake liposuction.

William LoVerme, MD · Answer

Liposuction can be done in a variety of ways mostly depending on how much fat needs to be removed. It can be done with straight local anesthesia, local with oral sedation, local with IV sedation, or general anesthesia. ALL of these methods use a local tumescent anesthesia solution which gives hemostasis, pain reduction and blows up the area a bit so it almost like working under a magnifying glass in seeing how smooth the result will be. Very small areas are easily able to be done under straight local. Larger areas need stronger types of anesthesia. I do not do a total liposuction where over 5 liters is removed as I believe this becomes much more dangerous for the patient. Secondary or re-do liposuction often needs a general anesthesia because the area has scar tissue from the first liposuction and the local tumescent anesthesia does not diffuse into the tissues as easily. A consultation with an experienced plastic surgeon is the best way to determine what is best for you.

Nick Masri, MD, FACS · Answer

Thank you for your question, dana1987!
Yes, local anesthesia is possible for liposuction, but it depends on several factors, like the amount of fat to be aspirated and the number of areas to be treated. Your preference matters, too.
I suggest you look for a reputable and board-certified plastic surgeon and ask him if you’re a good candidate for liposuction with local anesthesia. It won’t hurt to ask for a second opinion.
Best of luck!

Brian Kiesnowski, MD, MPH · Answer

I always perform my liposuction procedures under local anesthetic only. I find that the tumescent solution works very well. In addition to tumescent solution I also give my patients oral Valium and Percocet. I prefer to do liposuction procedures under local anesthetic because I have better and more predictable results. When a patient is dead asleep on the table it is very difficult to reposition them to reach certain problem areas. When performing liposuction under tumescent solution and oral sedation patients are free to reposition themselves on the table so that I can better reach problem areas in order to give the patient the result that they are looking for. If your surgeon feels that the amount of tumescent solution required would be more than is appropriate for your body weight then you could always consider multiple sessions as opposed to one large surgical procedure. I hope this helps and best wishes with your procedure.

Mats Hagstrom, MD (license on probation) · Answer

Many plastic surgeons prefer using general Anastasia for larger liposuction cases.
The majority of doctors who are not trained in plastic surgery usually offer this procedure without the use of general Anastasia.
The primary reason for this is the inability to gain operating room privileges without proper training.
For example dermatologist can generally not obtain operating room privileges in accredited surgery centers or hospitals.
This does not give them the option to offer a general Anastasia for liposuction procedure is.
During my plastic surgery training we used General Anastasia for almost all liposuction procedures.
Seven years ago I began specializing in exclusively on liposuction and fat transfer procedures.
At that time I learned how to perform all liposuction and fat transfer procedures using a local anesthesia with mild sedation.
At this point I prefer to avoid the general Anastasia whenever possible for liposuction including fat transfer procedures.
The primary reason is my ability to get better results with my patients awake.
Other benefits including improve safety, faster recovery, Less bruising and lower costs.
Worries of allergic reaction's to sedation sounds ludicrous since General Anastasia would include similar drugs used for sedation.
Choose the plastic surgeon who you think will give you the best care and let him or her choose the type of anesthesia.
General Anastasia is very safe.
Fears of general Anastasia are almost exclusively based on emotion and not actual risks.
My recommendation is to choose an experienced board-certified plastic surgeon who has extensive experience in body contouring with liposuction regardless of the type of Anastasia used.
Best,
Mats Hagstrom M.D.

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