What is It Like to Have Operations Such As Lipo with Iv Sedation?

I've had iv sedation for dental work and general for surgery and they seemed about the same in terms of how I felt.

Doctor Answers 7

Anesthesia and sedation for liposuction

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As one of the first to present the experience with local anesthesia (tumescent injection) to plastic surgeons, I can say with extensive experience in liposuction under general anesthesia as well as liposuction under local anesthesia with or without IV sedation, that the important thing is to understand what anesthesia is and what sedation is as well as the experience of the surgeon performing the liposuction. 

Originally liposuction required general anesthesia as there was no other option and it involved a lot of blood loss so performing the procedure in an operating facility with an operating team, anesthesiologist, and surgeon was required. This made it difficult for non-plastic surgeons to perform the procedure and like many procedures, the costs and side effects of general anesthesia were significant so a search was on for ways to perform the procedure under local anesthesia in an office setting whether the operator was a plastic surgeon or had hospital operating privileges or not. 

Tumescent injection for local anesthesia was actually developed by a non-plastic surgeon and it solved two problems. General anesthesia wasn't necessary to carry it out and it could reduce the amount of blood loss with the suction to nearly zero. Further study and experience showed that the large volume of extremely dilute local anesthesia used for tumescent injection was partially suctioned back with the liposuction and the remaining amount of local anesthetic and epinephrine was absorbed slowly and safely. 

If the operating surgeon is experienced and comfortable with tumescent local anesthesia, the procedure can be done in an office setting with minimal sedation such as some oral medication and the patient can get up and walk at the end of the procedure similar to a dental or LASIK procedure. If the patient doesn't want to be aware of the procedure as for something like a wisdom tooth extraction or a colonoscopy, then an appropriately trained surgeon and staff can do IV sedation which is not anesthesia but aids the patient in dealing with the local anesthetic administration and carrying out the procedure. This can also be done by a nurse anesthetist or anesthesiologist but isn't required. The two major national plastic surgical societies, ASPS and ASAPS, require their members to have accreditation to perform procedures with local anesthesia and IV sedation in the non-hospital or outpatient surgical setting, usually an office.

I feel the patient should choose whether they want their liposuction done with local anesthesia and oral sedation or IV sedation or under general anesthesia, but the plastic surgeon may not be able to offer all of these options depending on experience level, accreditation, and preference. Interestingly, today even if liposuction is done under general anesthesia, tumescent injection is still used to minimize blood loss and postoperative pain relief. 

To summarize, anesthesia means to put to sleep and this can be just local (the area operated on), regional (as an epidural or spinal), or general. Sedation is not anesthesia and is to sedate the patient to varying degrees for a procedure. With today's local anesthetic techniques and the drugs available for IV sedation, many procedures can be done comfortably and safely for the patient without general anesthesia. 

Boulder Plastic Surgeon

Lipo and IV sedation

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I think this is fine.It depends on the area or areas being treated.If I am suctioning the back or flanks then I prefer general with an endotracheal tube to make sure we have control of the airway.If you are doing a small area like the knees or the tummy local with IV sedation is fine.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 69 reviews

Sedation can be fine for liposuction

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I believe IV sedation can be an excellent anesthethic for liposuction.  In my practice, the sedation would be administered by a board certified anesthesiologist for your safety.

Liposuction with IV sedation is a great way to get the procedure done.

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Tumescent anesthesia with a very light IV sedation is so helpful for many patients who undergo liposuction and you should be able to walk out after the procedure and up and about the next day just fine.  Just avoid general anesthesia at all costs.  You want to be able to stand up during the evaluation of the results so the doc can fine tune you to get the very best results possible. Even with light IV sedation, you should feel totally awake and comfortable and able to move in all the positions your doc needs to do a great job.  Sincerely,

David Hansen,MD

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

Liposuction with IV sedation

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Liposuction is commonly performed under local, IV sedation, and for some general anesthesia. All are safe with proper patient selection, medical evaluation, and a competent certified provider. The anesthesia should be matched to the need and scope of the procedure, and the need of the patient to make the experience a pleasant one. If you felt well with sedation in the past, it may be right for you again.

Best of luck, peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Liposuction with IV sedation

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No matter where you have your procedure, please make sure that you are being treated by a board certified plastic surgeon, board certified anesthesiologist and having the procedure in an accredited facility.  Your experience with IV sedation versus general anesthesia for liposuction should be about the same.  In both cases, tumescent fluid is injected in the areas to be treated prior to liposuction.  The procedure is then performed.  With both IV sedation and general anesthesia, you should not feel anything.  In general, you will recovery faster (an hour or so) with the IV sedation versus the general anesthesia (a few hours before you are ready to go home).  In my practice, we use IV sedation for small and moderate liposuction cases and general anesthesia for major liposuction cases.  I hope this is helpful.


Good Luck.

Know your anesthesia options for lipo

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Whether with general anesthesia, IV sedation, or wide awake, all liposuction is done with an infusion of numbing solution into the fat tissue that will be removed. Advocates of the tumescent technique (wide awake) tend to exaggerate the small risks of general anesthesia, and ignore the option of IV sedation which may actually be the most common approach. The important thing is that you have a comfortable experience. Remember also that there is no magic technique such as lasers that make one type of anesthesia possible; the lipo technique and the anesthesia are separate issues.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 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.