Liposuction with local anesthesia or general? What is better?

I find it easier on both me and the patient to do liposuction under general anesthesia unless only one small area is involved.  In my experience doing liposuction under local anesthesia, the patient anticipates that it will hurt and thus is hyper-alert to anything that might cause discomfort.  They jump up on the table, grab the sides, grit their teeth and say, "Okay, let's go!"  As soon as I do anything, they start to complain that they can feel it.  As a result, I tend to slow down, get more conservative, and not get as much fat out as I might if they were asleep.  In reading reviews of places that do liposuction strictly under local anesthesia, patients are generally unhappy with their results.  It may be cheaper to do the surgery under local anesthesia but I don't think the results are as good as I can get under general anesthesia.

This is a great question, as there are advantages and disadvantages to both approaches.  Ultimately I see patients as falling into one of two categories: those who must have general anesthesia, and those who may choose either general or local anesthesia for their liposuction procedure.  In my practice, I offer both standard liposuction and laser liposuction in my accredited office operating suite and can safely and comfortably perform liposuction for select patients who wish to have it done without a general anesthetic, however if there are multiple areas or larger volumes to be treated, patients must consider a general anesthetic or multiple procedures to limit the risks.  If I believe that a particular area or combination of areas will simply not be well tolerated in the office surgery setting under local anesthesia, then I strongly recommend use of a general anesthesia so that results are not compromised by patient discomfort.  Ultimately the goal is safe surgery with as great a degree of comfort as possible, in consideration of cost.  General anesthesia is more costly, but if it allows for your goals to be met with a single operation and downtime it may be the best choice in the end. To break it down:Price will generally be less with local anesthesia techniques.Pain after the procedure is generally the same, but as you may imagine there is more awareness of the procedural pain if you are under local anesthesia only vs general.Recovery should be very similar, although there is some argument that we are gentler when patient is under local anesthesia and this may result in slightly easier recovery.Risk of general anesthesia is greater overall, however we use more local anesthesia medicine for a comparable procedure without sedation or general anesthesia and there is a limit to the total dose, so the specific risk of medication dosing may be greater under local, especially when larger or multiple areas are treated.Surgical time is shorter for comparable areas when performed under general anesthesia.Results should be similar, although there is a risk of limiting result if a patient is unable to tolerate treatment under local anesthesia so careful discussion of your comfort level and anxiety is important.Talk it over with your surgeon in detail and you will be better able to make the choice that is right for your situation and goals.

General anesthesia allows for more fat removal and body shaping. For best results with liposuction, I recommend a hi definition procedure like VASER liposuction. I use VASER HI DEF with ThermiRF and fat grafting to get the most fat removal, skin tightening, contour and definition. This combination will give you the most toned result. I recommend getting a formal evaluation with a hi definition physique expert. Best, Dr. Emer