Liposuction, Awake or Asleep?

Hi doctors, i'd just like to know, does it matter if i'm asleep or awake for the lipo? - will it affect my result? i'm having 5 areas done so i've been recomended to be asleep but i'm afraid that some fat may be missed as i won't be able to stand/sit up during the lipo, im also having hi def vaser done on my abs. (i've been reading so much and hear so many different opinions on google and would just like to know the honest truth).

Doctor Answers 25

Liposuction awake vs. asleep?

Thanks for your question.  I know how nerve racking it can be to some patients to have general anesthesia and go fully to sleep.  However, general anesthesia is a very safe procedure (as long as you are a healthy person).  It is very difficult to remove as much liposuction material on someone who is awake compared to someone who is asleep.  You can't make the person as comfortable and therefore tend to not be nearly as aggressive with removal of the fat.  Hope this helps.

Phoenix Plastic Surgeon
4.8 out of 5 stars 46 reviews

Anesthesia for Liposuction

Thank you for your question. I agree with your surgeon and would recommend parenteral or IV sedation, at a minimum, for five areas of treatment. If you were having 1-2 areas treated, then local anesthesia would likely be adequate for you to be comfortable during the procedure. I would not worry about not being able to stand during the procedure. An experienced surgeon will be able to perform the procedure without you being able to stand, and if you needed a minor revision at a later time, local anesthesia would most likely be adequate for that.   Hope this helps you make your decision. Good Luck!

Morgan E. Norris, III, MD, FACS
Houston Plastic Surgeon
4.6 out of 5 stars 26 reviews

Large Volume Liposuction under General Anesthesia

     Larger volume liposuction or liposuction of multiple areas performed with general anesthesia I feel allows me to get the best results.  If a patient experiences pain or is uncomfortable, the surgery is made more difficult for the patient and the surgeon alike.  In addition, when or if you are flipped to a prone position (on your stomach), having a secure airway is important.  This is difficult to achieve with sedation and local.  Every plastic surgeon has his or her own thoughts on this issue.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews


With 5 areas planned for lipo, I usually use "twilight" sleep sedation and combine it with local anesthesia.  The procedure does require sterile technique and once the patient is prepped with the surgical soap and sterile drapes are placed, position changes must be carefully done.  I do not have the patients stand for this reason.  I hope this information is helpful.

Ronald H. Stefani Jr, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 2 reviews

Type of Anesthesia during Liposuction

Liposuction can safely be performed either with general anesthesia (totally asleep) or with local anesthesia and sedation (not totally asleep).  When large volumes or many areas of liposuction are to be performed, I find that it is more comfortable and safer to have my patients asleep. 

I personally do not find it helpful for patients to stand during the procedure.  If I feel that I need the patient to sit for any reason to look at the areas, this can easily be accomplished while the patient is asleep using the specialized operating room tables available in our operating room.


Best of luck with your surgery.

Sacha Obaid, MD
Dallas Plastic Surgeon
4.8 out of 5 stars 134 reviews

Anesthesia During Liposuction

This decision is best left to your surgeon and your anesthesiologist. However, I would say that in your case, five areas is a long time to lay on the table awake. Even the most quick and efficient surgeons cannot complete this in less than a few hours if they are thorough. I would recommend that if your'e going to have this many areas done you find someone who can take you to an outpatient surgery center for anesthesia. It doesn't mean you'll have to be completely asleep, you can be sedated but still alert and able to help your surgeon by moving into certain positions etc. 

Cameron Rokhsar, MD, FAAD
New York Dermatologic Surgeon
4.5 out of 5 stars 35 reviews

Awake for liposuction

The length of time doing the procedure for five areas; if these are true areas and not those called areas by some offices, would require that the procedure would be better done with intravenous sedation or a general anesthetic in my office. It is too long under just tumescent. I hear about complaints from patients from offices that do this regarding the very uncomfortable nature of these. There are also risks or lidocaine toxicity due to the need to use a more highly concentrated and and a lot of tumescent local in that many areas. The issue of surgeon fatigue is a factor too and deeper anesthetic techniques allow for a more efficient and thorough result. A skilled and experienced surgeon does not need to have you stand up for this. 

David R. Stephens, MD
Bellevue Plastic Surgeon
4.1 out of 5 stars 13 reviews


I generally prefer general anesthesia for all but the most minimal liposuction procedures. The reasons are simple:

1. It is difficult to adequately anesthetize large areas without sedation and there is a higher likelihood of patient movement and recollection of the procedure

2. It is difficult to be very aggressive with the suctioning process when you are concerned that the patient may begin to feel discomfort if the cannula enters an area not fully numbed, or if the patient may become anxious with the activity.

3. Many of the cases of liposuction-related deaths reported in the media relate to overdosing of local anesthetics, often occuring at the hands of practitioners who are not board-certified plastic surgeons, at facilities that seek to cut costs for higher profit margins. If you are not sedating the patient or putting her under general anesthesia with a qualified anesthesiologist or CRNA, you may be taking inordinate risks with patient safety if you attempt liposuction of large areas under routine local anesthesia. I restrict lipo under local to limited submental fat excess, axillary rolls, minor cases of gynecomastia, touch-up revisions after more comprehensive lipo, and small love handles. I never do multiple zones under local at once.

Tim Sayed, MD, MBA, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 17 reviews

Anesthesia for Liposuction

The anesthesia technique for liposuction is usually based on the surgeon's level of comfort and experience. In our practice, all liposuction is done with tumescent infiltration of dilute local, under light sedation. This is probably the most common approach to liposuction, nationwide. The advantages of the tumescent fluid infiltration is that it limits blood loss to a very minimal amount, and is very comfortable for the patient. The sedation allows the tumescent infiltration without pain. General anesthesia always carries with it more risk than sedation or local, all other things being equal. We have found that the recovery is far easier for the patient after a light sedation than a general anesthetic, with its associated nausea and other side effects.

Matthew Concannon, MD
Columbia Plastic Surgeon
4.6 out of 5 stars 21 reviews

Awake or asleep for liposuction

     Nearly all but very small liposuction cases should be done under a general anesthesia.   General anesthesia is much safer and infinitely more comfortable.  The injections  of local  anesthesia alone can be terribly painful. Awake patients often are not comfortable and the doctors doing patients awake may  cut short the surgery because of discomfort.  Awake patients jump around and the doctors  may simply cut corners  and do not do as complete a liposuction.   Cases done awake are in fact very often under done or minimally done.  An anesthesiologist allows comfort and keeps you alive.  The anesthesiologist allow the surgeon to proceed in a careful, artistic, and safe manner.  The results are far better under general anesthesia  in larger cases.   In small cases local is okay.  I have an anesthesiologist present at my liposuction cases 100% of the time.  I would want this for my wife, and I treat my patients the same as I would treat my wife.   Remember,  non certified doctors in  non certified facilities  often have no choice but local because anesthesiologists  usually will not give anesthesia to doctors that do not have hospital privileges to do the surgery you are having in the doctors  possibly non certified operating facility.   Do not be absurd.   If you want it done properly, comfortably, and safely so it under a general  anesthesia that allows the surgeon to be safe and fully artistic.   Standing up during the case is not necessary, causes break in sterile technique, and may lead to infection.   FACS - ABPS surgeons with full hospital privileges do not  generally do large liposuction or liposuction of multiple areas under local anesthesia alone.   My Best,  Dr C

George Commons, MD
Palo Alto Plastic Surgeon
4.5 out of 5 stars 36 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.