Local anesthesia did nothing for me. I felt everything. Was this normal?

Question

During liposuction and bbl the local anesthesia did nothing to me. I FELT EVERYTHING.I felt as I was being slaughtered. Tried to get off bed a couple times and told the Dr I couldn’t go forward with it and asked why the anesthesia wasn’t kicking in. He continued anyway. Long story short there isn’t any difference and still haven’t gotten answers as to why the procedure wasn’t as successful as I was hoping for. Giving over 10k to a board certified surgeon I was expecting better, Was this normal?

Kenneth Hughes, MD · Answer

Limited liposuction can be performed under local anesthesia. You also do not want to be in pain during the procedure so that the surgeon must stop the procedure or do less than what is necessary. For this reason, general is a better option for my patients. A decisive factor can be the size of the patient and the complexity of the procedure: for instance, the amount of fat to be extracted. The patient's pain threshold and anxiety level should be taken into consideration.

Leyla Arvas, MD · Answer

Hello, BBL is an operation that requires both liposuction and fat injection. I am doing this operation under general anesthesia. Because I can both take a large amount of fat and allow me to bring butt to the size my patients need. I have never done it under local anesthesia and I do not recommend it. The process will not be as desired in this direction.

Camille Cash, MD · Answer

It's difficult to say why the anesthesia did not work for you.  It may have been the amount of anesthetic used for the area or that not enough time was given for it to take effect.  These procedures are typically done under general anesthesia for both your comfort and safety.  It also allows the surgeon to have better control, leading to a better overall result.

E. Ronald Finger, MD · Answer

Local anesthesia for liposuction is called tumescent anesthesia, and it should be very effective. The mixture of local anesthesia must be correct, and every plastic surgeon has access to the formula. Also the volume of tumescent fluid instilled into the area must be adequate. Lastly, the surgeon should wait at least 20 minutes for the medications to work. An added benefit besides numbing the area is that the formula constricts blood vessels so there is little bleeding. This allows the liposuction of much more fat than before the formula was formulated years ago.
If you demand local anesthesia, my suggestion is to be sedated as well with a pain medication and tranquilizers. 
Large liposuctions are usually done under general anesthesia with the tumescent anesthesia as well. Your experience is not normal, at least with my patients.
Thank you for the question, and sorry for your bad experience.

Eric Maiorino, MD · Answer

I'm sorry that you had this experience as tumescent anesthesia for liposuction can be a wonderful experience for many patients. Its hard to know why you felt so much but this could be a combination of not having enough tumescent fluid instilled in the areas being treated or not waiting long enough for the lidocaine in the tumescent to take effect.

Mats Hagstrom, MD (license on probation) · Answer

The ability to do large body contouring procedures without causing pain for the patients while avoiding general anesthesia takes skill and experience.

Plastic surgeons who don’t have the skill and experience to do these procedures awake use an anesthesiologist and I would say that is probably still standard of care in the country.

Board certified means nothing unless it’s in plastic surgery when it comes to having plastic surgery procedures.

My best guess is this provider is not properly trained in plastic surgery or they would’ve been doing it in an operating room with an anesthesiologist or regardless they are lacking skill and experience.

Look for board certified plastic surgeons who’ve been doing these procedures for at least a decade and during consultations can show a few hundred before and after pictures as confirmation of having proper experience.

Best,

Mats Hagstrom MD

Local anesthesia did nothing for me. I felt everything. Was this normal?

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