Under Local Anesthesia, is the Tumescent Fluid Injection Painful?

Liposuction when done by an experienced doc who knows how to inject the tumescent anesthesia is almost totally painless.  He/she should use a 30 g. needle to do the tiny skin injections slowly which numb up the skin and which don't hurt. (Derm Surgeons are especially adapt at this but any specialty can do a good job if trained well at it).  Then he would go through these spots to inject the fat layers under the skin and that is also almost painless.  Your experience should be a pleasant one.

We have our patients all watching Blu Ray 3D- DVD movies on a fancy headset which makes it seem so cool IMAX during the whole liposuction procedure. We make it a fun experience for all our patients. You are also to be commended for choosing the safest liposuction and hopefully will get the best results possible since your doc can stand you up and put you in all sorts of positions to fine tune the results. Hopefully he will be using the micro canulas which give the best and smoothest results possible and is staying away from some of those laser lipo machines which can have a tendency to cause dimpling, puckering and burns of the skin. Most docs do a little oral sedation or very light IV sedation with their tumescent anesthesia which is fine and often helpful in larger cases.  We all want you to have a great experience and tell all your friends!  Sincerely,

David Hansen,MD

                  Tumescent
liposuction represents a significant advance in the management of localized fat
collections.  When this technique
is utilized with local anesthesia alone the response varies from patient to
patient.  The majority of patients
appear to do well and have good results especially when smaller amounts of fat
are removed.  Unfortunately, we
frequently see patients who have had significant pain and discomfort during the
injection process when local anesthesia is used alone.

                  For
this reason, many surgeons supplement local anesthesia with I.V. sedation or
general anesthesia to minimize pain and discomfort during the procedure.  When utilizing this approach patients
can have more fat removed and avoid multiple procedures.  The procedure is more comfortable and
avoids break through pain which can occasionally occur with local anesthesia
alone.

                  It’s
important to realize that all surgical procedures and anesthetic techniques
have risks.  This is true whether
local anesthesia, I.V. sedation or general anesthesia are utilized.  Most surgeons who perform tumescent
liposuction agree that the anesthetic technique utilized is less important than
the use of a certified operating room and the presence of an anesthesiologist.  In other words you don’t want your
surgeon to be your anesthesiologist.

The local anesthesia injected into the skin prior to making the incisions is, for most patients, minimally uncomfortable. These injections do nothing to blunt the sensation of the tumescent anesthesia as it anesthetizes the fatty tissue. How much feeling you have is a function of the ingredients of the tumescent formula, how quickly it is injected and what your pain tolerance is. I have experimented with different formulas for anesthesia and have found that no matter what is done to minimize discomfort, some patients are very uncomfortable and others find it minimally bothersome. The real stimulation comes from the liposuction and based upon my experience most patients will have intermittent discomfort in varying degrees of intensity. The more fat that is removed or the more fibrous the patient's fat - the more likely they will experience pain. Dr Harrell

Patients frequently refer to "local" anesthesia for what we refer to as intravenous sedation.  Obviously, straight local into the incision sites is different than IV sedation.  You cannot expect a pain free experience.  The local anesthesia injections do hurt for a brief period of time and may not completely numb the underlying area.  Before undergoing any liposuction under straight local, I'd encourage you to speak with your surgeon in greater detail about expectations and also to see another plastic surgeon in consultation for an independent evaluation.  If it sounds too good to be true, it is frequently too good to be true!

Realistically, you can expect some discomfort with procedures done under local anesthesia only. At the minimal, this would be similar to going to the dentist and having local anesthesia injected.

Be very careful about promises made that sound too good to be true...

Best wishes.