Local or general anesthesia for Liposuction 360?

Question

Hi I am having lipo 360 (upper/lower abdomen, bra bulge/lower back, hips, inner/outer thighs). I weigh currently 135lbs and stand at 5’3”, I am 24 years old. Today at my pre-op my surgeon told me he will be using local which completely threw me off. I have never heard of this in my life. After gaining this info from him I’ve done quite some research. Is it safe to get lipo under local considering all the areas he’s treating? He said local is better because I can move for him..

David Hansen, MD · Answer

All liposuctions should probably be only done under tumescent local anesthesia with or without a little iv sedation when safety and quality are your concern.  General anesthesia is the old method of lipo with the bigger cannulas. Being awake and comfortable and able to move in all positions makes a huge improvement in the results.  You can even stand up occasionally for the doc to fine tune the results.

Athanasios Christopoulos, MD · Answer

Local anaesthesia is safe for treating small areas. Extended areas, as the ones described, may need general anaesthesia or epidural. Local anaesthesia for so many areas is not safe. I have seen many patients coming to my office after having incomplete suction of fat in large areas. The liposuction is incomplete because after a while the patient was not feeling comfortable and the surgeon had to stop the procedure. Local anaesthesia  for large areas may look safe and simple for some people but in reality happens exactly the opposite. General anaesthesia in hospital performed by a good anaesthetist during a procedure done by a board certified plastic surgeon is the best combination.

Robert M. Tornambe, MD · Answer

YourstrulyX.  That sounds like far too many areas of liposuction to consider performing it under local anesthesia. It will be far safer and you will be more comfortable having this done under general anesthesia. Discuss your concerns with your plastic surgeon and if necessary, seek a second opinion with a board-certified plastic surgeon. Good luck.

Shayne Webb, MD · Answer

Very few board certified plastic surgeons would perform this many areas under local anesthesia due to the possibility of lidocaine toxicity (and the discomfort during the procedure).  However, it likely can be done.  My advice would be to make sure that the surgeon is doing this as your best option versus doing this in their office because they aren't a board certified plastic surgeon and therefore not allowed to do this in a hospital setting.Best wishes

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  In my practice I perform lipo 360 with either general anesthesia or conscious sedation, both of which are administered by a board-certified MD anesthesiologist in order to optimize safety and comfort.  
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Jason Emer, MD · Answer

For multiple areas of liposuction such as this, general anesthesia is very much needed especially if etching is being done (which it should be in order to obtain optimal results). General anesthesia is vital. Best, Dr. Emer

Camille Cash, MD · Answer

Due to the number of areas you are having suctioned I would recommend general anesthesia.  This is for your safety during the procedure as well as keeping you comfortable.  When under general anesthesia a board certified anesthesiologist can monitor you so that your surgeon can focus on producing the best results for you.  Local anesthesia is ok for small areas of liposuction, but for this scale I think general anesthesia is the better choice.

Sanjiv Kayastha, MD · Answer

The best way to proceed with liposuction comes down to a few issues. The most important is that there is maximum safe amount of liposuction and local anesthetic that can be given in any one procedure. If these maximums are going to be approached or exceeded then liposuction needs to be performed in the hospital with anesthesia and postoperative monitoring. For smaller amounts or limited areas is not unusual to be able to perform liposuction in the office with oral medication and local anesthesia. Discuss your concerns with your surgeon. Consider a second opinion.

Karl William Schwarz, MD · Answer

You can certainly perform liposuction of your areas under a local anesthetic and it can be performed safely but it will not be comfortable and it will take a very long time and you might even have to urinate at some point during the case. I would suggest a general anesthetic where you will not feel any pain, and allow the surgeon to remove all of the fat without worrying that he is hurting you. I have performed liposuction under local and general and in my opinion the results are better and the patient is far, far more comfortable under a general anesthetic. We can move you during a general anesthetic to get to the areas we need to anyway.

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