It's possible your physician did use some sedation in your IV but if you did not have a breathing tube and were alert or semi-awake, this is sometimes called "twilight" anesthesia but often misnamed "local anesthesia" by some practitioners. True local means NO IV meds, and is a terrible way to have liposuction on large areas from a safety and comfort perspective. Local + IV sedation (which is what you are describing) is sometimes used for liposuction but has significant limitations.Sorry to hear about your experience with this other doctor. Was the doctor a board-certified plastic surgeon? Many doctors practicing liposuction without general anesthesia do so for a few reasons. I'm going to be a bit blunt here because I have seen the good and bad in busy markets like southern California and south Florida when it comes to liposuction. Some of the more common reasons a doctor would not be using general anesthesia in liposuction include:1. They are not surgeons AT ALL but are practicing cosmetic surgical procedures in the office and do not have privileges to perform the procedure at an accredited surgery center - I believe this is a situation to be avoided for a number of reasons... I won't elaborate and start a turf war on RealSelf, but understand that board certified plastic surgeons like myself consider ourselves the gold standard specialty for liposuction, notwithstanding that certain dermatologists and other specialists can often perform high quality liposuction. Board-certified plastic surgeons commonly perform procedures in accredited surgicenters for patient safety. 2. They are hoping to reduce cost to the patient by offering a procedure that does not involve an anesthesia professional - this is ok in some circumstances, particularly when treating small areas (your set of locations does NOT qualify as small areas in my opinion), or doing touchups where not a lot of surface area is being injected. Note that this approach may result in lower costs to the patient and/or preserve the surgeon's full fee rate, since bundled prices are often all the patient sees in determining who to have do their surgery. I have rarely seen the advantage of this approach from a cost standpoint as I find myself unable to deliver the same smooth patient experience and recovery when compared to using general anesthesia....3. They believe they offer a safe environment for liposuctioning reasonably large areas without the risks of a general anesthetic. The reality is that doing lipo under "local" often means the physician is unable to fully anesthetize the treatment areas as there is a limit on the amount of lidocaine that can be safely injected before toxicity range gets reached. For this reason, you may have felt only mildly numbed before the tumescent went in, because it is IMPOSSIBLE to fully numb such a large zone with a safe amount of normal concentration lidocaine, in my experience. You also may have only had mild sedation - not enough to make you have amnesia to the experience - and minimum analgesia (not enough pain meds through the IV to diminish the ability to sense the local and tumescent going in).
