I received 5 areas of tumescent lipo (back, flanks, abdomen). Is it normal to cover so much area while the patient is awake?

Question

I had tumescent lipo on my abs, back and flanks. I received Demerol and Ativan PO along with two other PO meds (I don't remember) 1 hr before my procedure. The doc started an IV (he had a LOT of trouble and it was the most painful IV I've ever had) and hung a bag to gravity with what was I assume antibiotics. I was numbed with lidocaine then tumescent solution was injected. I found it painful and at times excruciating. They told me I wouldn't remember anything but I do. Is this normal?

Jason Emer, MD · Answer

Each patient's pain and experience will vary and each Doctor will have their preferred technique. I do recommend following up with your Doctor about after care recommendations. You have swelling, which can last 3-6 months after your procedure. I recommend adding hyperbaric oxygen and lymphatic massage along with your compression to help decrease swelling. To improve your final results, I also recommend adding vanquish for further fat removal, exilis/venus legacy for skin tightening, cellutone/z wave to make the skin smooth, remove scar tissue, and improve the skin’s appearance. See an expert. Best, Dr. Emer

Connie Hiers, MD, FACS · Answer

Since you only had oral medication, you could stay awake and remember the process. With general anesthesia or IV sedation, patients do fall asleep and do not remember, and there is another physician or nurse taking care of your anesthesia needs. The amount and number of areas treated with awake liposuction is based upon your initial weight. Once properly tumesced, most patients do not feel much pain during the liposuction. However, enough lidocaine fluid must be placed in each area to numb properly. I would suggest discussing any concerns you have with your doctor.

Tim Sayed, MD, MBA, FACS · Answer

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).

David S. Rosenberg, MD · Answer

your experience is not unusual, sometimes people have no memories of the surgery or only remember a few things from the surgery but sometimes they remember everything.  Also everyone has different pain sensitivities, if you had done fewer areas perhaps you could have had a higher dose of lidocaine in each area and it would have been less painful.  Best to speak with your surgeon.  Good luck! DSR

I received 5 areas of tumescent lipo (back, flanks, abdomen). Is it normal to cover so much area while the patient is awake?

Answers (4)

Answer: Liposuction under local

Answer: Liposuction under local

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Everything you need to know about Tumescent Liposuction

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I received 5 areas of tumescent lipo (back, flanks, abdomen). Is it normal to cover so much area while the patient is awake?

Answers (4)

Answer: Liposuction under local

Answer: Liposuction under local

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Recommended reading

Everything you need to know about Tumescent Liposuction

Our mission is to create a world where every investment in modern beauty is Worth It.