Should minor liposuction for grafting purposes to indentation caused by kenalog be done under general anesthesia?

Question

Unfortunately have a horrible indentation on glute due to improper needle size when injected with kenalog for lupus flare up. Need fat grafted to that area & Plas. Surg wants to put me under gen. anesthesia. Is that common? He said I wouldn’t feel any pain that way but I know there are risks. He asked if I would prefer local anesthesia but how do I know? The surgery itself seems somewhat minor. He only needs about 12 ml of fat. Thanks for your help doctors!

Justin Yovino, MD, FACS · Answer

Great results can be achieved with local anesthesia or general anesthesia but there are significant differences.  In my practice, body lipoSCULPTing and fat Transfer is always performed with local anesthesia and light sedation. It’s safe, comfortable, shortens Recovery, and minimizes complications.  It’s all about experience and technique.

Jason Emer, MD · Answer

This will be the most comfortable and will give the most even result. Keep in mind, fat transfer technique is important for successful fat transfer. I recommend water-assisted fat harvesting which gives pure fat to transfer and combine with platelet rich plasma (PRP) to get the most viable and sustainable fat cells. I combine with Sculptra to improve final results. See an expert. Best, Dr. Emer

Gerald Minniti, MD, FACS · Answer

Hello,Board certified plastic surgeons can perform procedures like liposuction and fat grafting in hospitals and surgery centers where general anesthesia can be performed, unlike dermatologists and other surgeons not accredited for said procedures. Unless you like discomfort and being awake for the procedure, I recommend general anesthesia. Best of luck!

Daniel Barrett, MD · Answer

Dear Cloud90,type of recommended anesthesia depends on surgeons preference and prediction, but at the end the patient decides which type of anesthesia he/she wants. Generally speaking, minor liposuction and fat transfer can be done under local anesthesia. If you have any concerns, I would suggest you to discuss this with your plastic surgeon.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Tim Sayed, MD, MBA, FACS · Answer

You are correct that small volumes of fat can be aspirated and injected under local anesthesia in many patients. Depending on the extent and depth of treatment, though, your surgeon may be more comfortable with you being under anesthesia. For major liposuction, I use general anesthesia on the majority of patients for safety, comfort, efficiency, and more extensive results. For minor touchups, localized areas of fat grafting, etc., I usually advise local. Consider second opinions to hear more options in person.

Johnson C. Lee, MD · Answer

Generally speaking, liposuction is best performed under general anesthesia for the comfort of the patient and to allow the surgeon to perform an adequate surgery without patient movement or pain. Smaller areas however can be comfortably and successfully treated with local anesthetic only. This discussion is best to have with your surgeon so that you BOTH feel comfortable with the type of anesthesia so that you have the best results. Hope this helps!Johnson C. Lee, MD Plastic Surgery@drjohnsonlee

Bernabe Vazquez, MD · Answer

This is always a very patient specific question. General anesthesia is always more comfortable for both the surgeon and patient but involves more risk and more cost. 12 cc"s of fat to be transferred is a relatively small amount which should be able to be done under local anesthesia with some light sedation by mouth. The area from which the fat is removed is usually comfortably anesthetized with local but the area where the fat is transferred to is a bit trickier. Unless you are an extremely anxious type person I would think you can get away with doing this under local , safely and more economically.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and clearly the procedure can be accomplished either way.  The decision is really up to you!  If you would prefer local, tell your surgeon or find another.Dr Corbin

Jon A. Perlman, MD (retired) · Answer

You have the option of undergoing the procedure with oral or IV sedation alone or a light general anesthesia.  This depends upon the preference of your surgeon as well as your sense of whether you're more tolerant of mild discomfort or not.  Injecting the numbing medicine is somewhat uncomfortable but is very bearable and should be discussed with your selected surgeon.  Harvesting enough fat to inject 12 mL can easily be done under tumescent local anesthesia if you desire.  Best wishes,Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)Beverly Hills, California

Should minor liposuction for grafting purposes to indentation caused by kenalog be done under general anesthesia?

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