Why not BBL under local anesthesia to better prevent embolism?

Question

Hi docs!Thank you for taking your time to answer our questions.Why are most doctors doing BBL surgeries under general anesthesia and not in local?I'm searching for a doctor,who will do it under local anesthesia,but would like to have it done in FL.I have written with some girls,who didn't think it hurt that much.I would rather be awake,so I can turn around when doing the lipo,and move my legs from time to time,to prevent an embolism.I'm very healhty, but my mom had an embolism during a surgery.

Kenneth Hughes, MD · Answer

You do not necessarily need general anesthesia, but I do think it is a better patient experience.   I have performed many of these procedures with local and sedation, but it is certainly not for everyone and risk benefit analysis must be performed for each patient. Fat embolus may be avoided by epinephrine injection into the area to be augmented as well as the use of the use of blunt cannulae.
Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

John L. Burns Jr., MD · Answer

A Brazilian Butt Lift is an involved procedure.  Attempting this under local anesthesia will likely result in a suboptimal result and increases the risk of lidocaine toxicity.  Make sure to understand exactly why your surgeon wants no anesthesia and make sure they are properly board certified.

Ken Dolynchuk, MD · Answer

Hi and thanks for the question. It isn't the anaesthetic technique that gives rise to fat embolism but the depth at which the injection takes place, deep to muscle is the problem. If you are sedated orally and the operator is slow and gentle it can be done reasonably comfortably. Make sure the surgeon is board certified and experienced in the techniques and you should be fine. Good Luck!

Steven Wallach, MD · Answer

I have performed them under local, but the  majority I perform are under general. The patients do tolerate it pretty well.  Each patient is different and evaluating a patient in person is essential.

Robert Whitfield, MD · Answer

Being awake will not prevent an embolism.  Being awake will let you know when the muscle is being injected which will be painful.  The will help you avoid the embolism.  BBL can be done under local for smaller areas and reshaping.

Why not BBL under local anesthesia to better prevent embolism?

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