There are a number of ways to perform liposuction. Similarly, these varied procedures can be performed under varied forms of anesthesia. While it is possible to perform a fat harvest and transfer under local anesthesia, one should consider the goals of the procedure. Small volume fat transfer for correction of contour irregularities or facial filler can be performed under local successfully due to the low intensity of the procedure. Low volume harvest means less patient discomfort. However, high volume fat transfer as in BBL typically involves extensive harvest (>1L) and multiple donor sites. This would probably be better tolerated under general anesthesia.As always, discuss your concerns with a board certified plastic surgeon.