Is liposuction with local anesthesia safe for someone with low blood pressure (POTS)?

Limited liposuction can be done under local anesthesia. You do not want to be in pain during the procedure so that the surgeon must stop the procedure or do less than what is necessary. For this reason, general is a better option for my patients. I do not use local exclusively unless a small area of liposuction is planned.  Obtain clearance from your PCP to have the lipo so that your PS is informed of your POTS. The surgical staff needs to know beforehand of possible lightheadedness, trouble thinking, blurred vision or weakness.

Hello,Liposuction under local anesthesia is safe for individuals who are healthy and of a normal BMI, when performed by an experienced, board certified plastic surgeon. "Normal" blood pressure can vary among healthy individuals. As as long as your medical doctor has evaluated you thoroughly, and has not discovered any medical contraindications, you may proceed with surgery.In cases of large volume liposuction, fluid shifts are accounted for with careful and planned fluid replacement in the form of IV hydration. These cases typically require general anesthesia and monitoring to ensure the maintenance of baseline blood pressure. Warm regards,Dr. Pedy Ganchi                                                                                                                                          Village Plastic Surgery

you would need medical clearance I do this for all cases including local anesthesia but yes if medically healthy then you should be fine.
You need a formal evaluation by an expert in body shaping and contouring to determine what is best.  Traditional liposuction awake and smart liposuction are old methods and do very poorly for tightening skin or significant skin tightening or contouring.  Small problem areas can be improved slightly by these methods.  The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heat the skin with radio-frequency devices such as J PLASMA/RENUVION, InMode BodyTite, ThermiRF to heat the under surface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HIDEF VASER contouring and can only be done by a well . trained body contouring specialist. At the same time fat should be harvested, PRP and stem cells added and injected into muscles or indentations/cellulite to get body shaping and contouring.  This is known as a Brazilian butt lift when you inject the fat to the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face.  Cellulite should also be treated with cellfina, sculptra, subcision and/or fillers such as bellafill, renuva synthetic fat, or sculptra.  If skin is very loose before surgery then it will need to be removed such as lower abdominal skin (tummy tuck/abdominoplasty), breast skin (breast lift), arm skin (brachioplasty).  Overall you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting.  Dr. Emer.

Dear ia06nJsme255,
generally speaking, local anesthesia might be an option for a smaller region. In case of multiple regions, local liposuction might not be the best idea. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I appreciate your concerns, however many individuals have lower blood pressure as a norm for them. Generally speaking, this is not an added risk for liposuction, however astute monitoring of patient’s vital signs during and after surgery need to be done. This is a normal routine performed by board-certified plastic surgeons in fully certified office and freestanding outpatient surgical centers. Higher volume liposuction may require intravenous fluids as needed. The procedure can be done under local anesthesia for smaller areas, however larger areas usually require some sort of anesthesia to provide maximum patient comfort. Consult with a board-certified plastic surgeon in our area for a full evaluation. Good luck.

Occasional low blood pressure should not present a problem with in office lipo under local anesthesia.  You should push fluids before and afterwards but this should still be safe to perform in the office.  Good luck.  

I don’t think your POTS should affect you or Liposuction though you should discuss this with your plastic surgeon during the consultation.if anything the epinephrine is used in the numbing solution especially during awake Liposuction will maintain an increased blood pressure. if you’re awake for the procedure remind your surgeon before they start to have you get up slowly from the table at the end of the procedure.personally I perform all forms of Liposuction using local anesthesia with mild sedation. I’ve been doing liposuction this way for the last decade. During my plastic surgery training and in the first half of my career I primarily used general anesthesia for liposuction and fat transfer procedures.  I converted to doing awake Liposuction about a decade ago and feel it has multiple advantages.there’s a learning curve to getting patients through these procedures comfortably without general anesthesia. Make sure your provider has adequate experience.It’s possible your plastic surgeon may require or ask for medical clearance from your internist or primary care doctor.There are a number of factors we look at to assess if someone is a good candidate for Liposuction. Medical history is simply one of them.Best, Mats Hagstrom MD

First, you should be cleared by your medical physicians. Second, you are encouraged to consult a board certified plastic surgeon. A Skype or FaceTime consultation with a VASER specialist will help you get an accurate recommendation and pricing.
Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee