Typically when patients undergo liposuction they often address 2 or more sites at the same operative procedure. In many instances they may have multiple areas liposuctioned. As an example, a patient who comes in for liposuctioning of the abdomen may also undergo liposuctioning of the mons pubis, back and flanks to create overall improved contouring of the trunk region. Similarly, for the lower extremities patients often treat the outer thighs, inner thighs and knees at the same operative procedure. It is not unusual for patients to also add in submental (neck) liposuctioning at the same time as other areas are being addressed. First and foremost, it is important that the patient is evaluated by a board-certified plastic surgeon before undergoing liposuctioning to determine if this is the optimal procedure to achieve the patient's desired results. In cases where patients will have poor skin quality excisional surgery, such as an abdominoplasty, would yield a better result than liposuctioning alone as the latter could just create looser, empty appearing skin which hangs in a more dependent fashion. When multiple areas are being treated I find the best results are achieved when the patient is under general anesthesia. That way they have a more positive experience and do not experience discomfort, not only from the liposuctioning but also initially from the tumescent fluid which is placed in the tissues in order to provide analgesia as well as vasoconstriction to decrease bleeding, swelling and bruising. If the patient is having multiple areas treated under local analgesia only or with IV sedation then they may experience more discomfort which could limit the surgeons ability to adequately remove the excess adipose tissue. Furthermore, when the patient is under general anesthesia it is easier to move them about during the surgical procedure to obtain optimal results.