Tumescent liposuction includes local anesthesia.However, most patients still require some level of sedation for anything more than minor treatments.My preferred method is conscious sedation for IV sedation.I have abandoned the use of general anesthesia for liposuction except for rare cases.It's simply not necessary and has multiple drawbacks.These include risks of general anesthesia, nausea and vomiting, increased costs, inability to reach certain areas such as the back and flanks, compromising results, etc.Many plastic surgeons prefer to use general anesthesia.During my training, we always used the general anesthesia for liposuction.Having learned the techniques of doing liposuction with patients awake, I feel it is by far preferable.You will find most doctors who are not plastic surgeons will do this procedure without general anesthesia because they do not have access to operating rooms.To have privileges in the hospital operating room or surgery center, a doctor must have the correct qualifications and have been properly trained in surgery.There are certainly patients who are very sensitive or have high levels of anxiety who will do much better with general anesthesia.Ideally, all options should be available for the patient.Best of luck,Mats Hagstrom, M.D.