Should circumferential thigh, calf, and ankle tumescent lipo with oral sedation be staged or is it OK to do as one procedure?

I am 44 years old, pear shaped, 5'6" and weigh 140 lbs. My doctor, a board certified plastic surgeon, thinks it's ok to do everything at once. I am concerned about lidocaine toxicity. If it's better to do this in two separate procedures, how far apart should they be? And should the upper or lower leg be done first or does it not matter?

Doctor Answers 5


There is a limit, based on your weight, of the amount of local anesthesia that should be given. Some surgeons do not perform liposuction of the calves and ankles due to the length of time those areas stay swollen. Doingcircumferential surgery can also increase swelling. Second procedures can be done as soon as two weeks, unless there is a lot of swelling. You might want to go back to your surgeon and ask these questions.

San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

Leg Contouring / Skin Laxity on Legs and Knees -- VASER, ThermiRF, Venus Legacy, Thermage, Ultherapy, Exilis Ultra

I personally like to separate the thigh and calves as the swelling is HUGE when you do this all together. I suggest you see an expert who often stages procedures and treats large areas at once.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

General anesthesia all at once

This should be performed under general anesthesia all at once.  Staged is not a good choice neither is oral sedation.

Lipo under sedation

Under sedation the concentration of lidocaine can be lowered and most if not all can be done at the same time. Best of luck. If concerned, it can always be staged.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews


It depends upon your exam and your surgeon. Generally, circumferential thighs represent  a very large body surface area requiring IV fluid hydration and anesthesia.

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