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This area needs a very well trained physician who does a signficant number of lower leg procedures. Please consult with a VASER HI DEFINITION contouring expert for the best results. Don't let distance dissuade you, see an expert. Best, Dr. Emer.
If your preference is to stay awake during lipo, your options are not limited to only smart lipo. Almost all types of lipo can be done awake. The key is not the laser, it is the anesthesia that is injected into the fat before the procedure. Smart lipo uses tumescent anesthesia - a type of local anesthesia that was invented in the mid 1980s that reduces bruising, reduces bleeding and speeds recovery. All of these benefits of tumescent anesthesia and tumescent lipo (awake lipo) existed for decades long before smart lipo ever existed. The marketing people at the laser companies simply latched onto these benefits and "borrowed them" in a way that might mislead you.
You are right, SmartLipo is typically performed in the office under tumescent local anesthesia +/- oral sedation. And it is a very good procedure, particularly when some skin tightening is needed, as the laser energy assists with this. But is not the only liposuction procedure which can be done under local anesthesia. I suggest a consultation with an experienced, board-certified Plastic Surgeon to determine the best option for your particular situation. Best of Luck.