Local-only liposuction? It depends on what is getting lipo’d…

The success of liposuction has been well-documented for decades, and while many board certified plastic surgeons favor one type of lipo over another, many times it has more to do with the location of the unwanted fat than it does which technology to use. The same difference of opinion holds true for the best manner of anesthesia that should be used during this fat-removal procedure: local vs. general anesthesia.

by John Hammarley

Location, Location, Location

General anesthesia involves infusing medication almost always directly into the veins that allow patients to sleep during surgery. Local anesthesia involves injecting numbing medicine directly into the area to be treated and waiting until it is completely numb before the treatment. Board certified plastic surgeons are trained in using both approaches in a variety of procedures, including liposuction. But when asked which method they prefer, they often sound more like real estate agents who stress. “Location, location, location.”

“Their abdomen, both upper and lower, is an appropriate area to do under local,” says board certified plastic surgeon Dr. Sean Doherty of Concord, MA. “But if someone has an extremely large abdomen, and a large waist, I’d be reluctant to use local only.”

Dr. Doherty also warns that previous experiences with anesthesia, especially with dental procedures, can be a strong clue about what anesthesia road to take. “If they tell me it takes a lot of local to get to a point they can work on their teeth, they probably aren’t going to be good prospects for local-only liposuction.”

Patient Safety and Comfort are the Ultimate Decision Makers

Despite popular media and marketing strategies by some plastic surgeons who promote local-only lipo, many of their board certified colleagues say the most important factors to consider is the final result, patient safety, and comfort during liposuction.

“Our society has moved into the trend of minimally invasive, less anesthesia as always being a good thing,” says Dr. Steven Camp, MD, a Ft. Worth-based board certified plastic surgeon. “And really what should be the focus is the quality of the result of the surgery and the safety of the patient and their overall experience.”

“In my training, we were taught that bigger liposuction cases were always done under general anesthesia,” said Dallas-based board certified plastic surgeon Dr. William P. Adams, Jr. “I think it’s more comfortable for the patient and in many ways its safer because with bigger areas you’re working on it becomes harder and harder to anesthetize the patient.”

Short-term Benefits vs. Long-term Results

Another part of the balancing act of deciding what type of anesthesia to use for lipo is to keep the patient’s immediate comfort during the procedure in mind, as well as whether he or she will be happy with the results months, if not years, later. Many surgeons interviewed by The Plastic Surgery Channel say for those two reasons alone, they favor general anesthesia. Patients are more comfortable under general and surgeons say they can control the environment and get more aggressive in their fat retrieval if the patient is not just locally anesthetized.