Performing liposuction under local anesthesia alone can be a suitable option for particular cases, but it’s important to understand the potential risks and limitations associated with this approach. As a plastic surgeon who performs this procedure often, it is important to understand the goals for the procedure.

While liposuction under local anesthesia has advantages such as reduced recovery time and decreased systemic risks compared to general anesthesia, it also carries certain risks and limitations. The primary dangers associated with performing liposuction under local anesthesia alone include:

Inadequate pain control: Although local anesthesia numbs the targeted area, it may not provide complete pain control for the entirety of the procedure. Pain or discomfort during liposuction can cause patient discomfort and compromise the surgeon’s ability to perform the procedure optimally.

Surgical trauma perception: With local anesthesia, patients may perceive sensations of pressure, movement, or tugging during the surgery, which can be distressing for some individuals.

Limited scope: Performing liposuction under local anesthesia alone may have limitations on the amount of fat that can be safely removed in a single session, potentially necessitating multiple procedures to achieve the desired results.

Patient anxiety and discomfort: Some patients may experience anxiety or psychological distress during the procedure due to being awake and aware of the surgical process.

It’s important to note that the suitability of local anesthesia for liposuction depends on factors such as the extent of the procedure, the patient’s tolerance, and the surgeon’s expertise. In some cases, a combination of local anesthesia and sedation may be utilized to enhance patient comfort and safety.

Typically, though, this is for very limited cases. In my experience, patients do not recount awake liposuction as a positive experience. On the contrary, they recall it as unpleasant, owing to the aforementioned reasons. One patient described it as a “polite mugging”. Because of this, I seldom employ this technique in my practice. It is best utilized for “touch-ups” and small treatment areas.

In conclusion, while liposuction under local anesthesia alone can be a viable option in some cases, it is essential to consider the potential risks and limitations associated with this approach. A thorough evaluation and discussion with a board-certified plastic surgeon will help determine the most appropriate anesthesia option for each individual patient, ensuring both safety and optimal surgical outcomes.