Liposuction: Local or General Anesthesia?

With the increased availability of minimally invasive, nonsurgical cosmetic procedures, patients tend to think that some surgical procedures can be performed without needing a general anesthetic. Many liposuction patients from Harrisonburg to Richmond, VA, ask if they can undergo the procedure with just “twilight” sedation to avoid general anesthesia.

The answer in many cases is “absolutely.” But it’s important for people to understand the different levels of anesthesia and the circumstances under which it’s important to use a general anesthetic. I’ll briefly describe those differences in this blog post and explain the factors that can influence the recommendations of our board-certified plastic surgeons.

The Different Levels of Anesthesia

Minimal sedation is the lowest level of sedation, a condition in which patients can still respond to verbal commands but may have impaired coordination and thought processes. This is different than using a local anesthetic, which simply numbs the treatment area.

“Local-only” liposuction is rarely appropriate. Our Charlottesville, VA, surgeons typically combine a local anesthetic with IV sedation. This level of sedation is usually referred to as twilight anesthesia. This is the highest level of sedation that doesn’t require using breathing tubes. General anesthesia means a patient is completely unconscious and can’t control their reflexes or central nervous system. A board-certified anesthesiologist supervises the patient’s sedation in this case.

Twilight sedation offers a faster recovery time compared to general anesthesia. It’s generally associated with fewer side effects and complications and is less expensive because it requires fewer medications and supplies.

What’s Best for You?

The level of sedation used during liposuction is something patients discuss during their consultations with their plastic surgeons. For our surgeons, patient safety is the priority. Besides safety, choosing the type of anesthetic is based primarily on the following considerations:

• Location of the treatment: Liposuction is most frequently used on the upper and lower abdomen. A local anesthetic with sedation can be appropriate if the amount of fat being removed isn’t too large. Twilight anesthesia can be the best choice for patients getting liposuction for smaller areas, such as the neck.
• Number of procedures or areas being treated: Getting liposuction for multiple areas (or combining liposuction with a tummy tuck or cosmetic breast surgery) likely will require the use of a general anesthetic.
• Keeping the patient comfortable: Surgeons may ask patients how they’ve responded to other situations in which an anesthetic was needed, such as during a dental appointment. Their experiences with local anesthesia in those cases can provide valuable information about how they will respond during their liposuction procedures. Manual liposuction can also require vigorous movements and surgeons often want their patients under general anesthesia to keep them more comfortable.
• Providing the best long-term results: Plastic surgeons often believe they can create better, more long-lasting results by using general anesthesia during liposuction.

When considering plastic surgeons to perform liposuction, it’s important that they offer a range of anesthetic options. If they don’t, it could be a sign that they’re not as qualified to perform the procedure as they should be. Our surgeons at the University of Virginia Plastic Surgery practice discuss all of your options during the consultation.

If you’re interested in liposuction, you can see the results our surgeons created in our gallery of before-and-after photos. You can also contact us using the online form to request a personal consultation or call us at (434) 924-1234 (Charlottesville) or (540) 932-5771 (Fishersville) to schedule an appointment.