Recently, I responded to the following question posted on RealSelf.com:
I’ve tried to research the safest, best type of liposuction, but can’t seem to find whihc option is safest. My husband does not want me to undergo general anesthesia and is most worried about the safety of the procedure. He is an anesthesiologist and has seen the dangers. I just want my saddlebags done, I am pleased with the rest of my body. And, if a procedure is safer, does that mean it will be less effective?
Here’s my response:
Tumescent local anesthesia is safest for liposuction
From the patient’s perspective, local anesthesia for liposuction is a much better choice than general anesthesia. General anesthesia may be more convenient for the surgeon because it reduces the time needed to inject the necessary local anesthetic that is essential to performing liposuction safely. In tumescent local anesthesia relatively large volumes of saline solution containing dilute amounts of the anesthetic (lidocaine) and epinephrine (a drug that constricts the tiny blood vessels within the fat tissue), is injected throughout the volume of fat that is to be treated by liposuction. If correctly administered the anesthetic usually numbs the area completely (making the actual liposuction painless) and eliminates any appreciable bleeding (which greatly reduces post-operative bruising). I wrote the linked article (see below) in an effort to help surgeons maximize patient comfort during tumescent liposuction.
If general anesthesia is not used (and local anesthesia alone is used) it takes more time and effort on the part of the surgeon to thoroughly numb the fat tissue while maintaining maximum comfort for the patient. The usual result is greater (frequently 100%) numbing of the area to be treated, making the liposuction itself painless or nearly so. Also the constriction of tiny blood vessels is more complete, resulting in much less bruising and a faster post-operative recovery. Because such meticulous use of the tumescent local anesthetic is less likely to be done in the setting of general anesthesia, more extensive bruising and a longer recovery is often seen after the use of general anesthesia.
In addition to the advantages mentioned above, local anesthesia is nearly 100% safe, whereas general anesthesia is much more dangerous and can even be fatal. The safety difference is best illustrated by the fact that nearly all serious complications associated with liposuction have occurred in the setting of general anesthesia; virtually none have been seen when proper tumescent local anesthesia is used exclusively.
To learn more: How to Maximize Patient Comfort During Tumescent Liposuction