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Head-to-Head: Dr. Wix-Harris and Dr. Fodero Talk Liposuction Anesthesia

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One thing that plastic surgeons and cosmetic physicians agree on is that liposuction is the best way to completely remove all of the fat desired in a particular location. If you’re considering liposuction, you might find conflicting information about whether it should be performed under local anesthesia or general anesthesia. It’s an important distinction because it impacts your recovery, the safety of the procedure, and the results you end up with.

The truth is, liposuction can be performed under either type of anesthesia. And unlike the vast majority of cosmetic practices, we offer both options, because we believe they are great options – but each ideal for a different type of patient.

Two of our liposuction surgeons at Reflections Center sat down to discuss this topic so you can learn more about what goes into the decision and how it benefits you. Here’s what Dr. Renata Wix-Harris and Dr. Joseph Fodero have to say about it.

Local Anesthesia Allows for Repositioning and Different Angles of Approach That Cannot be Achieved When the Patient is “Asleep”

Liposuction is a medical procedure, but it’s a highly artistic one. The results you get depend upon your doctor’s skill, experience, and physical ability to precisely suction out curved body parts with a straight “straw”. To get into some of the nooks and crannies, it’s really important to bend and position the body. Local anesthesia means that the patient is fully numb, but awake. Being that the patient is awake, they can move around, flip over, or stand up during your procedure can help allow your cosmetic physician or plastic surgeon to assess and treat your body from every angle and position, ensuring they’ve achieved exactly the look you want.

Dr. Wix-Harris says, “One of the advantages, I think, which you have under local is that you can roll and flip people. You know, you can tell them, can you be half on your side or three quarters? And that just gives you a nicer angle on some things… under local, you tell the patient, could you please roll over? And not tell the anesthesiologist, hold the tube, everybody flip.”

With general anesthesia, there are only a few, set, standard positions the body can be in, and it’s positioned by a team – the surgeon, surgeon’s techs, and anesthesiologist. Standing for assessment is no possible with general anesthesia – and we all know how different our bodies look standing vs. laying down. This is why it’s more important for a surgeon to do extensive planning and marking for liposuction under general anesthesia, before the surgery begins. With proper technique, strategy, and markings, you can achieve the same results, but it may be more difficult for the surgeon, physically. Which is why many surgeons will limit the number of liposuction cases they do each week.

General Anesthesia is More Comfortable, Especially if We’re Going to Be Aggressive

Although local anesthesia can numb the treatment area, it can still come with some discomfort. You will feel the needle sticks as the numbing is injected into several locations throughout the body. You’ve probably had very similar injections at the dentist when you’ve had a cavity filled. It’s not unbearable, but it’s also not as gentle as just falling asleep with an anesthesiologist.

Local anesthesia can’t always block all sensation during liposuction, which is why there’s a limit to how aggressive your surgeon can be with this type of liposuction. You’ll notice that smartlipo and vaser are often done under local anesthesia. Both of these technologies make for gentler removal of fat cells, which is helpful in a local anesthesia case.

If you want a more defined or lean look that requires more aggressive lipo, says Dr. Fodero, it may be best to consider general anesthesia so you can be completely comfortable throughout the procedure. This allows your plastic surgeon or cosmetic physician to do what they need to do. Dr. Fodero says, “If you do [patients] under general, then you take full advantage that they’re not going to have any discomfort.”

Local Anesthesia Has Fewer Side Effects

General anesthesia is notorious for causing uncomfortable side effects after surgery. It even requires monitoring for a few hours after surgery, extending your stay and causing additional costs. Local anesthesia, on the other hand, means you can go home almost immediately after surgery, and you won’t have that “hangover” or loopy feeling that general anesthesia can cause.

This can have a very positive impact on your recovery, says Dr. Wix-Harris. “I think the recovery is easier because they don’t have the hangover from general anesthesia. I think that’s actually what is the toughest part. It’s not the recovering from the lipo necessarily, but it’s just the fact that [patients] had general anesthesia. You don’t have to monitor them for a long time afterwards. It’s a quick, safe thing to do.”

You will still need someone to drive you home after a procedure under local anesthesia, because we do give some relaxing medication by mouth, in addition to the numbing. You should feel sobered and no longer numb within a few hours of your procedure ending. Generally, though, patients feel a little sore, but not in need of any prescription pain medications, after this procedure.

General Anesthesia Allows for Combination Procedures

General anesthesia is the best option if you want to combine your liposuction with another plastic surgery, either for face or body. This mostly comes down to the limit of numbing medication we can use in any patient. The numbing medication used in local anesthesia only lasts for so long, and there’s a maximum dose we can give you within 24 hours. So we have to select individual areas, and have a time limit on how long we can treat those areas, before it wears off. In these cases, it’s better to not rush the surgeon, and use general anesthesia, knowing we can keep you comfortable long enough for a great outcome.

Dr. Fodero says, “If you’re doing isolated areas and you’re not doing large volumes, local’s great. If you’re doing something else, like… if you start to stack multiple things, [general is better]. I think that two or three hours is about as much as anybody wants to be awake for anything. But once you start stacking additional things, and even though it could technically be done under local, if it’s five hours, going to sleep is not unreasonable.”

Exploring Your Options with Liposuction and Body Contouring

Ultimately, the best way to pick between local or general anesthesia comes down to meeting with our award-winning cosmetic physicians and plastic surgeon. We can help you pick the right approach for your goals using our variety of techniques, technologies, and experience in surgical body contouring. After all, Dr. Fodero says, “I think that when we add all this stuff together, we have a lot of… things we can do. A lot of options. So whenever somebody comes, the goal is to just, is to fit them with the appropriate procedure.”

Schedule Your Consultation

At Reflections Center for Cosmetic Medicine, you’ll find a team of award-winning physicians providing all the best options for cosmetic care. We do this for one reason: we believe each patient’s ideal treatment plan is different, and we never want you to have to sacrifice, or be left without the complete picture of your options. Because we provide all of these treatments, our doctors can help guide you to the best option(s) for you, and ensure you’re provided with the very best care at every step in your journey.

To schedule your consultation, please call 732-356-1666 today!

We provide liposuction under general anesthesia in the Florham Park and Morristown areas of New Jersey. We provider laser liposuction and Vaser liposuction under local anesthesia in our private surgical suite, located in the Martinsville section of Bridgewater Township.