Available Types of Anesthesia for Liposuction
Although the subject makes a lot of people nervous, anesthesia is necessary for a smooth operation and proper recovery. Different types of anesthesia not only provide pain relief and keep the patient still, but help control the natural reactions of the body to pain or trauma.
Anesthesia works as an analgesic (pain reliever), as an amnesiac (loss of memory), by creating unconsciousness, by immobilizing you, and by stopping or reducing automatic responses such as increased heartbeat, rapid breathing, and a rise in blood pressure. The obstruction of sensory, reflex, mental and motor functions are needed to safely and effectively operate on a patient. These factors are what make surgery possible.
For plastic surgery procedures like liposuction, anesthesia may be administered by an anesthesiologist (a medical doctor who specializes in anesthesia), a certified registered nurse anesthetist (CRNA, or a nurse-practitioner with special training and certification in anesthesia), or the surgeon.
Although there are several types of anesthesia, not all surgeons will offer every one and not all are applicable to every type of surgery, or more specifically, to liposuction. There are basically four types of anesthesia: local, regional, conscious sedation, and general. Liposuction is generally performed using either
general anesthesia or local anesthesia. The choice depends on your surgeon's preferences and on how large an area you are having treated.
Local anesthesia numbs a small area and is most commonly used during smaller plastic surgical procedures. This is similar to the numbing shot you get in the dentist's office. This shot often consists of lidocaine, but there are several local anesthetics that are used. A topical local anesthetic can also be applied to the skin to numb the skin.
You will also usually get a sedative, a drug to keep you calm and relaxed, when you are having liposuction with local anesthesia. You may be given oral sedatives, such as Valium (diazepam), or you may receive it intravenously. If so, you will have an intravenous line inserted, usually into your arm. A bag of saline fluid will be attached that will be used to keep you hydrated, if necessary, or to administer medications. You will be awake and aware, but will be very relaxed. You may feel sleepy or even nod off during your procedure because of the sedation.
In wet, super-wet, and tumescent liposuction, the plastic surgeon will infuse the areas being suctioned with a solution of saline and epinephrine and lidocaine. Epinephrine is used to constrict blood vessels and reduce bleeding. Lidocaine is a local anesthetic and helps with pain control
General anesthesia can be given as an inhaled gas or as a liquid administered intravenously. You will be completely asleep and unaware during general anesthesia.
Anesthesia carries risks, although local anesthesia and sedation carries fewer risks than does general anesthesia. However, there are risks of allergic reactions to the drugs being used, even if you had anesthesia safely in the past. You must inform you surgeon about any underlying health conditions you have, such as allergies, asthma, and lung, heart or circulatory conditions, because these can increase your risks.
There is also the risk of an interaction between any of the anesthetic drugs being used and any medications or herbal products you take. Make sure you tell both your surgeon and whoever administers anesthesia of all the medications you take, including over-the-counter drugs, vitamin supplements, and herbal medicines. You do not need to stop taking every medication you currently take. You do need to make sure that your surgeon knows about them all. Check out our list of medications to avoid before, during, and immediately after surgery. This is not a complete list of drugs that you need to be careful about, but it is a resource.
Erwin J. Bulan, MD
Bulan Plastic Surgery
75 Main Street
Millburn, NJ 07041
Joshua A. Greenwald, MD, FACS
Cosmetic Surgery Associates of New York
166 5th Avenue
New York, NY 10010
Nikesh K. Patel, MD
New Reflections Plastic Surgery
1001 West Main Street
Freehold, NJ 07728