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Q&A with Dr. Steinsapir: General or Local Anesthesia for Facial Liposuction?

Published on March 8, 2015

Q:

I’ve heard that more fat can be taken out under general anesthesia than under local. Is it true? General anesthesia liposuction is a more expensive choice, but I want to take as much fat as possible from my outer thighs. On the other hand, local anesthesia lipo enables a patient to stand up to compare results. Which type is better?

A:

It is important to understand that the mortality rate for liposuction under general anesthesia continues to be much higher than the mortality rate for liposuction under local anesthesia. It is thought that this higher rate of death is related to several factors including the drugs needed for the anesthesia. The mortality rate for liposuction under general anesthesia varies with the reporting study but is somewhere between 1 in 40,000 cases to as high as 1 in 5,000 cases. The mortality rate when liposuction is performed under local anesthesia is approximately 1 in 300,000 cases.

Face liposuction

Even the rate of 1 in 5000 cases is rare enough that a single surgeon is not likely to experience an operative death from liposuction in their career. Your plastic surgeon can look at you straight in the face and tell you the complication has never happened to them and be telling the truth. That is why in medicine we look at what happens when large numbers of case are pooled together so we can learn from the experience of others. Another way of looking at this issue is that 98% of malpractice lawsuits regarding liposuction stem from liposuction performed under general anesthesia, although this data is now about 10 years old.

Why do doctors continue to do liposuction under general anesthesia despite the higher risk of death? It is partly cultural. General plastic surgeons are accustom to having their patients out. However, there is a financial reality. The liposuction that has to be done slowly and gently with microcannulas by the surgeons in their office operating room and may take several hours can be accomplished under general anesthesia in 45 minutes. So, it is much more profitable to perform liposuction under general anesthesia even when you factor in the economic cost of paying for the increase liability caused by surgery related death and illness. On average, I am going to guess that you will pay more for the liposuction under local simply because more contact time is spent with the surgeon even considering the extra cost of the anesthesia and the more expensive operative setting. Read more by Dr. Steinsapir

To learn more about procedures and treatments performed by Beverly Hills | Los Angeles Facial Plastic Surgeon, Dr. Kenneth Steinsapir, contact us at 310-274-7422