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Liposuction, Body

3 Reasons "Awake Liposuction" Could Be a Bad Idea

"Awake" liposuction and plastic surgery are among the most dangerous trends in cosmetic procedures. If you're considering receiving liposuction from an organization selling the benefits of "awake" procedures, it's definitely wise to do a bit more research. Self Magazine recently published an extensive overview of the recent national trend towards physicians advertising and performing liposuction procedures in-office with only local anesthesia.

While this trend may seem innocuous at face value, there can be a number of risks, as Self's reporters discovered. In most cases, the Doctors performing "awake" anesthesia lack training in plastic surgery. In other words, they're performing surgery under local anesthesia because they don't have the credentials to operate in a hospital or a certified surgery center.

Patient case studies profiled by Self demonstrated a shocking lack of concern for patient safety on the part of these under-trained, non-credentialed physicians. Patients, including Paulette Hacker of Sacramento, described incredibly painful experiences and rough treatment. Hacker proceeded to sue, but her experience isn't alone among patients who attend office operating rooms for liposuction, breast augmentation, and facelifts while awake.

Two More Quick Questions

Are Awake Liposuction Procedures Ever Safe?

In general, opting for "awake" procedures for the sake of convenience or cost savings will not help patients achieve their goals. Patients run a number of risks, including excruciating pain while under the knife, traumatic experiences, and poor results due to the fact they're being operated on by unqualified individuals.

However, awake liposuction can be safely performed under carefully selected circumstances, though not everyone is an appropriate candidate. If you are a healthy patient seeking a small amount of liposuction, awake liposuction with a board-certified plastic surgeon could be a reasonable option to achieve your treatment goals.

However, patients who qualify for awake procedures do not represent the majority. If you are looking to have multiple areas treated, are overweight or sensitive to needles, or have a history of chronic pain or insensitivity to local anesthesia, you are likely not the best candidate for an awake procedure. Join us as we review several of the biggest risks associated with liposuction and other forms of plastic surgery awake under local anesthesia.

1. Anesthesia is Inherently Risky

Modern anesthesia comes in many forms. Patients may require general anesthesia, twilight sleep, or local anesthesia (also known as "awake" anesthesia) for safe results. While all of these options are typically safe options for healthy patients, the safety hinges on several factors.

To have a safe anesthesia experience, your treatment must be administered by appropriately-trained personnel. Typically, a team of surgeons, nurses, anesthesia professionals, and surgical assistants working in tandem are necessary to ensure anesthesia is appropriately tailored to an individual patient's needs. Safety also hinges on the anesthesia being performed in a proper setting with the right equipment, which is almost always an accredited ambulatory surgery center or hospital room that is subject to unbiased 3rd-party inspections.

In other words, anesthesia is generally safe. However, it's inherently risky. Having a pain-free, successful surgical experience requires a team of experts, state-of-the-art equipment, and the right equipment to optimize your chances of success.

2. "Awake" Liposuction isn't Typically the Best Option

Awake liposuction isn't worth dismissing entirely. It's important to note that certain patients seeking particular procedures may be great candidates for local anesthesia. However, once again, these patients do not represent the majority of individuals who are considering plastic surgery.

Dr. Joseph M. Gryskiewicz, chair of the emerging-trends committee at the American Society for Aesthetic Plastic Surgery (ASAPS) wants patients to note that "awake" plastic surgery does not exist to improve your comfort level during surgery. Surgeons aggressively marketing this procedure aren't trying to ease patient recovery. In contrast, Gryskiewicz notes it's typically offered by physicians who "lack hospital privileges", and more grimly, "can't operate their way out of a wet paper bag." To err on the side of safety, you should probably avoid awake procedures unless a physician with certified operating room privileges objectively recommends it as the right option for you.

3. It's Risky

There's a growing trend towards "amateurism" in the field of plastic surgery. This trend means more physicians are flooding the field to offer liposuction, injectables, breast enhancement, and other cosmetic procedures. While an excess of supply can spell out lower prices for patients, that's not necessarily a good thing. Unfortunately, many individuals offering low-priced cosmetic surgery have a background in gynecology, internal medicine, family practice, general surgery, dentistry, or any number of other fields completely unrelated to plastic surgery. Unless a prospective surgeon is board-certified with the American Society of Plastic Surgeons (ASPS), they likely lack the proper training to operate.

Aside from the issue of questionable physician credentialing, awake procedures are inherently risky for some patients. Even with the best physician intentions, you could risk the following:

  • Deep discomfort: Some patients may find awake procedures uncomfortable. For some patients, they are outright painful or even excruciatingly painful. This may not only lead to patient trauma, it can also compromise the results of a procedure. Individual sensitivity to anesthesia can vary, which is another reason that a trained anethesiologist should be involved in the treatment plan for any major procedure.
  • Toxicity risk: In some cases, the amount of local anesthesia administered to patients during awake procedures exceeds recommended guidelines. The results of anesthesia administered against recommendations can be toxic to some patients, which can result in serious recovery issues or even patient death.
  • Setting-related risk: Many awake liposuction procedures are performed in office settings, which can lead to cost-savings for patients. However, it's important for prospective patients to realize the risks associated with out-of-hospital surgical procedures. Chances are a physician who performs surgeries in their office lacks proper monitoring equipment and certification. Even in extremely healthy patients, there is always a small amount of risk that something could go wrong during surgery. If you experience an adverse reaction to anesthesia or other aspects of surgery, being located in a hospital or certified operating room setting with access to the right equipment could save your life.

"Cheap" plastic surgery rarely yields the best patient outcomes. However, in the case of "awake" liposuction and other procedures, the results could be worse than just mediocre or unsatisfactory. You could experience a high level of pain during the procedure, adverse reactions, or even death. Don't assume you are a good candidate for local anesthesia plastic surgery unless an appropriately-trained and credentialed surgeon has told you so.

To find out if you qualify for awake liposuction, the most appropriate step to take is to consult with a plastic surgeon who is certified with the ASPS. They will be able to objectively evaluate your risks and goals and recommend the right type of anesthesia and procedure to achieve the outcomes you want.

To learn more about the best liposuction procedure for your goals, contact the San Francisco office of Dr. Larry Fan of 77Plastic. Fan is a board-certified, highly experienced, and reputable plastic surgeon who offers complimentary consultations to prospective patients.

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About the Author

Dr. Larry Fan is a Harvard educated, Board Certified Plastic Surgeon in San Francisco, CA. He is a Master Artist who is known for creating beautiful, stunning, and natural results. Dr. Fan has been named One of America's Top Plastic Surgeons for the past 10 years running and has received several national awards for his work in Plastic Surgery. He has successfully performed more than 10,000 cosmetic procedures of the face, breasts, and body over a 20 year period. Dr Fan has been an invited speaker at the American Society of Plastic Surgeons and the American College of Surgeons, and has been featured in national media outlets such as CNN, NBC, and ABC.

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