Awake Liposuction, also known as “tumescent liposuction,” is a surgical procedure that removes fat deposits from under your skin in the same manner as “traditional liposuction”. The difference is the type of anesthesia used. In awake liposuction there is no general anesthesia and no sedation given.
The patient is wide awake throughout the entire procedure. A narcotic and an anxiolytic are administered to help relax and help alleviate any discomfort. The wetting solution is a mixture of lactated ringers with lidocaine and epinephrine, it provides the local anesthetic and is infiltrated in the areas to perform fat removal. As with traditional liposuction this procedure is used to remove fat from areas of the body that are difficult to target with diet and exercise. This procedure returns your body to a more slim look without sacrificing unnaturalness. This may be a procedure for you if you want to restore or reshape areas of your body. If you’re considering liposuction surgery, consult a board-certified plastic surgeon. It’s important to understand what liposuction surgery entails, including possible risks and complications as well as set realistic expectations.
Am I a candidate for liposuction?
If you answer “yes” to any of the following questions, awake liposuction may be right for you:
- Are diet and exercise unable to achieve the appearance you desire?
- Do you have excess fat without hanging skin?
- Does your abdomen have good skin elasticity and no diastasis recti (stretched or separated abdominal muscles) due to pregnancy or aging?
- Do you want liposuction but do not want to undergo general anesthesia?
Awake Liposuction Before & After Photos
10 month postop
- Procedure: Awake Liposuction of abdomen, waist, hips and lower back
- Age: 40-50 yo female
- BMI: 31
- Weight: 162 lbs
How can awake liposuction help?
Eliminate Stubborn Fat from Small Areas
Patients that have achieved their goal weight and made adjustments to live a healthy lifestyle are often left with areas of fat deposits that are difficult to eliminate. These fat deposits typically are removed with traditional liposuction under general anesthesia. Since the patient is under general anesthesia we prioritize maximizing the amount of fat removed and maximize the number of areas. When the goal is not to remove as much fat as possible in as many areas as possible then awake liposuction is an excellent option. Awake liposuction can be used to remove this stubborn fat from the chin and neck, chest, abdomen, waist, hips, back, arms and thighs.
Surgery requires time off from work and even some time off from any of your daily activities. Your plastic surgeon will mandate a specific amount of time off which can be anywhere from 1-2 weeks to recover. This often prevents patients from choosing to undergo a cosmetic procedure. Awake liposuction can help reduce this time off especially when the areas are small and not much fat is removed. The avoidance of general anesthesia allows the patient to resume normal daily activities immediately after surgery. Restrictions are still placed secondary to having an operation but the patient is not limited by recovering from anesthesia.
Awake Liposuction – What to Expect
Awake liposuction is usually an in-office procedure but can be performed in a surgery center or hospital. The procedure is elective so may require medical clearance and blood work prior to the procedure. You will need a ride home and someone to monitor you for 24 hours after surgery. Although the wetting solution, a mixture of lidocaine with epinephrine and lactated ringers, provides the necessary anesthesia to tolerate the procedure it can still be uncomfortable. Your results are limited by the nature of the procedure in that you are awake and every patient’s level of pain varies. Most patients tolerate the procedure well and have excellent results.
Treatable Areas for Awake Liposuction
Awake liposuction, like standard liposuction, can be used to remove stubborn fat from almost any area of the body. It is often done to remove fat from the neck, arms, thighs, buttocks, or abdomen. In select patients aggressive liposuction is still possible with etching.
The Awake Liposuction Process
Once you fill out the online questionnaire, you will be contacted to confirm an appointment for a one-on-one consultation with the surgeon. You may also provide photos through our HIPAA compliant system and during your visit your surgeon can provide a personal 3D simulation using your own photos. This tool is a powerful education tool that helps identify what can and cannot be performed.
This appointment also includes an analysis of your health history, any medications you are taking, and what you desire to achieve with the procedure. Please have all of this information with you when you come to your appointment. All of which can be submitted electronically through our HIPAA compliant patient portal.
Your surgeon will discuss the areas of fat to remove that will best provide you with the results you desire and answer any questions you may have.
Your surgeon will review in detail all of the information you need to know prior to surgery.
Generally, patients should avoid nicotine products six weeks before surgery and stop taking anti-inflammatory medication (e.g., aspirin and ibuprofen) for at least two weeks before surgery. Some vitamins and supplements may also cause problems during or after surgery, so it is best to avoid them or to talk to your surgeon about potential side effects.
You may be asked to bathe using an antibacterial soap before your procedure.
Eating and drinking restrictions include:
- You may eat the day of your surgery.
- We ask that you eat a light meal prior to your drive to the surgery center/office.
- You may also have clear liquids.
- However once you get on the road we ask that you don’t eat or drink anything further.
- No caffeine the day of your surgery.
You may be asked to obtain blood tests.
Be sure to arrange for someone to drive you home and care for you for the first 24 hours after your procedure.
During the Procedure
Awake Liposuction is performed with local anesthesia only, in a surgery center or office setting. The length of time is variable based on the area and amount of fat to be removed. An IV will be inserted into one of your veins. It is performed using a specialized suctioning device, excess fat deposits are permanently removed through small incisions using a thin hollow tube called a cannula. The surgeon will place small incisions in inconspicuous areas. They are closed with absorbable sutures and covered with surgical tape. Sometimes the incisions are left open to allow drainage. In some cases drains are used. During the procedure, your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored
After surgery, your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the surgical center. You may continue to receive IV fluids and oral pain medicines.
You will have to wear compression stockings to help prevent blood clots and reduce swelling in your legs. You will be advised to wear a girdle or bodysuit with mild compression to aid in decreasing the swelling and to keep you comfortable. Compression garments are worn 24/7 for the first four weeks. Swelling will typically subside after about a few months but may last as long as 6 months.
Expect pain, bruising, and tenderness for which you will be provided pain medications as needed.
For the first few days after surgery you will need to get plenty of rest. Most patients are able to return to work in less than a week and resume regular exercise after about six weeks. After a few weeks, swelling and bruising will subside and the contours of your body will be noticeably slimmer and more defined. The results of liposuction are generally permanent, and patients can maintain their results by following a healthy diet and exercise regimen.
Your surgeon will give you more detailed information about what you can expect during your recovery.
Awake Liposuction FAQs
Q. Am I a good candidate for awake liposuction?
A. Ideal candidates for awake liposuction are similar to those for traditional liposuction. However, because this procedure does not use general anesthesia the range of candidates is expanded to include patients that may not qualify for general anesthesia because of weight or certain comorbidities.
Q. Will awake liposuction be painful?
A. This procedure should not be painful and your surgeon makes every effort to ensure this procedure is as pleasant as possible. Your surgeon will provide you with a “cocktail” of oral medications to help alleviate anxiety and discomfort. The wetting solution is made up of lidocaine which provides an excellent source of anesthesia. It is not uncommon for a patient to feel a level of discomfort or short burst of a burning sensation in certain sensitive areas. However, you should not be in pain and your surgeon may end the operation early if you are not able to tolerate the procedure for any reason.
Q. When can I go back to work after awake liposuction?
A. There are many factors that determine your ability to return to work. The amount of liposuction performed is the main factor as this determines how much pain and discomfort you will be in afterward. Which in turn determines how long you will be taking a narcotic. You will not be able to drive or perform certain work tasks while taking a narcotic. In general most patients are able to return to work in under one week.