Anxiety and Anesthesia

1. Is anxiety normal before having liposuction?

Yes. Most people experience anxiety on some level before surgery. Patients who are concerned about the pain following liposuction should be aware that most patients who undergo tumescent liposuction by local anesthesia rarely need more than an over-the-counter pain reliever to manage the soreness following surgery.

2. What medications are available to treat anxiety prior to surgery?

There are a variety of medications available to treat anxiety but they should be taken in moderation. Anti-anxiety drugs are called anxiolytics. Benzodiazepines, such as Xanax and Valium, can also reduce anxiety at low doses. At high doses, these drugs cause sedation and excessive doses can impair breathing. A liposuction surgeon may prescribe a benzodiazepine the night before surgery and one pill immediately before surgery. Clonidine is different type of anxiety-reducing drug that does not impair breathing. It is up to the surgeon to decide if anti-anxiety medication is necessary.

3. Can I have liposuction by local anesthesia if I am afraid of needles?

Most patients have no problem with tumescent infiltration (injection) once their anxiety has been alleviated with the help of an anti-anxiety medication. Very few patients require IV sedation. Patients who are very afraid of needles may choose to have liposuction under general anesthesia, but they should be aware that general anesthesia has more risks than tumescent liposuction performed totally under local anesthesia. Overall, liposuction by local anesthesia is typically less painful and has a shorter recovery time.

4. Is an anesthesiologist necessary?

An anesthesiologist should be present when general anesthesia is administered to a patient to ensure it is given safely. An anesthesiologist is not required to be present when local anesthesia is used as part of the tumescent liposuction procedure.

5. What are the risks of local anesthesia?

The three risks of local anesthesia for tumescent liposuction are toxicity from an excessively high concentration of the anesthetic drug in the blood, injury from a needle used to inject the local anesthetic drug, and discomfort during liposuction due to inadequate local anesthesia.

6. What are the risks of general anesthesia?

General anesthesia has more risks than a local anesthetic applied directly to the surgery site. Under a general anesthetic, there is a risk of respiratory depression and the impairment of airway reflexes. The only liposuction deaths ever reported in the U.S. occurred when the patients were under general anesthesia.