Lying awake for liposuction

Those desiring to fine tune their bodies with liposuction but leery of being knocked out from general anesthesia have an ideal alternative - stay awake.

Claudia Estes of Jackson had no problem with the idea.

"I was more afraid of the general anesthesia," Estes said. "I've had liposuction two or three times over the last five years with no problems."

Estes decided to have the procedure to eliminate the infamous "muffin top" - the fold of fat around the mid-section that spills over the top of tight-fitting waistbands. "When the jeans became lower cut, I wanted to do something so I could keep up with the fashion trends," she said.

Very pleased with her results, Estes said, "This was pretty much instant gratification."

Traditionally, liposuction has been done with a patient asleep under general anesthesia. But now a patient can be fully awake with only a local anesthetic to numb the procedure area. Known as tumescent liposuction, this method involves injection of a large amount of saline solution, which contains additional anesthetic and epinephrine, directly into the areas where excessive fat deposits are to be removed.

"I perform liposuction from three to eight times every week," said Dr. Shelby Brantley, a plastic and reconstructive surgeon with The Plastic Surgical Center of Mississippi in Flowood.

Also known as lipoplasty, liposuction is the removal of excess fat deposits to improve the contours and proportions of the body. Thighs, hips, buttocks and abdomen are the most common areas for fat removal. Fat deposits also can be removed from the arms, back, chest, cheeks, chin or neck.

"We make a small incision in the skin and insert a small tube connected to a vacuum type machine to remove the fat deposits," Brantley said.

Staying awake can have major benefits. "When the patient is awake, he or she can move into different positions to help me see where exactly we need to remove fat deposits and achieve ideal results," Brantley said. "That way there is a better opportunity for symmetry."

Another benefit is cost savings. Without the use of general anesthesia, the cost of an anesthesiologist can be avoided along with the costs of post-surgical monitoring.

"Typically, the procedure will run from $1,000 to $5,000 depending on the number of body parts or areas being done," Brantley said.

Plastic surgery has lost much of the stigma once associated with the practice. Guilty pleasure television programs, like the cable series Nip/Tuck and Entertainment Tonight's latest report detailing which celebrities have had work done, have broadened public thinking about plastic surgery.

Women aren't the only ones having the procedure. Brantley said he's seeing a gradual increase of men having liposuction. "Men want to look as good as they can, too," he said.

The American Society of Plastic Surgeons reports liposuction is second only to breast augmentation in popularity among patients seeking plastic surgery. Roughly 300,000 Americans have liposuction each year.

Dorothy Baker of Indianola made a life-changing transformation last year. She lost more than 60 pounds and feels like a new woman. Diet and exercise had a lot to do with her makeover, but she also got a little extra help from her plastic surgeon.

"I'd already started to lose a lot of weight and I wanted everything to match," Baker said. In addition to a tummy tuck and breast reduction, Baker had liposuction to contour her waistline. "Within a month, I could see the transformation," she said.

Baker wasn't quite comfortable with the idea of being awake during her liposuction procedure so she went the traditional route of general anesthesia.

Baker and Estes noted similarly short recovery times with only mild discomfort and pain. "I had the procedure done on Friday and was back at work Monday morning," Baker said.

Estes drove herself home after her liposuction and was back to work the next day. She did, however, wear a compression garment for three weeks.

Dr. Stephen Davidson, a plastic and reconstructive surgeon also with The Plastic Surgical Center, noted that, while many people aren't aware liposuction can be done while awake, the technique has been around for more than a decade.

"We've been doing tumescent liposuction for years," Davidson said. "It's ideal for patients who only want one or two areas of the body done and who have smaller volumes of fat to be removed."

Davidson also noted liposuction is not a cure for obesity or the answer to major weight loss. "Liposuction takes areas that are out of proportion and puts them back in proportion with the rest of the body." Generally, patients should be within 25 to 30 pounds of their ideal weight.

There are risks whether you choose general or local anesthesia for the procedure. According to the American Society of Plastic Surgeons, uneven skin contours and rippling or loose skin may be evident after liposuction. And there is always a risk of fat or blood clots and infection with either method. Swelling and fluid retention are normal and usually subside within a few weeks.

Most importantly, Brantley and Davidson stressed the importance of seeking a board-certified plastic surgeon to perform liposuction.

"Interview the doctor. Find out how many times a week he does the procedure," Brantley said. "Ask to see before-and-after photos of his work."

Davidson said, "Talk to people who've had the procedure done. What were their results?"

Baker has referred a number of friends and colleagues for the procedure. "I'll tell anyone that if you can look this good and feel this good about yourself, go for it."