Anaesthesia for liposuction may be administered by a nurse-anaesthetist (CRNA) or a doctor (anaesthesiologist).

Anaesthesiology is a distinct specialized practice and, as such, may be board certified as a recognized specialist by the American Board of Anaesthesiology.

The usual types of anaesthesia may be employed in liposuction procedures:

1) Epidural . . . injection near the spinal cord to produce complete loss of sensation of a group of extremities, such as lower abdomen and legs.

2) General . . . injected intravenously and renders the patient totally unconscious as in an unaware state of deep sleep.

3) Local aesthetic . . . introduction of an aesthetic agent only into the area to be cut and manipulated.

Although local aesthetic may seem to be the least complicated, it results in the absence of a CRNA or anaesthesiologist whose presence might be helpful in the event of unforeseen complications.

The final choice for anaesthesia is with the surgeon, the patients request and needs play an important role in the final decision.

Tumescent liposuction is performed with only a local aesthetic. Tumescent refers to the ballooning of the tissue by the infusion of large quantities of a wetting agent, most commonly today known as "Klein's Solution" after the doctor who developed it. This solution, in addition to being formulated to balloon the fatty tissue to be removed also contains lidocaine which is a numbing agent.

In the "straight tumescent" procedure, only local anaesthetics are used and may be performed with no overnight stay. Post surgical swelling and bruising may be far less, resulting in a quicker recovery as well.

Notwithstanding the improved methods by introduction of wetting agents such as Klein Solution, some surgeons still use a straight dry procedure, even though the amount of fatty tissue removed is usually less and the amount of blood aspirated is greater resulting in more swelling and bruising. These surgeons contend that the use of Klein's Solution, balloons the tissue to such an extent as to make it difficult for the surgeon to determine what tissue to remove.

The aesthetic procedure used in any particular case depends upon the surgeon and the patient's needs. The anaesthesia may be a combination of one or more of the above described methods, and it is not the intent of the author to suggest that one method is superior to the other.

A well trained, board certified surgeon is aware of all the available methods and will consult with both the patient and a trained certified anaesthesiologist before making a decision.