Body
What is it Like to Have Liposuction?
Liposuction usually involves small incisions, numbing fluid, removal of fat with a cannula, and a recovery period with swelling and compression. Whether you are awake, sedated or under general anesthesia depends on the treatment plan and the assessment of your surgical and anesthesia teams.
In this episode.
Episode summary
Liposuction usually involves small incisions, numbing fluid, removal of fat with a cannula, and a recovery period with swelling and compression. Whether you are awake, sedated or under general anesthesia depends on the treatment plan and the assessment of your surgical and anesthesia teams.
In this June 23, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD walks through the experience as it was typically managed in his practice. He explicitly notes that the process can differ between surgeons and facilities.
Key takeaways
🔎 Anesthesia is individualized.
Dr. Smith discusses local anesthesia for selected limited treatment areas and IV sedation or general anesthesia for more extensive treatment.
🔎 Tumescent fluid comes before suction.
Numbing fluid is introduced through small access incisions before a cannula removes the targeted fat.
🎯 Discharge follows a clinical assessment.
The recording describes same-day discharge in his practice after an appropriate recovery-room period.
🔎 Early care and final results are different milestones.
Compression, wound care and activity guidance support recovery while swelling gradually settles.
🩹 Recovery is not identical for everyone.
Dr. Smith compares common discomfort with soreness after a hard workout, while acknowledging that some patients experience more or less discomfort.
Questions this episode answers
Do I have to be asleep for liposuction?
Not necessarily. The episode explains local anesthesia, twilight or IV sedation, and general anesthesia. The appropriate choice depends on the areas being treated, your health and the individualized plan; no anesthesia option is risk-free.
When can I return to work or exercise?
The recording gives examples from Dr. Smith's 2020 practice, rather than a timetable everyone should follow. Your procedure's extent, recovery and type of work matter. Confirm when to resume work, exercise and showering with your own clinical team.
When will I see the final result?
Dr. Smith explains that early swelling can hide changes. In the recording, he describes contour becoming easier to appreciate as swelling decreases and a three-to-six-month period for the final result to develop. This is an estimate, not a guaranteed deadline.
🔗 Related information
Read about liposuction in Dr. Smith's practice and preparing for plastic surgery, or request a consultation in New York City.
Originally released June 23, 2020. Show notes updated September 30, 2026. This is general education. Current instructions, suitability, risks and expected results require an individual assessment.
Original show notes
Learn the secrets of liposuction from board certified NYC plastic surgeon Dr. Darren Smith. We'll explore what it's like to have the procedure, when you can expect to see the results, what recovery feels like, and more.
Read the conversation.
[00:08] I'm board-certified New York City plastic surgeon Dr. Darren Smith and this is plastic surgery before and after. Your source for the real deal about plastic surgery procedures, news about trends in aesthetic medicine and candid sessions with industry insiders. We hope you enjoy today's episode. Today we're going to talk a little bit about what it's like to have liposuction and I'll preface this by saying that this will vary by where you're having your procedure and who's performing your procedure, but what I'll describe here is how things generally happen in our practice. In our practice, liposuction can be safely performed under local anesthesia, twilight anesthesia or general anesthesia.
[00:53] Local anesthesia means that you've been given numbing medicine to make sure you're not feeling any significant discomfort, but you are awake, alert and breathing on your own. This is a very reasonable approach for limited areas of liposuction such as just performing liposuction of the flanks or the inner thighs or the arms, but if we start performing more areas of liposuction than this in a single setting, local anesthesia really isn't the best choice. For cases in which we're performing multiple areas of liposuction, it is very reasonable to have either twilight anesthesia or full general anesthesia. In twilight anesthesia, in addition to local numbing medicine, our board certified anesthesiologist is going to administer medication through an IV to help you feel relaxed and you will often be in and out of sleep during your procedure, however, you will be breathing on your own.
[01:50] In general anesthesia, our board certified anesthesiologist will make sure that you are completely asleep and your breathing will be assisted by a machine and a breathing tube. These are all very safe ways to proceed and the best choice really depends on individual patient preference and health. This is something that we'll discuss together with our anesthesiologist to come up with an appropriately tailored plan for you. The liposuction procedure itself begins by making several well-hidden 3 to 4 millimeter incisions that tend to heal in such a way that they are very difficult to see. These incisions are then used to instill numbing fluid or what is sometimes called tumescent fluid into the planned treatment areas.
[02:43] This is allowed to act for usually 10 to 15 minutes to make sure the area is nicely numb. And then the excess fat is suctioned out of the treatment areas with a specialized instrument called a cannula. After the excess fat has been suctioned from the treatment area, the small incisions are generally sutured shut with one stitch in each incision. A compression dressing is applied and the patient is brought to the recovery room. For cases that are done with local anesthesia, the patient can simply get up and go home after just a short while of recovery. For patients that have had either twilight anesthesia or general anesthesia, we generally keep them in our recovery area for one and a half to two and a half hours or until they are judged by our medical team to be safe to leave.
[03:36] And they also leave the same day. So liposuction is, in our practice, not a procedure that requires any kind of overnight stay. After the procedure, like we mentioned, you'll be in a compression garment and we like our patients to keep this on and in place for 48 straight hours. At the conclusion of the 48 straight hours, it can be removed. It is normal to have some oozing of the numbing medicine, this tumescent fluid from the small incisions that generally stops after approximately 48 hours. So when you remove that compression garment, most of that fluid leakage will be over. And at that point, you can shower and get cleaned up and really get back to work.
[04:20] So a very popular option for a lot of our busy patients is to have a procedure like this on a Friday so that they can reasonably expect to get back to work on Monday. And it's also pretty reasonable, in most cases, to get back to the gym for a light workout on a Wednesday, in this example, if you've had your procedure on the preceding Friday. You can expect to have some bruising that will generally not last more than 10 to 14 days. You will have significant swelling such that you probably won't see much in the way of a result from your procedure for one to two weeks.
[04:52] After about two or three weeks, that swelling starts to subside to the point that you can appreciate a nice difference in your contour in the regions that were treated. But it does take a full three to six months to see the final result of the liposuction treatment as that swelling goes down and your skin strings to fit the nice new contour that we've created. In terms of the level of discomfort that you can expect after liposuction, it's usually compared to what you can expect from a hard workout. It is not severe pain so much as it is kind of a cramping discomfort that is a general impression.
[05:28] For some people, it is a lot less than this, and for some people, it can be a bit more. But in general, the recovery from liposuction is not particularly difficult. So this makes it a very reasonable procedure for busy professionals to undergo and achieve a really nice change. Thanks for listening, and don't forget to subscribe, share the show, and head over to DarenSmithMP.com for more real-world plastic surgery talk.
Sources and context.
Original Captivate episode. Original release date: 2020-06-23. The recording is the source for the transcript and episode discussion. Later context in the written summary is identified separately.
Behind the conversation.
Darren M. Smith, MD, FACS