Yes. In fact, I did one in the office the other day for a forty-five year-old woman under her chin to give her more definition around her jawline. She took an antibiotic, a Valium and a Percocet beforehand and she was sleepy and high, but other than that I used all local anesthesia and she was awake the whole time, and she had no pain.
However, this answer has to be clarified. The amount of lipo you can do under local is limited for the following reasons:
1) You’re limited by the amount of local anesthesia that you can use. All liposuction is done with wetting (or “tumescent”) solution, which is put into the area first before the fat is removed. This is what controls pain and bleeding. When the patient is awake, you’re depending completely on the local anesthetic for pain control, and you can get much closer to the dosage limit much faster. Bottom line: You can’t use as much.
2) It can be tricky to do the fine “sculpting” because you have to use so much more local fluid—the area gets more swollen and the end result is harder to judge.
3) The patient must be patient. It is tedious—for everyone involved!– to do a good lipo under local and it can take several hours. The numbing fluid has to put in very slowly so the patient doesn’t feel it, and if they don’t fall asleep, he/she has to be willing to lie there awake, listening to their IPod or texting on their phone or talking to me the whole time. But as you can imagine, it takes a certain personality to be able to handle that. Also, if we’re doing more than one area, the patient usually has to get up and go to the bathroom in the middle because the fluid absorbs. Not everyone can handle this approach.
4) I can only speak for myself, but I can definitely be more aggressive when the patient is asleep—I can get much more fat out and it is easier to “feather” the areas because I’m not limited by the local.
So, you can see that all liposuction is not created equal.