"When you tell a patient they have to have four or five procedures instead of one, that doesn't make them happy," Fodor tells WebMD. "The average patient needs at least 2,000 [cubic centimeters] of fat removed, and you can't do that under local anesthesia."
Indianapolis plastic surgeon Charles Hughes, who performs liposuctions under both general and local anesthesia, agrees that office-based surgery under local anesthesia is fine for patients who do not need large amounts of fat removed.
"In truth, the dermatologists are making a big deal out of this because they are not surgeons and they don't have surgical privileges in hospitals," he tells WebMD. "They can't do this surgery under general anesthesia, but patients do want that option."
Hughes says many of the liposuction deaths reported in the 2000 study occurred because surgeons performed too many other cosmetic procedures at the same time. Chairman of the American Society for Aesthetic Plastic Surgery's body contouring committee, Hughes says education efforts have dramatically reduced the number of combined cosmetic surgeries.
"Some surgeries were taking 11 and 12 hours, because so many procedures were being done," he says. "That is a lot for the body to take. The bottom line is that liposuction in and of itself is pretty safe, regardless of the anesthetic used. But patients get into trouble when surgeons try to do too much."