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Diet and exercise have long been the standing prescription for those who want to get rid of excess body fat, and these methods work for many people. However, there are those who, for various reasons, are unable to eliminate stubborn fat in certain areas of the body. In such cases, board-certified cosmetic dermatologist Dr. Jason Emer and his team of board-certified plastic surgeons often recommend awake liposuction in Beverly Hills.
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Awake liposuction, also known as tumescent local liposuction, is a minimally invasive fat reduction treatment that does not involve the use of general anesthesia. Instead, a local anesthetic is injected to numb the area and prevent discomfort during the procedure, and the patient will remain awake throughout the fat removal process.

Awake lipo is best suited for the removal of minor fat deposits that do not respond to the patient’s efforts to reduce fat naturally by getting regular exercise and eating a nutritious, calorically appropriate diet. Common treatment areas include the chest, arms, neck, and abdomen. Bra rolls and pesky bulges of fat in other areas of the body can also be eliminated with awake lipo.

Though being conscious during surgical fat removal does not appeal to everyone, many men and women are thrilled to be able to achieve their fat reduction goals without the need for general anesthesia. General anesthesia, which renders the patient unconscious, is likely to cause the patient to experience side effects, which can include nausea, chills, vomiting, dizziness, and memory loss.

In contrast, the use of a local anesthetic is associated with a lower likelihood of side effects and a faster return to normal activities. General anesthesia also requires an overnight stay in the hospital or surgical facility following a liposuction procedure, and many patients choose awake lipo because they prefer the option to return home the same day as their fat removal treatment.



Whether or not awake lipo is right for you is a decision to be made by you and your surgeon. As with any cosmetic surgery, candidates must be generally healthy and free of any medical conditions that interfere with the body’s wound-healing processes.
Candidates for awake liposuction must be at a stable, healthy weight. Awake liposuction is a body contouring procedure, not a weight-loss treatment.
Patients who are considerably overweight or obese will need to reach and maintain a more ideal body weight in order to meet candidacy requirements. Weight fluctuations after liposuction can have a negative impact on your procedure results, so it is important that candidates do not have plans to gain or lose a significant amount of weight after this treatment.
Smoking and vaping can interfere with proper blood circulation, slow the healing process, and increase a patient’s risk of complications after surgery, so non-smoking patients are considered preferred candidates. However, smokers who commit to abstaining for four to six weeks before and after awake lipo, as directed by our surgeon, can also be suitable candidates.
Awake liposuction can be a good option for patients who are unable or unwilling to be “put under” with general anesthesia. However, the size of the treatment area(s) and extent of fat removal desired will factor into our surgeon’s recommendations regarding the best liposuction approach for your unique needs.
Patients who plan to undergo a liposuction procedure involving larger treatment areas, multiple fat removal sites, and/or additional cosmetic surgeries are most often better candidates for liposuction with general anesthesia. Additionally, patients who are queasy about needles or other aspects of surgery may want to opt for liposuction under general anesthesia as opposed to awake lipo.


The first step in the tumescent local lipo treatment process is a consultation with one of our surgeons. At this initial appointment, you will be asked about your aesthetic goals, and our surgeon will perform a physical examination of the proposed treatment area(s).

The exam will allow our surgeon to determine how much unwanted fat is present and can be safely removed and whether your skin has the necessary elasticity to contract aesthetically to fit your trimmer post-op contours. If there is loose, drooping skin at the treatment site, our surgeon can discuss your options for a combination procedure that pairs the appropriate liposuction technique with surgical skin excision or internal radiofrequency skin tightening.

Your consultation will also include a review of your relevant medical records. Our surgeon must be provided with complete information regarding diagnosed medical conditions, previous surgeries, allergies, and any prescription and/or over-the-counter medications you take. Our surgeon will need to know whether you have ever experienced abnormal scarring, as well.

Our surgeon will use all of the information gathered during this appointment to assess whether awake lipo is the best treatment approach for you. Your treatment options can then be discussed with you in detail.

Our team strives to support our patients however we can in making an informed choice for their care. Please feel free to ask any questions you may have about awake lipo, complementary cosmetic enhancement procedures, pre and post-operative requirements, and/or other aspects of your personalized treatment plan during your consultation.


Once you have scheduled your tumescent local lipo procedure, we will provide you with detailed pre-operative instructions. Preparing for awake lipo can involve lab tests or medical evaluations to ensure that you meet the applicable health standards required to safely undergo and recover from cosmetic surgery.

In the days or weeks leading up to your awake lipo procedure, you may need to cease or begin taking certain prescription medications, or you may need to adjust the dosage of your current medications, as directed by our surgeon. You will need to stop taking anti-inflammatory medications and supplements that thin the blood, as well.

It is imperative for your safety and the success of the procedure that you stop smoking and vaping several weeks prior to awake liposuction surgery, as advised by our surgeon. You also must not consume alcoholic beverages for at least two days prior to your awake lipo treatment.

In addition to taking these precautionary measures, preparing for awake lipo involves planning for a smooth recovery. Some aspects of this process to consider include:

  • Coordinating with a friend or loved one who can drive you home after your surgery
  • Making arrangements for necessary time off work in the initial stage of your recovery
  • Setting up a comfortable recovery area in your home
  • Scheduling post-op IV therapy, lymphatic massages, and other recommended surgical aftercare treatments


First, our surgeon will use a surgical marker to draw on the treatment area, as needed, to create a visual map of your unique awake lipo surgical plan. We are happy to review procedure details with you at this time, if you’d like, and can address any final questions you might have.

To begin the procedure, our cosmetic surgeon will administer the local anesthetic. This involves the subcutaneous injection of tumescent fluid at the targeted site. Tumescent fluid contains saline, lidocaine to numb the area, and epinephrine to minimize bleeding.

Depending on the patient’s needs and personal preference, oral sedation may be paired with the local anesthetic to ensure that he or she is as relaxed as possible during the procedure. The combination of oral sedation and local anesthesia is often referred to as twilight sedation.
In either case, you will be conscious for the duration of your fat removal treatment.

Once the surgeon is assured of your complete comfort, the necessary incisions can be made. Awake lipo incisions are quite small and function as insertion sites for the liposuction cannula.

A liposuction cannula is a thin tube that is gently manipulated to separate fat cells from the surrounding tissue before a specialized medical suction device is used to draw the unwanted fat cells through the inserted cannula and out of the body for good.

You will be able to go home within a short time after your procedure is complete. Before you leave, we will review your post-op care instructions with you and fit you with a compression garment.

Wearing the compression garment as directed helps to secure and protect your enhanced contours and encourage optimal skin retraction. Compression garments also work to minimize post-op swelling, bruising, and discomfort. These symptoms are a normal part of the recovery process and will gradually diminish as healing progresses.

IV vitamin hydration therapy, along with daily lymphatic massage and hyperbaric oxygen therapy sessions can significantly shorten the duration of your awake lipo recovery period. These and other surgical aftercare treatments are available at Dr. Emer’s West Hollywood and NYC medical practices and are highly recommended to support optimal healing.



Awake liposuction, like every type of liposuction, permanently removes the targeted fat cells. Patients who practice healthy lifestyle habits and properly manage their weight can enjoy long-lasting improvements from an awake lipo treatment.

To maximize your awake lipo results, we will design a personalized protocol of non-surgical cosmetic treatments which will allow you to maintain and even enhance your awake lipo outcome. Our customized treatment plans for promoting firm, smooth, and slim contours and a youthful look long-term can include a combination of:

  • Bioelectrical muscle toning and strengthening with truSculpt® flex or BodyTone
  • Skin tightening and collagen stimulation with external radiofrequency and/or ultrasound treatments
  • Cellulite reduction with Avéli
  • Contour refinements with bio-stimulatory dermal fillers like Sculptra® and Bellafill®
  • Non-surgical fat reduction with Kybella® or BTL Vanquish ME
  • Hormonal optimization to promote weight management and other aspects of overall wellness
  • Hormone peptide therapy to aid in muscle development and fat reduction


In comparison to traditional liposuction performed with general anesthesia, tumescent local liposuction offers the following advantages:

  • The patient remains alert during the surgery and can change positions, as needed to allow the surgeon optimal access to the treatment area.
  • Less post-op swelling and bruising for a more comfortable recovery experience.
  • Minimal downtime and shorter overall recovery time
  • Patients do not need to stay on-site for hours of post-op monitoring once their surgery is complete.
  • \Initial improvements are often visible immediately.


Personalization and optimization are central to our comprehensive care strategies and are key to the exceptional awake lipo treatment results our patients rave about. We know that the foundation of any successful cosmetic surgery outcome is understanding the patient.

We take the time to learn about a patient’s motivations for undergoing awake liposuction, as well as to accurately conceptualize their desired results and overall cosmetic ideals. From there, a shared vision can develop, and we can determine the specific procedures, surgical techniques, and pre- and post-op treatments that will work best to produce a lean, sculpted look you can enjoy for many years.

Each patient’s treatment plan is uniquely tailored to their anatomy and aesthetic goals, but when it comes to optimizing awake lipo treatments, energy-based skin tightening is a given. Advanced internal radiofrequency devices like BodyTite and Renuvion can be utilized immediately following awake liposuction to pull the skin inward, so it fits tightly to your newly enhanced contours.

Further enhancements can be achieved during awake liposuction recovery with non-surgical post-op radiofrequency fat reduction and skin tightening. We frequently utilize BTL Exilis Ultra, BTL Vanquish ME, and/or Venus Legacy treatments to put the final touches on patients’ awake lipo results. to Avéli. In some cases, removing excess fat in the thighs and buttocks is the only way to experience the maximum benefits of Avéli.

Small fat deposits can often be eliminated with a series of treatments with non-surgical, radiofrequency-based fat reduction devices. If bulk fat removal is required, liposuction is the preferred option.


The price of your awake lipo procedure will be reviewed with you once Dr. Emer has created your personalized fat removal treatment plan. The overall cost of awake liposuction will reflect the number of treatment sites, quantity of fat to be removed, and whether you combine your procedure with complementary cosmetic treatments.


If you are tired of fighting a losing battle against diet and exercise-resistant fat deposits, it’s time to explore your options for permanent fat removal with awake liposuction. To find out if tumescent local liposuction is right for you, contact our office to schedule a consultation with one of our esteemed cosmetic surgeons.