'Awake' cosmetic surgery: what a local anaesthetic can and cannot cover

'Awake' surgery is a phrase Cornish readers may have spotted in clinic adverts. It sounds gentler, but it describes the anaesthetic, not the size of the operation, and it does not suit every procedure.

Instead of a general anaesthetic, the area being treated is numbed, sometimes with light sedation so the patient stays relaxed. AKM Clinic, based in Istanbul, carries out several operations this way. Its pages, medically reviewed by founder Dr Akif Mehmetoğlu, call the awake approach "a deliberate choice for the right candidate, under medical supervision".

The clinic's awake high-definition liposuction uses tumescent local anaesthesia plus twilight sedation. It takes about three hours with one night in hospital, and the clinic expects everyday life to resume after around three days. It is clear that this is contouring, not weight loss, and that it will not tighten loose skin on its own.

Facial fat transfer at AKM Clinic is also done awake, usually in one to two hours. A little fat is taken from the abdomen or flanks and placed in the cheeks or temples under local anaesthetic, with sedation adjusted to the patient. Not all of the transferred fat survives, and some early fullness settles as the area heals.

By contrast, a 360 body lift, which takes away loose skin around the whole body after major weight loss, is a much bigger undertaking. The clinic lists it at five to six hours with a general anaesthetic, three weeks before daily activities and four for the initial recovery, and explains the reasons in this procedure guide.

Dr Mehmetoğlu works with two other surgeons: nose and facial specialist Dr Göknil Gültekin, and Dr Aylin Yılmaz, a plastic surgeon whose specialty is the breast and body.

Being awake does not remove surgical risk. For liposuction the clinic lists swelling, bruising, fluid build-up, uneven contours, infection and, rarely, clots. The NHS suggests holding off on flights for five to seven days after liposuction, so plan the trip home to Cornwall with that in mind, and ask who will monitor any sedation.

Whatever the anaesthetic, the same checks apply: the name of the surgeon, the plan if a problem appears after you get home, and enough time to decide without pressure.