Local alone would be very difficult for you and the surgeon. You want the best possible result and trying to do all this work under local anesthesia is a compromise. Local with sedation is an option but the best way of doing the surgery is under general anesthesia where everything is very well controlled.
There are medications you can take before the surgery like Emend that will help decrease the possibility of nausea after the surgery. Also you need to mention this to the plastic surgeon as well as the anesthesiologist so that they can give you medications before, during and after the surgery to help with the nausea.
Good luck.





