This procedure can be 2-3 hour procedure and involves a great deal of cutting and stitching. I am not in favor of twilight because of the length of this procedure and the complications of administering local anesthetics. I perform this procedure using light general anesthesia. There is much less risk of complication with general anesthesia and the clients are more comfortable afterwards. Local anesthesia if over used can be toxic and can lead to breathing difficulties during a surgery.





