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Can a Tummy Tuck Procedure Be Performed Under Local Anesthesia ?

Can a Tummy Tuck Procedure Be Performed Under Local Anesthesia ?

Doctor Answers (13)

Can a Tummy Tuck Procedure Be Performed Under Local Anesthesia ?

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The previous question was regarding mini tuck, it may be able to be done under local anesthesia, but I would not recommend it due to comfort of the patient. Same is true of full tummy tuck, although it may be possible, it will limit the type of tummy tuck and thr extent of improvement that is possible. Patient comfort will also be a problem. Just because a procedure is possible under local anesthesia alone, it is not necessarily the way to approach the surgery.


Sacramento Plastic Surgeon
5.0 out of 5 stars 84 reviews

Tummy tuck under local anesthesia?

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Yes, some very limited mini tummy tucks can be performed under local anesthetic; however, a full tummy tuck with major work including abdominal plication with or without liposuction should probably be done under general anesthesia at an accredited facility.

You will get many different opinions on this.  Remember: err on the side of safety. I don't ever recommend cutting corners to save money.

Best of luck.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 40 reviews

Tummy Tuck under local anesthesia NOT recommended

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Hi there-

There are many things in Plastic Surgery that CAN be done, but that doesn't mean they SHOULD be....

In other words, and unfortunately, some things are done because they are in the best interests of the surgeon, and not necessarily the patient. While I understand the average person's reluctance and fear of general anesthesia, the reality is that the alternative should scare you more...

Having been part of a practice that performed all of its tummy tucks under local with sedation for 2 years, and with 8 years of experience doing them under general anesthesia, I can personally tell you that my opinion is that under local with sedation your safety is severely compromised and your outcome has no chance of being as good as if you had done it under general anesthesia.

If we take a step back from the trees and realize we're looking at a forrest, it will make sense-

The goal of the endeavor is for you to SAFELY undergo a procedure that results in the BEST abdominal appearance possible, right??

If we agree on that, then doing ANY type of abdominoplasty under local anesthesia is foolhardy.

The critical step in any abdominoplasty is repair and tightening of the muscle layer. This can simply not be accomplished with equal effectiveness if the muscles are not completely relaxed, which means you have received a dose of muscle relaxant medication, which is NOT possible under local anesthesia or sedation.

Why? Because these medications also stop your diaphragm from working, requiring the Board Certified Anesthesiologist that is always in the OR with me to assist you with breathing. As long as this professional is there, for healthy patients the vast majority of us believe this is your safest alternative. Why?

Because the secret truth doctors who market their "local only" procedures don't want you to know is that there is a limit to how much local anesthetic you can receive, and many of the plastic surgery deaths we have all read about over the past few years were caused by toxic doses of local anesthetic. 

Understanding this issue is a very long conversation, but realize that local anesthesia is NOT without risk, and for larger procedures like abdominoplasty, those risks can be alarming.

So why do some surgeons offer this option? In my experience, either because the OR they preferred to use could not offer general anesthesia (they were not certified to do general anesthesia and doing so would be against the law), because they themselves are not allowed to do the procedure in an OR with general anesthesia capabilities (because they are an ER doctor or EYE doctor) or because the surgeon uses the technique as a marketing gimmick.

Let's face it, the fact that you're asking this question proves that telling women you can do a tummy tuck under local anesthesia for them can be effective marketing...

But the bottom line remains the same- if you were my sister, wife, or mother, there is NO WAY I would let you have ANY kind of tummy tuck under local.

I mentioned before that I used to be part of a practice that did tummy tucks under local with sedation. You should know that my concerns for the safety of what we were doing are a large part of the reason I left that practice. Equally concerning to me at the time was the fact that my tummy tuck patients simply didn't look as good as I know they could if their muscles had been relaxed. 

So, if you could have what you want- to have your tummy tuck under local, but I told you that your safety would be in danger, or that you would never look as good as you could, would you still do it?...

You should think very carefully about this.

Armando Soto, MD, FACS
Orlando Plastic Surgeon
5.0 out of 5 stars 113 reviews

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Local anesthesia for tummy tucks?

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Yes, abdominoplasties can be performed under local anesthesia with intravenous sedation, but in my experience, having seen a number of these patients is that the results have been less than satisfactory for the patient. I would recommend having a general anesthetic so the surgeon can fully relax the muscles and adequately tighten the muscle fascia without you feeling anything or moving during the surgery. General anesthesia is typically very safe and comfortable and makes the procedure more efficient.

Todd C. Case, MD
Tucson Plastic Surgeon
5.0 out of 5 stars 32 reviews

Tummy tucks under local anesthesia

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Most plastic surgeons perform tummy tucks under general anesthesia only. Some prefer to perform the procedure with intravenous sedation (twilight) and local anesthesia.  I don't think any plastic surgeons perfrom the procedure under only a local anesthetic because of patient discomfort and the excessive amount of local that would be required.  I've always used general anesthesia for increasd patient comfort and maximal muscle relaxation prior to plication of the fascia. 

Kelly Gallego, MD, FACS
Yuba City Plastic Surgeon
5.0 out of 5 stars 35 reviews

Full Tummy Tuck with local anesthesia (video)

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I perform 90% of my full tummy tucks without general anesthesia.  The anesthetic is a combination of deep IV sedation and local anesthetic.  I use only board certified anesthesiologists and my office operating suite is accredited.  Proper patient selection is important, I wouldn't consider this in an obese patient.   There is no problem with muscle tightening without a general anesthetic.

The advantages of a full tummy tuck without general anesthesia in my opinion are

  • Lower risk of major complications such as DVT and pulmonary embolism
  • Lower risk of malignant hyperthermia
  • Less immediate post-op pain (local anesthetic effect)
  • Less post-op nausea and vomiting (a major contributor to wound healing problems and pain)
  • The advantages of the ability to do this procedure in my office OR (cost, convenience, lower infection rate)

The disadvantages are:

  • Higher risk of lidocaine toxicity (with care, this risk can be very low -- I haven't seen a single case of even mild lidocaine toxicity with this procedure)
  • Higher risk of injury to underlying structures during injection (low risk with any experienced plastic surgeon)
  • More challenging for the surgeon - requiring the skill and expertise of injecting the right concentration of local anesthetic in the proper locations.

A full tummy tuck without general anesthesia has a learning curve for plastic surgeons.  I would not have even considered it 10 years ago.  I have been doing this for the past 5 years and would not go back. 

I believe there is a significantly lower complication rate without general anesthesia. At this point we have done over 250 full tummy tucks without general anesthesia.  We have had no significant infections and only one DVT (which resolved without problems) in these patients.

At this point, I feel the need to apologize to my larger patients who will have a general anesthesia.

York Jay Yates, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 61 reviews

Local Anesthesia for Tummy Tuck

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You can perform any procedure under local. While it might be reasonable to do a truly mini tummy tuck under local, I would not advise doing any other type of abdominoplasty any way other than general anesthesia. If you are worried about safety, make sure the person doing the anesthesia is fully qualified and the facility is fully certified. By doing so, you assure the safest anesthesia possible. Many physicians do these procedures in an uncertified office without an anesthesiologist either to save money or because they cannot do them in a certified facility or get an anesthesiologist to work with them because they do not meet the qualifications to do so. They, therefore, tout local anesthesia as being safer, when in fact, the things that make anesthesia safe are lacking.
 

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 4 reviews

Tummy Tuck Under Local Anesthesia

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Tummy tucks (abdominoplasty) come in a lot of flavors. There are some that are really advanced and invasive and others that are not as complicated. Nearly all types of tummy tucks can be performed under local anesthesia, though that might not be the best choice. 

Sometimes patients ask that question because they are worried about having general anesthesia. While general anesthesia is very safe some patients are fearful and prefer to avoid "going to sleep". Tummy tucks can be done without general anesthesia in many ways: under local anesthesia, with sedation (sometimes called 'twighlight'), and with spinal/epidural anesthesia (like when having a baby). For patients that do not want or cannot have general anesthesia I usually recommend spinal/epidural. It is very comfortable and the recovery is often easier than general anesthesia.

You should discuss these options with a board certified plastic surgeon and make the best choice for you and your goals. 

I hope this info helps!

Adam Rubinstein, MD
Miami Plastic Surgeon
5.0 out of 5 stars 11 reviews

Yes, some type of tummy tucks would be easier to perform under local anesthesia only than others

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Hello,

Yes, many procedures can be performed under local anesthesia, the bigger question is which type of abdominal contouring procedures are reasonable to perform under local anesthesia only.

Liposuction: easy to perform under local only

Mini tummy tuck: easy to perform under local anesthesia

Full tummy tuck: more cumbersome and not ideally recommended under local anesthesia alone.  local plus Iv sedation is reasonable

Full tummy tuck with muscle tightening: at lead IV sedation plus local anesthesia

 

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 98 reviews

Tummy tucks under local anesthesia

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If you are having a mini tummy tuck it can be performed under local. For a full tummy tuck you need the general anesthesia relaxationof your stomch muscles for the best tightening of the muscles.

Morad Tavallali, MD
Vienna Plastic Surgeon
4.5 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.