Local vs general anesthesia in breast fat transfer surgery? Blood thinners after surgery for blood clot risk reduction?

Question

Of the doctors here who perform breast fat transfer surgery, do you use local or general anesthesia? I have read that the risk of death and complications during surgery are greatly reduced if using local anesthesia. What is your stance on this? Do you use blood thinners after surgery for blood clot risk reduction? I have a family history of blood clots, but have none myself.

Justin Yovino, MD, FACS · Answer

i perform fat tranasfer to the breasts under local anesthesia with light sedation. It's a specialized technique that most surgeons don't offer. It's a lot safer and the the recovery is easier. There's no need for blood thinners under local anesthesia.

Kenneth Hughes, MD · Answer

Many physicians will do this to save money on anesthesia, but in many cases, you will need to harvest at least 600 cc of pure fat to perform the procedure.  The liposuction of this amount of fat may be 3 liters of lipoaspirate, and most patients cannot tolerate this with just local anesthesia.  Also, the injection of the fat can be painful as well.You will have to be cleared for surgery by your hematologist if you have a family history of blood clots. Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Peter D. Geldner, MD · Answer

As in most situations, the details matter. Injections of fat into he breasts can be performed with local anesthesia with some sedation. General anesthesia (which can include total intravenous anesthesia TIVA) is not necessary, but might be more comfortable. Though the risk of DVT is lower for sedation alone than general anesthesia, those risks are low and the specific risk is patient specific. The real question is where you want the fat to be removed for transfer. If the doner site is on the back side (flanks, back, posterior thighs), I would suggest general anesthesia to protect your airway. If it's from your abdomen, sedation would be adequate. Remember that despite what some will tell you, liposuction is at best uncomfortable, at worst, very painful. Talk to a board certified plastic surgeon, or several. You need to learn your best options and come up with a solution that meets your needs.

Ryan Hoffman, MD · Answer

Local or gen anesthesia can be used to do fat transfer to the breast. Usually, gen anesthesia is the preferred method.  The risks of death and complications in healthy patients undergoing elective surgery is very low. If there is a family history of clots, patients are sent to a hematologist prior to surgery. You can discuss these issues with a board certified plastic surgery.

John L. Burns Jr., MD · Answer

Anesthesia done by a board certified aneshesiologist in a properly certified surgical center or hosptal setting is the preferred method for fat transfer breast augmentation.

Harry T. Haramis, MD, FACS · Answer

Can be under local or general- depends on extent of procedure. If multiple areas are to be liposuctioned, general may be better as it would also include IV fluids.Either way, we routinely have medical clearance for all of our patients. You would also have a hematology clearance with blood thinners for safety.An exam and consultation with a plastic surgeon who performs these procedures is recommended to confirm you are a candidate as well as discuss your options and expectations.

Steven Turkeltaub, MD · Answer

Fat transfer to the breasts can be done under local, sedation or general anesthesia. Which one would be best for you would depend on a variety of factors that can be determined at the time of your consultation with an experienced board certified plastic surgeon.As regards the usage of blood thinners, in general, there is no reason to use them and even more not to use them.Steven Turkeltaub, MD

Erika Sato, MD, FACS · Answer

It is most comfortable and you get the best result with both the areas of liposuction for harvest and the breast fat transfer if you do the surgery at least under IV sedation. I prefer to do this procedure using TIVA (total IV sedation). With this method of anesthesia you are  monitored by an anesthesiologist under heavy sedation but no paralysis or breathing tube. This way you feel no pain during the procedure. If you have a family history of blood clots it is safest for you to undergo a workup to figure out if there is a genetic predisposition. If there is a genetic predisposition your hematologist will give recommendations on peri-operative anti-coagulation.

Daniel Del Vecchio, MD · Answer

fatal complications like fat embolism are more associated with fat grafting to the Buttock - but not the breast. I have performed thousands of fat grafting cases to the breast and I'm familiar with most of the surgeons in the world who perform the surgery frequently and blood clots are not any more common in fat to breast than any other plastic surgery procedure  this operation could be done under local Anastasia or general anesthesia. Hope this helps. Best of luck

Local vs general anesthesia in breast fat transfer surgery? Blood thinners after surgery for blood clot risk reduction?

Answers (9)

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