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

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. 

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 

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.