How do doctors avoid intravascular injection of local anesthetics?

Dear rdy2bemeagain,
in case of local anesthesia or any injections, surgeon will make aspiration in order to check if he/she is in the blood vessel. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

The skin arteries are usually small and injection directly into an artery is actually difficult. I have injected many breasts with local and all did well. Stay off the Internet please.

The risk for intravascular injection of local anesthesia to the breasts is low. The reason is that the area that is anesthetized does not have large vessels that could inadvertently be injected. Also there is not a large dose of anesthetic given in one area. I encourage you to speak with your surgeon about your concerns.

The risk of intravascular injections is small and areas that don’t have big blood vessels.
Injecting, local anesthetic in the skin around the breast has no more risk than injecting, local anesthetic and other areas.
The needle is moved back-and-forth so even if it passes through a blood vessel, typically the worst that happens is the patient gets a bit of bruising from some bleeding.
Small amount of anesthetic were injected into a blood vessel. It is unlikely to cause serious complications.
Try not to worry about things that are not described as normal complications.
For example, with implant removal things, the patient should be concerned about our issues like are you sure you’re not going to want to implants in the future? Are there capsules that may require capsulectomy? These are more Appropriate concerns that may require some thinking through.
Talk to your surgeon if you have concerns.
Best,
Mats Hagstrom MD.