Tummy Tuck under local or IV sedation? (Photo)

Hello BBD4411,
Thank you for your question about the possibility of undergoing a tummy tuck with local or IV sedation, and for providing your picture and history.
Given your specific case, where you don't require rectus abdominis muscle plication and considering your weight of 101 pounds, it is feasible to consider the procedure under local or IV sedation. However, it's important to be aware of lidocaine toxicity, which is a real concern, especially for someone of your weight. There is a limit to the amount of lidocaine that can be safely administered.
In light of this, I recommend opting for IV sedation. This approach is likely to be safer for you and could result in a more comfortable experience with less pain compared to relying solely on local anesthesia. Ensure that your plastic surgeon works with a qualified anesthesiologist or a Certified Registered Nurse Anesthetist (CRNA) to administer the IV sedation.
Ultimately, while a tummy tuck under local or IV sedation is possible in your case, prioritizing safety and comfort is crucial. Discuss these options thoroughly with your plastic surgeon to make the best decision for your situation.
I hope this information assists you in making an informed decision about your tummy tuck procedure. Wishing you a smooth and successful surgery.
Sincerely,
Dr. Katzen

Your photo is not very clear. If you do not have a significant skin laxity in the upper abdomen, if the problem is mainly the looseness of the lower abdominal skin, fat can be removed with abdominal Vaserlipo and tightness can be achieved in the lower abdomen with Mini Tummy Tuck. It is possible to perform this procedure with sedation-assisted local anesthesia. However, if there is severe damage and sagging in both the upper and lower abdominal skin and separation in the abdominal muscles, Your photo is not very clear. If you do not have a significant skin laxity in the upper abdomen, if the problem is mainly the looseness of the lower abdominal skin, fat can be removed with abdominal Vaserlipo and tightness can be achieved in the lower abdomen with Mini Tummy Tuck. It is possible to perform this procedure with sedation-assisted local anesthesia. However, if there is severe damage and sagging in both the upper and lower abdominal skin and separation in the abdominal muscles, Lipoabdominoplasty or Full abdominoplasty should be performed instead of Mini Tummy Tuck. Since this surgery takes longer (3-4 hours) and plication is required for muscle separation, it is very difficult to perform with sedation-assisted local anesthesia. The drugs used for local anesthesia have the possibility of causing toxicity above a certain dose. Therefore, we cannot use as much as we want. or Full abdominoplasty should be performed instead of Mini Tummy Tuck. Since this surgery takes longer (3-4 hours) and plication is required for muscle separation, it is very difficult to perform with sedation-assisted local anesthesia. The drugs used for local anesthesia have the possibility of causing toxicity above a certain dose. Therefore, we cannot use as much as we want.

Thank you for your question. You appear to be relatively thin. If you do not require muscle repair, then a tummy tuck can be done under local anesthesia. I use tumescent solution, which is a very dilute solution of lidocaine. This solution is used all the time in cosmetic surgery and is very safe.

Dear BbAD4411,
some procedures such as mini tummy tuck and umbilicoplasty can be done under local anesthesia. However, full tummy tuck is a major procedure and local anesthesia is not the best choice. 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

Thanks for your question!
There are a few variations and options for tummy tucks and certain variations are easier to perform under local anesthetic alone. IV sedation is less commonly offered as an anesthetic for traditional abdominoplasty given the amount of area (upper and lower abdomen with flanks) being treated and the need for effective and safe anesthesia to do so. Mini tummy tucks are confined to the lower abdomen and can commonly be done under local only if there is no upper abdominal skin laxity or muscle repair needed. In these cases, local anesthetics like Lidocaine and Marcaine are commonly used and weight-based guidelines are followed to avoid the risk of toxicity you mentioned. Full abdominoplasty is commonly performed under general anesthesia in order to be able to safely address the laxity and fullness of the entire abdomen, repair the muscle separation as well as perform liposuction, depending upon the technique used. General anesthesia can be exceedingly safe and measures can be taken to reduce postoperative nausea and narcotic requirements that have historically complicated it.
Thanks!

From your appearance, you may benefit from a mini tummy tuck, which can be done under local anesthesia. You may also benefit from an umbilicoplasty which can be done under local anesthesia as well. This would limit the amount of Lidocaine needed. You are correct that Lidocaine toxicity does exist.

Best Wishes,

Gary Horndeski, M.D.

Safety is always the number one priority in surgery. For that reason I perform tummy tucks under general anesthesia. During a consultation each patient's medical history is reviewed and questions answered not only about the surgery and recovery but also any concerns about anesthesia are addressed.

You can do what I call and mini-mini tuck which is tucking the lower abdomen and not tightening the muscle under local anesthesia. Yes, lidocaine is used. However, you can have this procedure under a spinal anesthesia as well. A spinal can be used for a full tummy tuck, but local anesthesia will be needed for the upper abdomen. Do realize any tuck might change your tattoos. The amount of lidocaine used will be calculated to your weight.

Hello. I have reviewed your case and based on your photos I can say that you probably do not need muscle repair. Regarding the anesthetic technique, we regularly use epidural anesthesia and sedation. You will wake up in the recovery room. Thank you.

In my opinion, even a mini tummy tuck is a bit much to do using only local anesthesia without sedation.
They need to cauterize can be very painful.
Surgeons who have extensive experience doing body contouring primarily liposuction and mini tucks with patients awake may have the experience to do these procedures without undo excessive pain.
I think ideally an anesthesiologist managing your discomfort with potential deep sedation would be best.
A lot depends on if the surgeon is going to undermine and separate the skin and fat layer from the entire abdominal wall.
Honestly, I don’t see a good indication for having a tummy tuck, and even a mini tummy tuck may cut into your lateral torso tattoo.
having had a previous bad experience with anesthesia should not stop you from having the correct form of anesthesia for upcoming surgeries.
One incident does not make a certain procedure or medical experience bad.
I recommend avoid making emotional decisions when it comes to healthcare.
Allow your doctors to guide you through the process and rely on their experience in regards to what’s the best way of doing this.
Patients should avoid making their own assessments and prescribing their own treatment plans.
Best,
Mats Hagstrom, MD