Breast augmentation preference - Awake during surgery?

Dear Doctors, I consider myself as a Plastic Surgery Enthousiast; who is fascinated by the human body, innovation and creativity. After seen many live procedures, being awake during three surgeries, I'd love to be awake during my next revision. (600 cc to 800 cc) Are there Surgeons over here where this is allowed, or is it not allowed by Law? Thank you in advance.

Doctor Answers 11

Breast augmentation preference - Awake during surgery?

If there were one breast augmentation/implant procedure that I would possibly consider doing with a patient awake it would be a simple exchange of implants.  Providing local anesthesia should be straightforward if there is no capsule contracture present.  Now the real question for you to consider is why would you seek 800 cc implants?  Please watch the video above for my evaluation of the risks of such large implants over time.  Best wishes,

Jon A Perlman MD FACS 

Certified, American Board of Plastic Surgery 

Extreme Makeover Surgeon ABC TV

Best of Los Angeles Award 2015, 2016 

Beverly Hills, Ca

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

The Breast Revision Procedure

Typically, a breast #implant #revision procedure is an outpatient surgery performed under oral sedation, IV sedation, or general anesthesia.  Such depends upon the length and complexity of surgery.  Your board-certified plastic surgeon will brief you on what may be best for you and your medical needs.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 110 reviews

Having surgery and being awake

is very doable BUT very few are alert enough to really appreciate the experience as you describe and the incisions are so small, that you really won't see anything except the implant going in and the immediate impact of the implant.  I did local sedation procedures for years as we had trouble getting anesthesiologists to commit.  But doing the procedure under general is much more relaxing and comfortable for my patients that my routine is to use general anesthesia.  They can choose local sedation but none have done so since I switched over.  If you want to be alert and watch your surgery,make sure your surgeon understands this before scheduling such a procedure.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

"Awake" plastic surgery

Thank you for your question.  "Awake" plastic surgery procedures is very common.  There needs to be the right mix of the type of procedure and the type of patient.  In general, breast augmentation surgery is best done with the patient under anesthesia for comfort.  A simple exchange could possibly be done under local or mild sedation, that would be up to your surgeon and anesthesiologist. 

Brian C. Reuben, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 36 reviews

Plastic surgery while awake

'awake' plastic surgery works for some procedures - tumescent liposuction and some cosmetic facial procedures. For breast revision surgery patients, the preference in our clinic is to have patients asleep - the sometimes lengthy revisonary breast surgery procedures can be completed more efficiently.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 65 reviews

Breast augmentation preference - Awake during surgery

Simple revision I have done many times with patients awake under local anesthesia.  Going to a large size that you are asking may be more comfortable under some sedation.  See an experienced plastic surgeon for advice.

Christopher Costanzo, MD
Thousand Oaks Plastic Surgeon
5.0 out of 5 stars 39 reviews

Breast augmentation revision

Breast augmentation revision can be simple or very complicated requiring tissue rearrangement in order to optimize your results; the more complicated cases would require you to be under anesthesia. A consultation is necessary to provide you an accurate recommendation regarding your level of anesthesia.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 67 reviews


Thank you for the question and certainly one could be awake during surgery if that is the best way to accomplish the desired result with the least risk of complications .  So go on some consults and be evaluated.  

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 61 reviews

Breast augmentation preference - Awake during surgery?

Thank you for your question. You will find that there are a variety of different types of anesthesia that can be utilized during revisionary breast augmentation surgery. The type of anesthesia that can be utilized is not dictated by law.

I  personally perform revisionary breast augmentation surgery in an out patient surgery center, and under general anesthesia administered by Board Certified Anesthesiologists.  I believe that this type of anesthesia provides for a comfortable/safe/immobile environment to  perform the  procedure. Personally, I feel  that this type of anesthesia allows me to achieve the patient's desired outcome in the most predictable, safe, and comfortable fashion possible. Although I understand your curiosity and interest, in the end you will be most interested in achieving the desired outcome.

I hope this, and the attacked link, helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Awake during surgery?

Thank you for your question.  There is more to surgery than just experience for the patient.  Safety of the patient is paramount and in order for a surgical team to have better control of the variables involved in surgery and being awake may not be a realistic option.  Good luck.  

David J. Wages, MD
Peabody Plastic Surgeon
4.8 out of 5 stars 24 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.