If I want to replace my implants with a bigger size, can I hope for a big discount? Can it be completed with local anesthesia?

  I am sorry to hear about your concerns after breast augmentation surgery.  

In cases where an unfavorable outcomes are present it is best for patients to discuss their concerns in a calm/constructive fashion; most plastic surgeons very much want their patients to be pleased and will do everything they can to improve outcomes.  On the other hand, an accusatory stance taken by a patient does not end up working out well for anybody involved. Overall, staying emotionally even keel tends to be helpful in these cases.

When it comes to revisionary surgery costs, policies will vary: charges such as facility and/or anesthesia fees are quite customary in most practices.  Often, surgeons will reduce or waive fees.  I can tell you personally that I am much more likely to waive fees for patients who demonstrate an understanding of the circumstances as opposed to patients who expect "perfection" and approach the complication in an accusatory or faultfinding fashion.In my practice I prefer the use of general  anesthesia provided by a well experienced board-certified anesthesiologist. I find the use of this type of anesthesia provides for a safe, comfortable, and immobile patient;  these conditions are important when it comes to achieving optimal outcomes.
Best wishes for an outcome that you are pleased with long-term.

Great question!  Unfortunately sizing is the #1 cause for patients to have a revisionary breast augmentation.  Although we try sizers on during the time of consultations, it only give an idea and is never 100 percent accurate.  I always tell patients that the true size is about 10% smaller than what the sizers seem during consultation - which it what it seems like you had done as well.  All we can do as surgeons is try our best to provide you with the most accurate information, but understand that surgery is an art and not an exact science.  With that being said, every office does revisionary surgery in different ways, so you will need to speak with your surgeon about this - most offices do provide some sort of discount though.  As far as local anesthesia, it is not recommended as there is a lot of manipulation that occurs during surgery and you don't want to have a traumatic experience that could affect the rest of your life.Best of luck and hope this information helps!
- Dr. Roger Tsai  @DrRogerTsai
Board Certified Plastic Surgeon

I am sorry that you feel you're still small and need to have replacement to be larger in size. This happens nationwide to about 10% of patients (estimated figures). It is usually the patient's responsibility to bear some of the cost of this and a frank and calm talk with your surgeon can certaily help. Dr. Prousti's advice is excellent below. Hope this helps.