Can a Tummy Tuck Surgery Be Done with Local Anesthesia?

I know I am in the minority on this but I prefer local anesthesia with IV sedation for a full tummy tuck.  I am a board certified plastic surgeon, I use only board certified anesthesiologists to administer sedation. 

I spent the early part of my career doing every tummy tuck with general anesthesia.  At the time, I would have believed anyone doing this procedure without a general anesthesia must be compromising on muscle or skin tightening.  Having done this procedure safely and effectively with local and IV sedation for the past 5 years, I can assure you this is not the case.  

We run the sedation pretty deep and I would not feel comfortable doing this procedure without it.

Watch the video for a basic demonstration

York Yates, MD.   Utah.

Dear lala08,

Thank you for your inquiry about the possibility of undergoing a tummy tuck procedure under local anesthesia. While it's technically feasible to perform a tummy tuck using only local anesthesia, I must express my reservations about this approach.

First and foremost, I rarely recommend tummy tucks under local anesthesia due to several reasons. One of the primary concerns is pain management. Tummy tuck surgery involves significant tissue manipulation and muscle repair, which can be quite uncomfortable even with local anesthesia. Additionally, there's a limit to the amount of local anesthetic that can be administered before reaching potentially toxic levels of lidocaine in the body.

Moreover, performing a tummy tuck under local anesthesia may compromise the quality of the results. Without the muscle relaxation provided by general anesthesia, it's challenging to achieve optimal muscle tightening and tissue contouring. Pulling and tugging the tissues adequately to create a smooth, tight abdomen may be limited under local anesthesia.

I understand your hesitation about undergoing general anesthesia, but I urge you to consider the primary reason for wanting your surgery under local anesthesia. If it's due to fear or concerns about general anesthesia, I want to reassure you that modern anesthesia techniques are incredibly safe, and complications are exceedingly rare. An experienced anesthesiologist will carefully monitor you throughout the procedure to ensure your safety and comfort.

Ultimately, the decision regarding anesthesia should prioritize your safety and the quality of your results. While local anesthesia may seem less intimidating, opting for general anesthesia could provide a more comfortable experience and ultimately deliver superior outcomes.

If you have any further questions or concerns, I encourage you to discuss them with your plastic surgeon during your consultation. Together, you can determine the most appropriate approach for achieving your desired aesthetic goals.

Sincerely,

Dr. Katzen
Plastic Surgeon

Thank you for your question. a Tummy tuck procedure can be perform under local anesthesia.I would suggest to be treated by board certificated plastic surgeon with experience in this procedure, to get the best desired results.
Kind Regards,Dr. Emmanuel Mallol Cotes.-

                  Although abdominoplasty can be performed under local anesthesia, the
vast majority of plastic surgeons prefer general anesthesia when performing
this procedure.  They feel that
general anesthesia offers significant advantages compared to local anesthesia.

                   The
procedure is more comfortable and avoids break through pain which can
occasionally occur with local anesthesia alone.  When general anesthesia is utilized procedures can be more
extensive and this can potentially improve the surgical result.

 It’s important to realize that all surgical procedures and
anesthetic techniques have risks. 
This is true whether local anesthesia or general anesthesia are
utilized.  Most Surgeons who
perform abdominoplasty agree that the anesthetic technique utilized is less
important than the use of a certified operating room and the presence of an
anesthesiologist.  In other words
you don’t want your surgeon to be your anesthesiologist.

Abdominoplasty is best done under general anesthesia so that the details of the procedure can be accomplished without movement of the patient. I don’t think local anesthesia can adequately anesthetize a patient to relieve the pain of the procedure.

It sounds as if you would require a full tummy tuck and I generally do not advise these under local anesthesia. However, you could undergo a regional. Discuss the options with your surgeon AND anesthesiologist.

Many people are more afraid of the anesthesia than the surgery, but if done by a qualified provider at an accredited surgical facility then it is probably safer than trying to get by under local, and certainly more comfortable. Your safety and comfort are paramount.

While some will tout that they can do almost any procedure with some sedation and local, there are some operations that you should be out for.  With a tummy tuck, most plastic surgeons will make an incision, tighten the muscles underneath, take off extra skin and fat, and then put you back together, (remembering to bring the belly button where it should go).  This really should be all done with the patient out.  You don't want to short change yourself.  Remember you need to be a healthy candidate as this is elecive surgery.

Best to see your Board Certified Plastic Surgeon.  He will tell you if you are a candidate for the surgery, and how he usually performs the operation.

Tummy tucks are best done under general anesthesia. During a tummy tuck, not only is your extra skin removed, but your abominal muscles are tightened as well. It would require a lot of local anesthetic to numb the entire abdomen including the muscles, and local anesthesia in high doses can be very dangerous. I understand many patients have a fear of "going to sleep", but in reality, general anesthesia administered by a qualified practioner is very safe. Unfortunately there are doctors not trained or qualified to perform surgery who take advantage of this fear and advertise doing procedures under local anesthesia only, as if it implies better technique or greater safety. This is simply not true. The best way to ensure your safety is to 1-have your procedure by a surgeon certified by the American Board of Plastic Surgery (not an imitation board), 2-in a facility that is appropriately certified (for example, AAAASF or Medicare certified). You can also request the name and contact information for your anesthesiologist or certified registered nurse anesthetist (CRNA) to research him or her as well. If you wanted a more limited procedure such as a C section scar revision, then local anesthesia may be a reasonable option, but for tummy tuck I recommend general anesthesia.

It is very misleading today because of very aggressive advertising by physicians that are NOT plastic surgeons that always seem to throw in the phrase "and you can avoid the risks of general anesthesia".  General anesthesia IS safe if administered by someone with the proper training and credentials.

Other procedures that are sometimes performed under local anesthesia (ie SmartLipo) do not address the looseness of the muscle and may not be aggressive enough depending on how much loose skin you have. (I'm being honest here, because I happen to be a fan of SmartLipo).