Could I have a BA with just a local instead of general anesthesia?

I recently read a post where a woman was not happy with size and wanted to go larger. Her PS performed the revision with a local which saved her a ton of money. How plausible is this? I'm thinking yes since i had a c-section with just a local. Is this an option that most PS offer? If not why?

Doctor Answers 20

Could I have a BA with just a local instead of general anesthesia?

The answer is yes............why would you though???? The patient you are referring to had a revision and the pocket had already been developed. If you are to have the implants placed behind the muscle, it's preferable for the comfort and safety of the patient to have it done under general anesthesia. Even in subglandular breast augmentations, the use of local with IV sedation should be the very minimum done.

I have been in private practice and performed breast augmentations in the Miami area for the past twenty-nine years. Our South Florida region is filled with mom and pop cosmetic surgery clinics offering unheard of discounted breasts augmentations. They will frequently advertise the lowest price without advising you that it is done with local anethesia only. You are then given a choice of adding IV sedation or general anesthesia at additional costs. Once they have you within the confines of the clinic or center, the mission of the sales person ( that's what they are) is to close the deal.

Breast augmentation in the Miami area has become extremely competitive and unfortunately we have many practitioners lacking years of experience performing countless procedures at very low prices. The Miami area has some excellent plastic surgeons but unfortunately the costs and fees have been driven down as a result of simple and demand. Less expensive does not mean a sacrifice in quality but you must be diligent about your search. Not all surgeons nor cosmetic surgery centers were created equal. Research, research and the research some more.

This is South Florida where it's a woman's goal to look great in a bikini whether you are 20 or 50 years old.
Always seek out the opinion of a surgeon certified by the American Board of Plastic Surgery with years of experience in breast augmentations. Furthermore request to see before and after photos of previous patients by that doctor....not a clinic or surgery center. Do your homework......research and verify the doctor's credentials. Have they had problems with the Board of Medicine, disciplinary or otherwise. Any law suits?

How about the center, clinic or facility? Are they accredited by a national organization or do they just have State approval. Understand that at the current time, there are three nationally recognized organizations responsible for the highest levels of patient safety, AAAASF, AAACH and JCHO. You owe it to yourself to position yourself for the best possible results but under the most stringent safety regulations, If you have kids, even more so.

How about anesthesia? Will you have a medical doctor certified by the American Board of Anesthesiology or a certified nurse anesthetist (CRNA)? Understand that there is no substitute for research. Cosmetic surgery, no matter how simple it may be to the patients, are invasive procedures and as such carry certain risks and complications.

In our office we use TouchMD which is a web based program in which patients have the ability to load their picture unto the program. I then evaluate them and can actually draw on the picture to show a potential patient where the incisions would be located and how the procedure is to be realized. It's all done to comply with HIPPA which is the federal law that protects the patient's medical information. Look them up.

We are very use to accommodating patients national and international patients. I would venture to guess that you could fly directly to Miami have your surgery, visit our famous "South Beach", stay for a week and still pay less than you would at home. Contact our office and we will be happy to give you all of the info necessary. We can even set you up at a bed and breakfast near the Institute

Give yourself the highest percentage of a sucssesful operation. Good luck

Breast aug under local

This is generally not recommended because if you go under the muscle this can be uncomfortable and you may end up fighting the surgeon because of the pain.also if you are experiencing a fair amount of pain then your blood pressure will rise and cause more it is best to be relaxed and not have any discomfort.We do it with sedation all the time and it is safe and effective. 

Robert Brueck, MD
Fort Myers Plastic Surgeon
5.0 out of 5 stars 54 reviews

BA under local anesthesia

Breast augmentation surgery requires precision.  The implant pocket must be made to fit the implant.  There can be no bleeding from the dissection.  This requires retraction and manipulation of the breast.  I would not want my surgeon performing this operation with one hand tied behind his back.  Now some revisions can be done under local but it will vary from patient to patient.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 16 reviews

Breast Augmentation surgery is more comfortable under general anesthesia

Your question is not an uncommon one. While breast augmentation surgery can be done under local anesthesia, I would not recommend it due to the extreme discomfort it would place on the patient. General anesthesia is extremely safe when done in a certified surgery center and with a board certified physician anesthesiologist. The surgery can be done much more efficiently under general anesthesia than under local anesthesia or even IV sedation. It is also not uncommon to perform revisions or re-implantation surgery under local if the patient wants to save money, but this is not the same procedure as an initial breast augmentation surgery when the pocket formation and implant placement is crucial as discussed by another surgeon on this forum. I wish you luck in your decision to go forward with your surgery.

Could I have a BA with just a local instead of general anesthesia?

Primary breast augmentation is best performed under general anesthesia. While it is possible to perform it under local with sedation, I would not recommend it for a primary augmentation. The situation you describe was likely done in a procedure room and is a total different surgery where it is often just opening the old incision and removing the implant and placing a new large one. If no work on the pocket is needed the pain and discomfort is significantly less than a primary augmentation under the muscle. The savings desrcibed is likely is due to the minimal facility fee asociated with a procedure room and with straight local no need for a nurse or doctor to administer sedation or anesthesia.

David Mathes, MD
Aurora Plastic Surgeon
5.0 out of 5 stars 6 reviews

General anesthesia is by far easier on the patient and probably safer for a breast augmentation

While it is possible to preform augmentation mammoplasty under local anesthesia with or with out sedation, you will have a much more pleasant and safe experience under general anesthesia. A short general anesthesia is very safe and gives the surgeon more control which makes it safer. If you were to develop a problem during surgery the anesthesiologist can be a great asset. 

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 15 reviews

Could I have a BA with just a local instead of general anesthesia?

Two COMPLETELY different situations! Exchange you already have the implant pocket dissected (hopefully under the muscle). In primary implantation the dissection is quite uncomfortable. Over 98% of boarded Plastic Surgeons recommend some form of anesthesia with Local, why rock the boat... We want your experience to be as pain free as possible... 

?Local anesthesia

A revision is a completely different procedure than a primary augmentation, since the pocket is already made. 

Although it may be possible to do you procedure under local, the likelihood of having to abandon the procedure due to pain is high enough that I would not advise it. Furthermore, many procedures under local add a considerable amount of OR time, wiping out any savings from not having to pay an anesthesia provider. 

As to the c-section under local, I would suspect some sedation or block was also done, and that an anesthesia provider was present. 

All the best. 

Breast augmentation under local anesthetic

Simply replacing implants under local is a different operation than the original procedure just because the pocket is already there. As Dr. Seckel mentions, the creation of a submuscular pocket and division of the pectoralis muscles is just too much to manage with local anesthetic alone. In addition, a rushed operation due to patient discomfort is far less likely to result in a pleasing outcome, either aesthetically or from a safety standpoint. I would not recommend it.

Earl E. Ferguson III, MD, FACS
San Antonio Plastic Surgeon
5.0 out of 5 stars 12 reviews

Local anesthesia for breast augmentation

Thank you for your question.  Simply replacing breast implants with larger implants is certainly possible under local anesthesia.

However if you're having her first breast augmentation you most definitely will need IV sedation in addition to local.

However in my experience especially if your implants are placed beneath the chest muscle general anesthesia is required.  The discomfort with the dissection and simply too great to be managed without very deep IV sedation which can be dangerous without an adequate airway.

I only performed breast augmentation for first-time patients with general anesthesia.

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.