Breast reduction with local anesthesia?

While local anesthesia can be used, this is a surgery that is performed under general anesthesia by the vast majority of PSs in the US. The PS and anesthesiologist want to provide the safest and most comfortable environment for the patient; and the patient does not want to be in pain during the procedure so that the PS must stop or do less than what is necessary to provide the patient with the most dramatic transformation possible. Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

I recommend general anesthesia by a board-certified anesthesiologist.   I also recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Most patients are only too happy to go off to sleep for their surgery. However, there are a very few who, because of personal preference or medical necessity, would rather have local anesthesia with sedation. I have done both breast reductions and breast augmentations in awake patients. This requires close collaboration between the surgeon and anesthesiologist and, of course, a plastic surgeon who is comfortable with this approach.  All the best.

A breast reduction is a significant procedure and I'm not aware of anybody performing them with local anesthesia. It can be performed with deep sedation and an intercostal block. Keep in mind that general anesthesia is extremely safe in a healthy patient.#StayBeautiful #RealDrWorldWide

Breast reduction is a significant surgery.  I am not aware of anyone performing this under straight local anesthesia.  Unfortunately, an epidural is not possible as it would affect your ability to breath.  Surgery in an accredited facility with a board certified anesthesiologist is a very safe and well tolerated procedure.  Best of luck.

Dear stripes23,most plastic surgeons won't do breast reduction under local anesthesia. Finding the right Dr. is extremely challenging especially with the number of online platforms and resources available. There a lot of great Dr's available. Definitely check to make sure your choice specializes in the procedure you want and spend the time to read through patient testimonials. 
You can always pick up the phone and call around also, find an office you feel comfortable with and set up a few consultations. Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

as the techniques today are much gentler and you can even avoid nausea completely.  Your anesthesiologist gives you something prior to being wheeled to the OR to completely relax you and then you can have airways that do not require tubes down your throat so you won't wake up with a horrible sore throat.  Being under general anesthesia is just so much nicer than trying to labor under locals and to keep you comfortable at the same time.  And whats even better, you should have no recall once you got the first shot.

While I have done skin only breast lifts under just local anesthetic, with the two cup size breast reduction you are asking for, I would recommend general anesthesia.  While it seems frightening to consider “going under”, a local anesthetic in this scenario would require more IV sedatives than I personally think are safe unless you are “asleep” and have a protected airway with a tube in place. And that tube that protects your airway is the difference between “going under” and  sedation.   Sedation works great in some procedures that don’t require significant dissection.  A big area, like a reduction or. Tummy tuck, would require what maybe dangerous levels of local anesthetic to make things numb as well as high levels of sedatives so that you aren’t horribly uncomfortable while being numbed.  Unfortunately in my community many of those that offer complex procedures under local anesthetic do it because they are not board certified plastic surgeons and cannot get facility privileges to perform the procedures under general anesthetic. In those cases, “local” is not a selling point. Please see board certified plastic surgeons for consults.  Don’t let the type of anesthetic be your deciding factor.  Look at their skill and experience and ask to speak with their anesthesia providers to allay your fears. 

   It is possible to do a breast reduction under local anesthesia, but not wise.  It is major surgery, and rather than being afraid of the anesthesia, I would encourage you to realize that the anesthesiologist is the one keeping you safe!  They will protect your airway, ensure you have good oxygen levels, monitor your fluid status which is so important with this surgery, and also prevent complications from overdosage of local anesthestic.   Get a consultation with an ASPS plastic surgeon who specializes in breast reduction and learn more about the benefits and risks of the procedure.  Even if you find someone who will do it under local, I would not recommend it.  Good luck to you.

Thank you for the question and congratulations on your decision to proceed with breast reduction surgery; this operation tends to be one of the most patient pleasing operations we perform.
There are many different types of acceptable techniques of anesthesia that can be used for the breast reduction procedure. As long as the plastic surgeon and anesthesiologist involved are “expert” at the technique selected, patients generally do very well.
My advice to patients is: concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.
Once you have chosen your plastic surgeon carefully, everything else, including the type of anesthesia ( and most importantly SAFETY concerns)  will follow. 
Having said that, 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.Anxiety prior to surgery is very normal; its complete elimination is usually not possible.  Again, assuming you have chosen your plastic surgeon  carefully, other important "variables" such as anesthesia provider and surgery facility will be selected based on everyone's first priority: safety.  This careful selection should give you some peace of mind that you will be safe around the time of surgery.  Discuss your specific areas of concerns with your plastic surgeon who will be in the best position to help you calm your nerves.
I ask my patients to try to be as calm as possible prior to surgery; this “calmness" tends to translate to a smoother postoperative course. You may be able to alleviate some pre operative anxiety with music, exercise, meditation, a glass of wine (if ok with your surgeon, and positive/objective focus on the long term outcome/benefits etc. prior to your procedure.
 Most patients describe the experience of anesthesia as a "pleasant nap";  your "wake up" should be smooth, as well as pain and anxiety free. There are a variety of methods available to help with pain control.   
Best wishes for an outcome that you will be very pleased with.