Dog ear revision - general or local anesthesia? (Photo)

Question

I am going to have a tummy tuck revision on a dog ear and I was wondering if I should just go under or do local. I have a decent pain tolerance. It doesn't seem like a big fix. As a surgeon what do you prefer or suggest.

Ronald J. Edelson, MD · Answer

I like doing it under local anesthesia. It allows the patient to lie in there which makes it easier.

Raffy Karamanoukian, MD, FACS · Answer

Abdominoplasty scars can be quite complex, ranging from the simple hypertrophic scar to a multiplane inflamed keloid. Pigmentation, discoloration, chronic inflammation, scar visibility can all occur in the short term. We begin each treatment with combination therapy using Yellow broadband BBL, Vbeam, fractional erbium, intralesional IIT, and scar modulation. Start with a combination of Plato's Scar Serum massaged twice daily after one week of epithelialization followed by Luminase/Exfolase. Scar consultation and revision may be recommended.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Robert M. Wald, Jr., MD · Answer

As long as your pain tolerance is good, you can have this done under local anesthesia. This is not a big revision, so the option is up to you.

Zoran Potparic, MD · Answer

Excision of dog ears is usually done in local anesthesia as an office procedure. Hope this helps.Good luck.

Camille Cash, MD · Answer

For smaller procedures such as the dog ear revision that you are considering local anesthesia is often adequate.  We also offer Pro Nox to our patients who a little anxious prior to the revision.  Speak with your surgeon on what is recommended for you.

Darryl J. Blinski, MD · Answer

Based on the posted photos, local anesthesia could service for this minor dog ear revision as seen in the posted photos. If you’re doing more surgery like liposuction, or any other procedures, then you should consider the general anesthesia option. Regards.

Mats Hagstrom, MD (license on probation) · Answer

It’s difficult to give you guidance because it completely depends on the skills and experience of your provider.
My practice is currently mostly emphasized undoing body contouring with Liposuction and fat transfer. I spent 20 years doing general plastic surgery, and I have lots of experience doing all types of procedures.
I currently do all my liposuction, including fat, transfer procedures with patients awake using local anesthesia with mild sedation
There is a significant learning curve to doing major surgery with patients awake avoiding unnecessary discomfort. The question is how much experience does your provider have doing local anesthesia procedures, such as what you are describing.
If the surgeon hasn’t done this before, then, the procedure can be potentially very painful
This is especially true if the surgeon is also inpatient or doesn’t spend enough time getting you comfortable.
Surgeons who have ample experience doing awake Liposuction should have no difficulty getting you properly numbed up for this type of procedure.
Some surgeon do a lot of procedures with patients awake while others generally shy away from it and this means they have less experience.
Ask your surgeon what type of procedures and how many they’ve done using a local anesthesia in their office before.
For dogear revision, patient positioning is really important. The procedure is best done with patients laying on their side.
While it’s possible to position patient on their side, using general anesthesia. It is a bit cumbersome and a bit unpopular with anesthesiologist and nursing staff.
Some people have the financial mean cost of a facility and anesthesiologist. It’s not a major financial burden. For some people, it is simply cost prohibitive.
There are lots of things to take into consideration. By far the most important variable is the skill and experience of your provider.
In my opinion, a well done tummy tuck shouldn’t require a revision for dog ears but this is a fairly common outcome of tummy tuck surgery.
The number one reason patient end up with dog ears from tummy tuck surgery is because the surgeon didn’t want to turn the patient during general anesthesia. 
Good luck,
Mats Hagstrom MD

Dog ear revision - general or local anesthesia? (Photo)

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