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