Thank you for inquiring about the possibility of undergoing an arm lift using only local anesthesia. Yes, the procedure can be conducted under local anesthesia, but the suitability hinges on your individual pain tolerance. For those with a high pain threshold, it may be a viable option. However, there's a limitation to the quantity of local anesthetic that can be administered safely in one session. Consequently, in most instances, only one arm would be treated in a session due to this restriction. This is a key reason why many plastic surgeons prefer general anesthesia for arm lift procedures. But, if you're open to having each arm done separately and have a good tolerance for pain, local anesthesia might work for you. Sincerely, Dr. Katzen