Thank you for the question. 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. Having said that, given the extensive nature of the procedure ( and priorities such as patient comfort, positioning, immobility…), the vast majority of breast reduction procedures are done under general anesthesia. 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. 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. Most patients describe the experience of anesthesia as a "pleasant nap"; assuming you are working with a well experienced plastic surgeon and anesthesiologist, 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.