What are the pros and cons for breast augmentation done under local anesthesia instead of general anesthesia?

Breast implants placed under the muscle should only be performed under general anesthesia for your safety. 

I have been doing breast augmentation under local anesthesia
with Twilight sedation for 25 years. General anesthesia carries additional risks
beyond conscious sedation. Patients seem to recover more quickly when we avoid
general.

Nicoya79,Thank you for your inquiry and congrats on considering the BA surgery.To answer your question, it is best to perform BA under general anesthesia as it will be the most safe and adequate approach for the patient.It is important to mention that the
finest cosmetic results in any particular case are based on a variety of
factors, including: the unique anatomy of the patient, realistic expectations,
a well-informed and detailed discussion with your plastic surgeon concerning
the best options for you especially covering a deep understanding of the pros
and cons of any given choice you will adopt.



Please keep in mind that following the
advice from a surgeon online who offers to tell you what to do without a
physical examination covering the nature and the status of the tissue,
assessing your desired outcome, taking a full medical history, and discussing
the pros and cons of each operative solution would not be in your best
interest. With that in mind, it is the safest and for your best interest to
find a plastic surgeon with solid experience and certified by the American
Board of Plastic Surgery who is ideally a member of the American Society of
Plastic Surgeons that you will trust and be comfortable with. You should
discuss your concerns with that surgeon in person.



Good luck!!!



Ali Sajjadian, MD FACS

Dear nicoyawhen you are trying to have a procedure performed outside the routine, you have to make sure you have something substantial to gain. Breast Augmentation, specially when done in the submuscular plane, is technically easier and more consistent in a patient with relaxed muscles. In patients who are awake or not relaxed, the surgeon has to deal with more issues and this can lead to more discomfort for the patient both in the short and in the long term. I for one can't lay still and not move and shift my position for an hour.The question is why do you want to avoid anesthesia? You should discuss anesthesia, its safety and inherent risks with your surgeon to make sure you are avoiding anesthesia with and for the right reasons.

Thank you for your question.  Though there are surgeons who perform augmentations under local anesthesia, I favor the use of general anesthesia for both patient comfort and safety.  In my opinion, general anesthesia permits a more controlled environment in the operating room, and takes out variability that can occur with the use of only local.  

The standard of care nationwide is providing caring anesthesia that controls your safety.  Outpatient anesthesia surgery has been proven safe from many studies and continues to become the safest when provided by a certified person whether a CRNA or MD.  In fact most anesthesia is provided by nurses.  There simply far more RN providing anesthesia than doctors.Local anesthesia is setting yourself up for an uncomfortable experience with lack of control for surgery and outcome.  I would not recommend this to my family for breast augmentation.

a maxim in anesthesia says that there are many things you can do while standing up in a canoe, but not advisable.Everything about local anesthesia is good until it isn't. Results may be compromised or poor decisions made because of lack of adequate anesthesia. To have a board certified anesthesiologist in the room to be there for your safety is worth every penny

For the patient's comfort and safety, I strongly feel that BA with implants placed under the muscle should be done under general anesthesia. It is possible to perform breast augmentation under local anesthesia especially if the implant is placed above the muscle. However, one should be wary of a plastic surgeon who insists on performing BA under local anesthesia only. 

Other than potential less cost and less nausea after surgery there really are none. General anesthesia is very safe today and there are medicines that help reduce the potential for nausea and pain that can be given both before and during surgery. The cost is often the same as you are paying the anesthesia doctor for his/her time. Personally having performed thousands of breast implant surgeries I always recommend general anesthesia. If you are afraid of going to sleep you can have an IV general. Make sure whatever you choose you are in an accredited facility and have board certified anesthesia. 

Thank you for the question.Every surgeon will have his/her preference. I prefer the use of general anesthesia provided by a board-certified anesthesiologist. I have found that the use of general anesthesia is safe, comfortable for the patient, and predictably maintains a patient in a good position (without movement) during the procedure. I think the latter is important as we are trying to achieve as much symmetry is possible. Best wishes.