Implants Under Local Okay?

Wil I be ok with local if implants 20yrs old,silicone,don't know which type,wd rather go for safest option but equally happy to have local if this is safe,dr also told me a padded bra wd be fine after?do I not need a support bra?thanks for yr help

Doctor Answers 10

Breast implant removal under local anesthesia

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Thank you for your question. If your implants are intact, not ruptured, and you do not havecomplications such as capsular contraction, then implant removal under local anesthesia should work fine.

If however more extensive surgery is needed such as removal of a ruptured implant, and I would suggest general anesthesia.

Local anesthesia for breast surgery

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In general, I am not a proponet of local anesthesia for breast augmentation surgery.  Patient's safety and comfort are of the utmost importance in any type of surgery.  Local anesthesia for removal of 20 year old silicone implants followed by replacement is unlikely to be very comfortable for you.  I would not recommend it.

Breast surgery under local

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    Do you want to just remove the implants or replace them ?  If you want just to remove them and the implants are intact ( MRI or mammography can help ) you can do it under local anesthesia. However if the implants raptured, it will be very uncomfortable to remove all the liquid gel in the pocket.  If you consider replacement and you have capsule contracture, you definitly need to do it under general anesthesia. Capsulotomy or capsulectomy will be extremely uncomfortable under local anesthesia. Be sure to consult with an experienced board certified plastic surgeon.

                   Good luck,

                                            Dr Widder


Replacement of implants under local.

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I prefer not to use straight local for patients for most breast surgery. I think that patients are more comfortable with sedation of general anesthesia. If they are comfortable, then I can do my best work and focus on the surgery.

Replacement of silicone gel implants under local anesthetic

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It is very possible that when the surgeon attempts to remove 20 year old silicone gel implants, they will crumble in his or her hands.  This may require removal of old implant material and scar capsule.  It is best to have the procedure done under a general anesthetic where you'll be comfortable and the surgeon will be able to work efficiently exposing you to less anesthetic.  Why shortchange yourself?

Removal and Replacement of Implants

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I utilize sedation for removal and replacement of implants.I find the replacement of silicone  implants may require additional dissection which is more comfortable for the patient and me with some type of sedation.

Replacing breast implants under local anesthesia?

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If these were saline implants then I think replacing them under local anesthesia might be reasonable, but in general terms, with 20-year-old silicone implants and the possibility of rupture, you may need extensive surgery.  I would not "fail to plan, and therefore plan to fail." You need to speak with a board certified plastic surgeon if you have not already and/or seek further consultation if you are uncertain about the recommendation given. Personally,  sight unseen, I would schedule you for general anesthesia and be prepared to do capsulectomies (remove the scar tissue around the implants), possibly deal with removing ruptured 20 year old implants, and do implant replacement.  I wish you the best of luck.

Implants Under Local

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While some surgeons will perform breast augmentation using local anesthesia to provide cost savings or due to the fact that their facility is not accredited for a greater level of anesthesia, the generally preferred method to ensure patient safety and comfort is to provide general anesthesia with a MD anesthesiogist. Padded bras are also not required. Consult with 3 - 4 expert and experienced board certified plastic surgeons to explore your options.

Breast Augmentation Surgery under Local Anesthesia?

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Although it is not completely clear, I am assuming that you are having an operation to remove recurrent breast implants and breast re augmentation performed at the same time. If this is the case, my preference would be to use more than local anesthesia. In my practice, these operations are done under general anesthesia under the supervision of a Board certified  anesthesiologist.  Doing the operation in this fashion, I believe provides for maximal patient comfort and an  environment where I can adjust the breast implant pockets etc. without concern for patient comfort/movement etc.

In regards to safety concerns, I would suggest that you choose your plastic surgeon carefully, make sure the procedures done in a fully accredited facility under the supervision of a well-trained/experienced anesthesiologist.  Depending on your age and health status preoperative workup/medical clearance may be helpful.

I hope this helps.

Implants Under Local Okay?

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In our practice we are very concerned about safety.  We perform Breast Augmentation surgery under a general anesthesia.  Surgeons have similar but their own techniques with post op care.  We do not require a padded bra after surgery. 

Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.