Is it possible to do brachioplasty with the twilight sleep?

I routinely do my brachioplasties under ketamine-propofol anesthesia.  We use lidocaine tumescence and patients have excellent peaceful surgeries.

Thank you for your question regarding whether it is possible to do a brachioplasty or arm lift with twilight sleep anesthesia. Yes, it is possible to perform a brachioplasty, also known as arm lift or arm reduction, under twilight anesthesia. During twilight anesthesia, medication is given through your veins to minimize the pain and help you relax. During twilight anesthesia, you are awake and breathing on your own. During twilight anesthesia, you are not paralyzed. Twilight anesthesia is different than general anesthesia. During general anesthesia, you are given medication to paralyze your muscles completely. Since you are paralyzed, your breathing needs to be supported with a ventilator. Therefore, a breathing tube is placed in your windpipe during general anesthesia. This is different than twilight anesthesia, where you are not paralyzed and, thus, do not need a breathing tube. Similar to twilight anesthesia, during general anesthesia, you are given medication so you do not feel anything during surgery.


During a brachioplasty, arm liposuction is performed. There were five different types of brachioplasties or arm lifts. The most common brachioplasty is performed with an incision from the armpit to the elbow. Then, a large elliptical area of inner arm skin is removed. The arm lift incision is typically placed between the biceps and the triceps. The incision is placed in this position to maximize arm lift scar concealment. The arm lift scar is hidden when your arm is by your side. Some inexperienced plastic surgeons and general surgeons place the arm lift scar on the back of the arm. Though technically easier to place the incision on the back of the arm, the resulting arm lift scar is much more visible. Drains are usually not used during a brachioplasty. After the arm lift surgery, compression garments will be required for approximately 6 to 8 weeks to minimize swelling, offer structural support, and help flatten the arm lift scar. Consider taking approximately 3 to 4 weeks off work if your job entails significant lifting. If your job is mostly clerical or sitting at a desk, you can return to work approximately 2 to 3 weeks after your brachioplasty.

Good luck. I hope I have answered your questions regarding whether it is possible to do a brachioplasty or arm lift with twilight sleep anesthesia. If you have any questions regarding the arm lift, arm reduction, or brachioplasty, please get in touch with an arm lift expert. Since a brachioplasty or arm lift surgery is difficult, please seek an experienced, board-certified plastic surgeon with significant experience performing these types of arm lifts. Do your research. Make sure your chosen plastic surgeon has performed at least 150 arm lifts. Make sure they have the before and after pictures to prove it. Please carefully look over their before and after pictures and check their reviews on RealSelf. Sincerely, Dr. Katzen. (Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Brachioplasty can be performed safely under general anesthesia, or light sedation "twilight" anesthesia. I have done brachioplasty surgery with both types of anesthesia. My anesthesia recommendation depends on the individual patient.The more extensive the brachioplasty, the more likely general anesthesia will be recommended.The end goal is to obtain the best brachioplasty result, and your surgeon will make the anesthesia recommendation with that in mind. Good luck!

Hello, and thank you for your question. There are many options for anesthesia regarding a brachioplasty. We perform this surgery under some light sedation as well as deeper general anesthesia depending upon the patient's request. We also have the availability for a board certified anesthesiologist to help with your decision. You can discuss this with an inpatient consultation with a qualified board certified plastic surgeon in your area. We have an office in St. Petersburg and would be happy to see you for a complimentary consultation to discuss all of your choices. You can visit our website for further information .  Best of luck with your decision.

Technically, yes it would be possible.  However, I do recommend this even though I have had several patients ask.  The reason I will not is because in order to complete the operation under sedation, local anesthetic has to be injected into the arms which causes swelling of the arms.  Notoriously, when doing a brachipolasty, the arm swells tremendously on its own without injecting local and even though the final result is usually as tight as the skin will allow, over the next few days to weeks, the swelling resolves and the tightness of the arm is less than immediately after surgery.  Adding swelling from local would only make this problem worse and make the results worse, in my opinion, long term.  Thus, I think this procedure is best done with the patient off to sleep.  An LMA (laryngeal mask airway) is a nice alternative to an ET (endotrachial tube) in this type of situation so that general anesthetic can still be given without the trauma to the airway.  Best of luck!

If by twilight sleep, you mean deep sedation, then it would be possible, much like some surgeons can perform abdominoplasty the same way.  I don't perform either procedure this way, as I want my patients experience to be a good one and I think having no memory of the surgery and no pain during it, makes for a good experience.  Deep sedation requires the area to operated on to be made numb by injection of a numbing solution.  The injection can be a requirement but can also be uncomfortable for the patient and in spite of the best efforts, some areas may not be made fully numb so can be uncomfortable when these areas are reached during surgery.

Thank you for your question.  Yes it is possible to perform a brachioplasty under twilight anesthesia.  I prefer light general anesthesia so I can use less lidocaine . However, I know colleagues do the procedure safely under sedation.  Many patients want  to avoid general anesthesia due to anxiety and fear of being put to sleep.  General anesthesia in the hands of a board certified anesthesiologist or certified anesthetist is very safe.  Discuss this at the time of your consultation with your board certified plastic surgeon.  It is always possible to discuss your preference with the anesthesia team days before your surgery as well.I hope this helps

I would caution against this.My question back to you is why would you want to do that. The problem is in order to adequately anaesthetise the area with being asleep you would need a significant amount of local anaesthetic. This would put you at risk of local anaesthetic toxicity, which can be very dangerous.If you are conservative with the local anaesthetic then you may find the experience unpleasant or be moving around which will make the surgery difficult for your surgeon.A relatively light general anaesthetic is usually all that is required. This is a much safer option with a qualified anaesthetist present.CheersRichard

I have done this option for anesthesia with brachioplasty, but prefer light general anesthesia.......