Can a mini tummy tuck be performed under local sedation?

Tumescent liposuction tightens the skin significantly if the Plastic Surgeon is aggressive with Liposuction. Smart Lipo is just a Hype and there is nothing smart about it.
Considering that you have had two c-sections, there is a high likelihood that you have poor skin elasticity, especially in the lower abdomen. Therefore, doing a mini-tummy tuck along with lipo is a very good idea. Otherwise, you will most likely have some redundant and wrinkled skin in the lower abdomen.
Although all these procedures can be done under local anesthesia, the extent of surgery would be very limited. Meaning that what a doctor can accomplish under general anesthesia is usually more dramatic than under local anesthesia.
The risks of either method are not different as long as you have an anesthesiologist. Often times, patients who are have liposuciton under local aneshtesia don't have an anesthesiologist monitoring them, and this can be a risky thing, especially that during local liposuction patient do also recieve intravenous sedative and other medications.

From your description it sounds like there are several options you are considering. I encourage you to visit with a few board certified plastic surgeons near you for consultations to listen to varying opinions. Generally a mini tummy tuck should be performed under general anesthesia. However if you have mild skin laxity and no muscle separation you may be a candidate for BodyTite which is performed under local anesthesia. I've included a video on this procedure that I hope you find helpful.

Liposuction is focused on removing fat from pockets of excess.  It is most successful when these areas are limited and prominent, such as saddlebags on the thighs or prominent flanks.  Tummy tucks tighten loose skin and muscles.  If your skin is loose, removing excess fat will only make the laxity more apparent.  Although Smart Lipo is heavily promoted, its results can be heterogeneous with regard to skin tightening, resulting in some areas that are tight and others that are looser.  This yields a cellulite-type appearance that is extremely difficult, if not impossible to correct.  A consultation with a board-certified plastic surgeon will allow you to determine the pros and cons of different combinations of liposuction and skin tightening.

I understand your frustrations with your stomach contour but the first question I would ask is if you intend to have children again. Having children again can undo your results. I would also ask if you’re breastfeeding. If you are, then it’s best to wait a few months after you’ve stopped before considering surgery.Your photo shows very little sagging skin. This may make it difficult to remove the stretch marks with a tummy tuck, since you don’t have much skin that can be removed. You may want to consider nonsurgical options to treat your stretch marks and see if you have success with them. As for your scars, a scar revision can be performed to reduce their visibility.

Liposuction is less invasive and quicker to recover from than a Tummy Tuck (abdominoplasty). This is because liposuction only involves removing fat from beneath your skin. Your body will cause the overlying skin to contract only to the degree it is capable, often leaving redundant skin which can be unsightly. In other words, you need good elasticity to get a good result. A Tummy Tuck involves removing redundant skin and tightening the underlying muscles. Sometimes liposuction is combined as needed with a Tummy Tuck for the best possible result. The question is whether the shape of your abdomen is affected by an excess of fat, skin, muscle separation or laxity, or some combination thereof. This can only be determined by examination, so go ahead and consult with a board certified plastic surgeon. Some of my patients elect to have liposuction first, and then opt for a Tummy Tuck if the results are not satisfying.

Great question and one we deal with every day in the office. Skin quality can range from normal to very lax and redundant. It can retain much of it's elasticity or it can be stretched and have lost the ability to retract. We see this loss of elasticity after considerable weight gain then loss or often after pregancy. The telltale signs of lax skin are stretch marks (stria). Simply put, these stria are tears in the deeper layer of the skin called the dermis. Also, your surgeon can assess the skin elasticity on physical examination.  If there are a lot of stretch marks and the skin is loose, then there are few options other than to remove the excess skin. If we remove the fat beneath, the skin will not retract and will simply hang loose. Skin excision is required when the skin is loose and has lost it's elasticity. If this loose skin is mostly below the belly button then a mini tummy tuck is a great option. For those with loose and lax skin that extends above the belly button, a full tummy tuck would be a better option. Many patients in your situation are "on the fence" and it is not entirely clear whether liposuction alone or liposuction with mini tummy is appropriate, even for the surgeon. There are three ways to approach this. First you can choose to do the liposuction and mini tummy tuck together. This will almost certainly give you an excellent result in the right hands. In my opinion, the only real downside is the scar, but this should not be much greater than the c-section scar you already have. The risk of adding a mini tummy tuck incision is quite low. Another option is to do only the liposuction based on the surgeons determination that the skin elasticity is good. The risk of this approach is the possibility of a poor result that then would require the mini tuck later. Ultimately, this is much more costly than the first option. Finally, you can agree to leave the decision to your surgeon to make intraoperatively (during the procedure). Of course this requires a great deal of trust that you hopefully already have with your chosen surgeon. Both liposuction, mini tummy tuck and the combination can be very safely performed under sedation with local anesthesia. I hope this helps.BRK