Is It Common to Use Local Anesthesia for Brachioplasty Revision?

I had a Brachioplasty (Arm Lift) done in early 2009. The surgeon and I agreed a revision would be a good idea to remove the remaining excess hanging skin. He has suggested doing this in his office with local anesthesia...I will be awake. Yikes..

Is it routine to do such a procedure in an office (not a surgery center) with only a local? I think if I see him cutting my arm flesh off I'll pass out! Has anyone removed excess skin all the way along the length of both arms in an office with just a local? Thanks for your input!

Doctor Answers 30

Brachioplasty can be done in the office OR.

It is not unusual to perform scar revision surgery in the office operating room.  In fact, many of us (including myself) do the actual brachioplasty surgery in the office operating room with relatively light sedation.  I do not disagree with a general anesthesia and stil do this occasionally for patients who are not good candidates for a procedure without general anesthesia.

Understand, this is a AAAASF certified operating room and not just a minor procedure room.  I have included a video for your reference.

Salt Lake City Plastic Surgeon
4.9 out of 5 stars 175 reviews

Brachioplasty revision with local anesthesia

Thank you for your question regarding arm lift or brachioplasty revision done under local anesthesia.

In my practice, performing revisional brachioplasty scar surgery is very uncommon. However, performing revision brachioplasty scar under local anesthesia is not entirely unacceptable. Basically, if you can tolerate it and the doses of local anesthesia are not too high, it may be safer for you to have this revision performed under local anesthesia, rather than general anesthesia.

If you decide to go ahead with local anesthesia, perhaps ask your plastic surgeon for a Valium or Xanax. In addition, if you do not want to see what is going on, a surgical drape can be easily applied. Another good option I use for my patients, is to bring your headphones and a airplane sleeping mask to cover your eyes. You can just relax and listen to your music while your plastic surgeon revises the arm lift scars.

Good luck with your quest for skinnier arms.
If you have any questions, please do not hesitate to contact my office.

Sincerely, Dr. Katzen

J. Timothy Katzen, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 195 reviews

The Choice of Anesthesia Depends on the Situation

                  Brachioplasty patients may occasionally require revisional surgery. Revisional surgery may be necessary for a wide variety of reasons. In some cases, the problem may be minor, while in other cases, it may be major.

                  The choice of anesthesia is dependent upon the nature of the deformity. In some cases, where deformities are minor, local anesthesia is acceptable. In other cases where major deformities are present, general anesthesia is probably more appropriate.

                  The choice of anesthetic is also dependent upon the patient’s preference, surgeon’s preference and the patient’s overall health. It’s important that these issues be discussed prior to surgery so the patient can have a comfortable experience. 

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Arm Lift Revision

Yes, I have. However, I counsel patients carefully prior to having them undergo any procedures under local that are more extensive because of the very concerns you’ve expressed. You may wish to rethink your decision even though it may have economic consequences. You will be a lot happier if you do this under anesthesia in a regular outpatient facility and your surgeon is perfectly capable of doing what he thinks you and he want, but it sounds like you have too many reservations to execute this procedure while you are fully awake under local anesthesia.

Paul Vanek, MD
Cleveland Plastic Surgeon
4.8 out of 5 stars 30 reviews

Arm lift revision

Many revisional surgeries can be performed in the office under local anesthesia. You can leave the office immediately after the procedure and will not have the cost and postop side effects of sedation. If you are placed properly on the OR tsbke, you will not see a thing. If you have anxiety about it, your doctor can provide oral medication, such as Xanax, to take the edge off. If you opt for anesthesia, you may have to incur additional costs so check with your plastic surgeon.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

Scar Revision Armlifting?

Thank you for the question.

Unfortunately, the scars that result from arm lifting surgery may be problematic;  scar revision surgery is often necessary. This procedure may be done under local or general anesthesia. This decision should be made mutually by patient and surgeon  after discussion of the pros/cons  of each type of anesthesia.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

A revision brachioplasty can be performed under local anesthesia

A revision brachioplasty can surgely be performed under local anesthesia in an office. This can be a cost effective way to further improve the results. The trade off is that it will be less comfortable and may take longer versus performing this with sedation or general anesthesia as an outpatient.

If there is any doubt about you tolerating this approach including regarding the pain issue or anxiety, then elect to do the procedure either with the sedation or with general anesthesia - it will make your experience more pleasant though it will cost a bit more.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 30 reviews

Brachioplasty(arm lift) revision anesthesia options

 Local anesthesia can be a viable option for revision arm lift surgery.    Revisions in an office setting can be very cost effective but there is some discomfort as a trade off.  Often some oral sedation can make even a larger procedure under local anesthesia not only possible but a good option.  Personally, I get a little faint when I get blood drawn so IV sedation in an approved facility looks better.

Craig Harrison, MD, PA
Tyler Plastic Surgeon
5.0 out of 5 stars 28 reviews

Local anestesia is only advised for revisions if you are able to relax.

It is common to have revisional surgeries under local anestesia if you are able to handle it.  It is easier for you and your surgeon if you are relaxed and not full of anxiety.  You will be injected with numbing medication and should not feel much.  Local also involved oral medication to help you relax.  The injections may be the worst part.  If you feel you may be a little anxious about it, schedule general or even a twilight procedure. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Brachioplasty scar revison

It is certainly acceptable to perform a scar revision on a brachioplasty scar under local anesthesia.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

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.