Is a breast lift with implant removal under local anesthesia safe?

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for your question! Depending on your and your plastic surgeon's comfort level with surgical procedures via local anesthesia, it certainly is a safe procedure and can be done via local only or a little sedation. It is difficult to answer about the appearance of your breasts without a photo or examination. Removal of your implants alone will create a smaller breast with somewhat similar shape. Discuss your concerns with your plastic surgeon and the possibility for a breast lift, either at the same time or at a later date, if deemed necessary. Many times drains are placed as well as compression garments used postoperatively. Cost varies among surgeons as well as geographic location. Certainly, for simple removal without any capsule work, the procedure can be tolerated with local anesthesia alone. I typically prefer to remove the capsule. The addition of a lift with the procedure may be difficult to do simply under local anesthesia.  Best wishes!

I am not a proponent of local with sedation for major breast surgery. I would recommend general anesthesia for safety and optimizing the surgeon's ability to do his/her best work. Often times, during local anesthesia- even with sedation- the patient experience untreatable pain, in which case the procedure is compromised or less effective. Therefore, i recommend general anesthesia for best outcome. For more info about this topic- you can read my blog here:

Safety is always the number one priority in surgery. For that reason I perform the surgery you are planning under general anesthesia. This is not only for your safety, but also for your comfort. In addition it will provide your surgeon the opportunity to optimize your results.

There are 3 basic types of anesthesia used for surgical procedures:Local anesthesia (patient is wide awake)Local with sedation or conscious sedation anesthesia (twilight sleep)General anesthesia (patient is totally asleep)The type of anesthesia chosen depends on the comfort of the surgeon and the patient.  The key is having the procedure performed in a nationally accredited facility with board certified anesthesia coverage.  That way you are assured that there are trained professionals to handle any emergency that might arise during the procedure (not like Michael Jackson (twilight sleep) or Joan Rivers (also twilight sleep).The recovery is fastest for the local anesthesia and probably second fastest for the general anesthesia.  The longer recovery is probably the twilight sleep because more medication is used to keep you asleep than with the general or local alone.  The cost should be the same for #2 and #3 and cheaper for #1.It would appear in this situation that you will have a long procedure 2-4 hours.  It is hard to hold still for that long, so I would recommend a general anesthetic.Good Luck!

Thank you for the question.  Careful selection of your plastic surgeon will be important. Make sure that you see lots of examples of his/her work, achieving the types of outcomes you will be pleased with.  I would NOT suggest that you select your plastic surgeon based on what type of anesthesia he/she offers.A variety of different types of anesthesia may be used for breast lifting surgery depending on the type of surgery being done and the surgeon's/ patient's preferences.In my practice, the majority of breast surgery is done under general anesthesia dnder the supervision of a board-certified anesthesiologist.  The majority of patients undergoing breast implant removal surgery, I do utilize drains.  I hope this, and the attached link (dedicated to breast implant removal surgery concerns) helps. Best wishes.

Fortunately, you added that sedation will be used.  As such, and in general, doing the procedure you mentioned (bilateral removal of breast implants and a breast lift) under local anesthesia with sedation is considered safe.  You should, of course, use board-certified doctors (plastic surgeon and anesthesiologist) and have the surgery performed in an accredited surgical facility.  This combination is often referred to as MAC (Monitored Anesthesia Care), DIVA (Deep IntraVenous Anesthesia) or even intravenous general anesthesia and, in fairness, the precised definition of some forms of anesthesia is debatable.The use of drains is largely a question of individual surgeon preference.  I almost always use drains for a procedure such as this, particularly since there is the space left by the implants that risks accumulating fluid, including blood and serous drainage, that (I feel) are better evacuated mechanically than allowed to absorb on their own.  But many excellent surgeons do not use drains for this procedure and there are no absolutes in this regard.Doing the procedure under local anesthesia alone is not something I would have advised but, thankfully, that's not what you really meant....I hope that this helps and good luck,Dr. Alan EnglerMember of #RealSelf100@RealSelf