Anyone have breast augmentation while awake?

Found a few doctors that do breast augmentation while awake and just using a oral medication that calms you and numbing your breast with a medication that's like novacaine? I just started looking around and am considering this route. Just wonder if anyone else has done it that way if so how did it go?

Doctor Answers 6

Awake for Breast Augmentation?

Thank you for your question. I would recommend visiting with 2 or 3 Board Certified Plastic Surgeons who are reputable and provide for a safe surgery for you. The amount of medication needed to numb you up can be unsafe for this procedure. You may think you are saving money by choosing the cheapest surgeon but it will cost you in the long run. General anesthesia is very safe and definitely worth the cost where your health is concerned. The long term results of your augmentation will also be much better if done right the first time. Best Wishes.

Saint Paul Plastic Surgeon
4.8 out of 5 stars 62 reviews


Although it may sound like this route would be safer and more simple the opposite could be true. I recommend that you consider why most board certified, experienced Plastic Surgeons would opt for general anaesthetic during BA. In general, only elderly patients or those with significant medical problems (like heart, lung, or liver disease) are at increased risk with anaesthesia. Younger, healthy patients virtually never have issues with anaesthesia, so much so that I often do not discuss anaesthesia in-depth during the consultation compared to other risks. Ask your Plastic Surgeon about the certification of their anaesthesiologist and facilities they use during consultation.
All the best

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Not the way to go.

Hi only4you, I understand you are weighing all of your options when considering surgery, but I urge you to ask some more questions to these doctors as to why they use this option for their patients? My guess is because they don't have any other options. Some other important questions are where they have hospital privileges and what boards are they certified by? My best guess will be no where and none. Breast augmentation surgery is rarely performed "awake" when done by a board certified plastic surgeon and would not be considered by anyone I know who is experienced performing this procedure. I don't know if your motivation for considering the procedure be done this way is fear of anesthesia or a monetary consideration. (For most people it seems to be a way to save money.) You will hear it time an time again, but you should be choosing your surgeon based on their experience and credentials, not how inexpensive they are. There's a saying in our field, "Be careful choosing cheap plastic surgery. You will get cheap plastic surgery..." As far as health concerns, you will be under general anesthesia for less than an hour for a straight forward breast augmentation. The amount of medication required to numb you and keep you still while awake for this procedure is far riskier in my opinion. Your health and safety is the most important. I urge you to reconsider this route and look for a new surgeon. Best of luck to you. 

William Aiello, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 48 reviews

Local anesthetic

Breast augmentation is a procedure best done under general anesthesia. Careful monitoring and control of blood pressure can help ensure a blood less field during surgery, thereby helping provide a good cosmetic result. Saving a few dollars by not using a board certified anesthetist is not worth it. If you have health issues that make general anesthesia unsafe, I would recommend you defer the surgery. 

Arko Demianczuk, MD
Vancouver Plastic Surgeon
4.9 out of 5 stars 11 reviews

Awake breast augmentation?

Though it is possible to have this done under local, it has never been proven that these cases are safer than general anesthesia especially for a short case like this.  The most dangerous aspects of this case under local would be patient movement due to failure of properly numbing the areas, lidocaine toxicity, and not having the airway protected with proper monitoring in place.  In Tennessee, as far as I know, only doctors that are not allowed to have hospital privileges perform these cases under local so be careful who you choose.Best wishes and be careful with this one because you might find out that your 'Board Certified' doctor is actually an OB/GYN, a general surgeon, or not even a surgeon at all...

Shayne Webb, MD
Nashville Plastic Surgeon
5.0 out of 5 stars 47 reviews

Anyone have breast augmentation while awake?

Thank you for the question. Every surgeon will have his/her preference. I prefer the use of general anesthesia provided by a board-certified anesthesiologist.  I have found that the  use of general anesthesia is safe, comfortable for the patient, and predictably maintains a patient in a good position (without movement) as well as muscle relaxation during the procedure. I think the latter is important as we are trying to achieve as much symmetry is possible.

 I would suggest that you select your plastic surgeon carefully; NOT based mainly on the type of anesthesia that he/she will perform their procedure under. Then, communicate your goals carefully as well. During this consultation process, your other questions in regards to type of implants, incisions, size concerns… will be addressed. 

I would suggest starting with the American Society of Plastic Surgery and/or the Aesthetic Society of Plastic Surgery to obtain a list of well experienced board-certified plastic surgeons. Then, I would suggest you visit a few surgeons whose practices concentrate on aesthetic surgery. Ask to SEE lots of examples of their work AND preferably speak/see patients who have had similar procedures done. Be very careful with your decision-making. You will find, while doing your due diligence, that there are many different “specialties” who will offer their services to you; again, I strongly recommend you concentrate on surgeons certified by the American Board of Plastic Surgery.  I hope this, and the attached link/video, helps.  Best wishes. 

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 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.