There is no benefit to having such an extensive procedure while you are awake. In fact, it would be more dangerous and less controlled. The anesthesiologist is there to protect your airway and monitor your vital signs, and titrate the anesthesia to just the right level allow the...
For the patients that are already on pain medicine, we ask that they continue their baseline levels. The supplemental narcotics helps with the surgical pain. It is often best to have the pain management specialist managing the narcotics.
Surgical assistants are helpers to the Surgeon. They are not qualified as Surgeons and hence cannot practice as Surgeons. Letting a non surgeon misrepresent/ falsely represent himself as a Surgeon would be considered against the law in all countries.