Should I request general anesthesia for my mastopexy instead of local anesthesia?

Thank you for your question.
Different surgeons tend to have their own personal preferences with regard to the choice of anesthetic for surgical procedures. However, the vast majority of plastic surgeons would normally perform the surgical procedure of mastopexy/uplift under general anesthetic. In selected cases it is possible to perform this kind of procedure under twilight and, when appropriate, I have done it.
However, it depends on the surgical plan, expected operating time and,
to a certain extent, patient's preferences.

I would advise you to contact your surgeon and maybe ask him to speak to some of his previous patients who had the same procedure under local anesthetic under his care?

All the best.
Andrea Marando
Plastic and Cosmetic Surgeon
Manchester and London, UK

While some surgeons prefer local anesthesia for smaller or less invasive procedures, a breast lift, especially if combined with other body contouring surgeries, is generally performed under general anesthesia to ensure your comfort and safety. It is completely valid to request general anesthesia, especially if you feel that local anesthesia may not provide the necessary comfort and safety for such a comprehensive procedure.
Some surgeons do perform breast lifts under local anesthesia, particularly if the procedure is less invasive (e.g., a small lift or just a minimal reduction). Local anesthesia alone can be uncomfortable for extended surgeries or multiple procedures, whereas general anesthesia ensures you're fully relaxed and unconscious throughout the operation. For more extensive lifts, general anesthesia is typically preferred for both patient and surgeon comfort.
Your surgeon should be open to discussing the anesthesia options and may provide additional insights based on their experience.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

If you are a DDD, then you would do better with a breast reduction, otherwise, you may sag again. If you are worried, then ask for general anesthesia. This will be easier on your surgeon as well.