I had a Pannulectomy (major tummy tuck & muscle repair) in July 2006 while we were stationed in South Korea. There were some bad dog ears on both sides, plus a golf ball size lump left of my belly button. I am having a revision done, and I was wondering if it is normal to do that under local anesthesia? It seems scary. He said he has to go 6 inches farther on the right and 5 inches farther on the left, so basically nearly all the way around to my spine. They said they do them all under local.
Revision Pannulectomy Under Local Anesthesia?
Doctor Answers 6
Revision panniculectomy rarely done under local anesthesia
Panniculectomy is an effective procedure to remove the excess overhanging skin of the abdomen. This is usually not performed with a muscle repair. Patients who receive this procedure are prone to have additional sacking of the skin and may need a revision at a later date. If the revision is limited to the skin, or a scar repair, this may be done under local anesthesia. However, if deeper layers of the abdomen need to be accessed, this should be done in a surgery center under regional or general anesthesia.
Although local anesthesia may be more convenient, please always keep your health and well being first.
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Revision panniculectomy under local anesthesia
Revision panniculectomy is a relatively common procedure, most often done to address dog ears, as in your situation. It is well within reason to address such a revision under a local anesthetic. The procedure itself is essentially pain-free, quick, and requires nothing more than a local anesthetic in most cases. If you are apprehensive, I would relay the concerns to your plastic surgeon so that she/he can formulate a plan to make your experience as pleasurable and stress-free as possible.
Best of luck!
Thanks for the question -
The dog-ears can likely be corrected with local anesthesia. I would be concerned about the lump to the left of your belly button. This could be a hernia (especially if you have had gastric bypass surgery or other abdominal procedures prior to your first panniculectomy).
If you have a hernia then correcting this should be done under general anesthesia. You don't mention correcting this lump in your description. If its just the dog ears then local may be ok.
I hope this helps.
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Revisional Surgery is Not Uncommon Following Panniculectomy
It’s not unusual for patients who undergo abdominal panniculectomy to require revisional surgery. This surgery may be necessary for a variety of reasons. These include wound healing problems, additional weight loss, and the effects of gravity.
Lumps, bumps, and dog ears are not uncommon following abdominal panniculectomies and often require revisional surgery. Depending on their causation, size, and location many of these contour irregularities can be treated under local anesthesia.
In your case, it appears that large bilateral dog ears are present, as well as a golf ball sized mass in your mid abdomen. Correction of the dog ears will require localized dissection of the lateral incision areas and could be performed under local anesthesia. Unfortunately, exploration of your mid abdominal lesion will require opening a large portion of your abdominal wound. Although this could be performed under local anesthesia, it would probably be a more comfortable experience under general anesthesia.
Pain tolerance varies from patient to patient. For this reason, it’s important to discuss your anesthetic options with your plastic surgeon. Your surgeon should be able to determine which option is best for you.
Pannic reviiosn under local?
Revison of dag ears can be done under local anesthesia. Hernis should be done under gen anesthesia
Dog ear revision
A simple dog ear revision can be done under local. If on the other hand a formal lower body lift along the flanks and back are being performed, I would recommend general anesthesia or at least sedation.