You are really asking several questions at once. First, is local anesthesia sufficient for fat transfer breast augmentation? The answer is that fat harvesting and implanting can be done using only local anesthesia. However, patient comfort is important, as is monitoring the patient for safety. The safest situation is one in which the surgeon performs the procedure and an anesthesia provider monitors the patient. Once you have monitoring, you can have straight local, local with IV sedation or general anesthesia. All of these are safe if you are healthy and adequately monitored. If your surgeon is not able to provide monitoring, or is trying to save you money by avoiding an anesthesia provider, you should ask if it is worth the risk to you to have surgery in this way. I perform small fat transfers in my office under local anesthesia, but for breast augmentation, patients do best in a monitored environment. The next question you are asking is what is the best way to get a good result from fat transfer to the breast? The data is clear that fat transfer alone to the breast without preparing the breast is not generally satisfactory. In order for fat to survive, it is important to create a site that will allow the fat to live. With the breast, the use of the Brava system has been shown to enhance results. This process takes some time prior to surgery to maximize your result. Even in the best of cases, as much as one third of the fat can be reabsorbed in the first 6 months. A surgeon certified by the American Board of Plastic Surgery can help you understand your options and results and help you decide what is best for you.
