How painful is a tummy tuck under tumescent (local) anesthesia with IV sedation?

Hello and thank you for your question. While it is possible
to do a tummy tuck under local anesthesia, I don't consider it a good idea.
General anesthesia is the standard practice for most Board Certified Plastic
Surgeons. It allows for the best pain control and comfort of the patient, and
allows the surgeon to focus on the operation at hand. With a Board Certified
Anesthesiologist administering and monitoring your anesthesia, your risks for
complications are low. Talk about this in depth with the surgeon you've
selected. If you can communicate clearly to them why you are concerned about a
general anesthesia approach, they can explain to you what your best options
are. Best of luck.

Although in abdominoplasty could be performed with sedation and local I think this is a needless exercise. General anesthesia will shorten the operation significantly and allow the surgeon more freedom in giving you better result.

It is important to understand that IV sedation can result in varying depths of anesthesia ranging from very light to what is essentially general anesthesia without control of your airway.  In performing a procedure with IV sedation and local anesthesia, the main goal of the IV sedation should be to keep you calm and comfortable while the local anesthesia is being administered.  Once the local has been injected and has been given time to work, it should be responsible for your pain control during surgery.   You should speak with your doctor and anesthesiologist regarding these issues.