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

Although most surgeons prefer general anesthesia I have done over 500 abdominoplasties under sedation.  Effective local anesthesia is the key.  There are advantages including virtually eliminating the risk of deep vein thrombosis (blood clots).  Make sure your surgeon has experience.  It is entirely possible to effectively anesthetize the muscle and tighten the muscle sheath.

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.  

Properly maintained sedation is a positive experience. You can have a tummy tuck them in this manner. I prefer general anesthesia  for the muscle relaxation. Every practitioner has his preference

   I have used general anesthesia for all tummy tucks.Kenneth Hughes, MDLos Angeles, CA................

Dear tonysmome,       Is your surgeon a board certified plastic surgeon ? Does your surgeon perform his surgeries in an accredited surgery center, which is level C facility or a hospital ? For best result and comfort , you should have your tummy tuck done under general endotracheal anesthesia in an accredited surgery center for your safety. I am recommending it to you after being in practice for 27 years and having done tummy tuck on over 1,000 patients. It might be cheaper at first to do it under local anesthesia with sedation in a non accredited facility, but if you will need revision surgery due to suboptimal result , the cost will escalate significantly. So, do your due diligence and check the before and after pictures, to make sure that they are numerous, consistent and you like them. Check also the reviews for positive patients experience.                 Best of luck,                                    Dr Widder

I agree that for most routine cosmetic abdominoplasty procedures the use of a certified operating room and general anesthesia is certainly the standard procedure.  Most anesthesiologists I have spoken with agree with this. Other sedation techniques requested by patients may actually increase the risk of anesthesia. As a board certified plastic surgeon I am held to higher standard then many other cosmetic surgeons. This of course is a great thing because my goal is for maximum patient safety. Good Luck!

Your physician's choice for anesthesia falls below the standard of care for abdominoplasty surgery.  I agree with my colleagues and recommend that you avoid this type of care.  Make sure your physician is Board Certified by the AMERICAN BOARD OF PLASTIC SURGERY.  

Although a lot of things "can be done" doesn't mean they "should be done". This is a case in point.The other surgeons both said do not proceed and I wholeheartedly agree. Let me tell you why:1. There is no medical reason that I can think of as to why local with sedation is better here than either general anesthesia or an epidural. With sedation, you will get more sedation and narcotic pain medicine which lasts in the body longer than if you are given an inhalational anesthetic (general anesthesia) which is eliminated fairly quickly from your body. Also, if your surgeon is having difficulty making your abdomen numb, there are limits to how much numbing medicine you can receive before the blood levels become toxic. If you require a lot of sedation, the amount you receive will be limited by the fact that your breathing and ability to protect your airway will be impaired if you receive too much sedation and then the anesthesiologist (your surgeon isn't foolish enough to give the sedation himself, is he/she?) will have to put you to sleep anyway!2. I agree, local anesthesia is not the best way to proceed if you are plicating (tightening) the abdominal muscles, either.3. This is a big operation and although some do it without general anesthesia, I feel that in my opinion this is a suboptimal way to proceed. It is harder on the surgeon not to have you asleep or with an epidural, and the only reason I can think of that some surgeons do it is to save money so as not to pay an anesthesiologist. An anesthesiologist will monitor your state of hydration and make sure you have receive enough intravenous fluid so that your blood pressure doesn't go dangerously too low (or too high!). Safety matters above all else and I do not believe that this is a safe way way to proceed. Without the services of an anesthesiologist or at the minimum, a nurse anesthetist, I would consider this to be quite dangerous!

Over
the past 20 years, I’ve performed tummy tuck (abdominoplasty) under general
anesthesia on all of my patients who have done well and had a great
experience. The procedure can range from
1-1/2 to 3 hours and it is more comfortable for patients to be under a general
anesthesia.