Breast aug: Local anesthesia vs general anesthesia?

A doctor from real self says to ask the surgeon I'm consulting with if they use local or general anesthesia, he said local.. Is it common to use local? Is it really that bad? I really like this doctor but I'm afraid about the local anesthesia. Also, he has a cosmetic and breast surgery certification.. I didn't see his American board of plastic surgery certificate. Red flag?

Doctor Answers 21


Yes this is a red flag. You should consult with a board certified plastic surgeon. You should also have your surgery done under general anesthesia by an accredited facility by an anesthesiologist. 


Toronto Plastic Surgeon
4.9 out of 5 stars 469 reviews

General Anesthesia by a Board-Certified Anesthesiologist

Thank you for your question.  Yes, I would have to agree with my colleges that this is a red flag.  Your surgeon does not appear to be certified by the American Board of Plastic Surgery.  I also agree that for the best result you should have your surgery done under general anesthesia in an accredited facility by a board certified plastic surgeon.  

Best of luck,

Dr. Peter Newen

Peter Newen, MD
Orange County Plastic Surgeon
4.4 out of 5 stars 31 reviews

Red flag

Breast augmentation should be performed by a plastic surgeon certified by the American Board of Plastic Surgery.  It does not sound like your "surgeon" is a trained plastic surgeon.  There are some Board Certified plastic surgeons who do perform breast augmentation under local anesthesia only, however, I don't think this is as safe as general anesthesia.  I also inject local anesthesia during the operation to help with pain after surgery.  

David S. Chang, MD
San Francisco Plastic Surgeon
5.0 out of 5 stars 4 reviews

General Anesthesia by a Board-Certified Anesthesiologist

Breast #augmentation with #breast implants is performed under general anesthesia by a board-certified anesthesiologist. Also, our procedures are performed at one of our preferred outpatient surgery centers which are accredited, meeting the highest standard of patient safety and care.

Your procedure should be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Breast Augmentation - Local vs General?

Thank you for your question. This is a big red flag!! The surgeon is clearly not certified by the American Board of Plastic Surgery. The best way to ensure a successful outcome is to have the surgery performed under general anesthesia in an accredited facility by a properly trained, board certified plastic surgeon. 
I would not have this surgery performed under local with a surgeon not properly trained to perform it.

Steven J. Rottman, MD, FACS
Baltimore Plastic Surgeon
4.9 out of 5 stars 81 reviews

Breast augmentation under local

i agree that breast augmentionn is best performed under general anesthesia to insure perfect placement of the implant.  Revision surgery is always more difficult and it is best to take every possible measure to insure the best possible result.  Concerning board certification the Bay Area has many qualified board certified surgeons to chose from. 

Steven K. Struck, MD
San Francisco Plastic Surgeon
4.9 out of 5 stars 37 reviews

Local Anesthesia for breast aug

I never use local. I most always place the implant under the muscle for a more natural look.  This is very difficult under local. I do not recommend.

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 76 reviews

Breast augmentation under local anesthesia?

Thinking in terms of both safety and quality of surgical outcome I would strongly recommend that you consider being operated upon by a board-certified plastic surgeon under general anesthesia. Undergoing surgery at a certified operating facility with a board-certified plastic surgeon provides the greatest assurance of your safety and satisfaction in my opinion.
Regards and best wishes.

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
ABC-TV Extreme Makeover Plastic Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

Local Anesthesia

The red flag is your surgeon not being Board Certified.  I would definitely take time to either ask the office or do research to see if that is true.
In general, I do not recommend breast augmentation surgery with just local anesthesia.  I am afraid that the only reason your doctor is performing it that way, is that they are not a surgeon and hence don't have priviledges at a surgery center.
Please due your due diligence before undergoing your surgery.

Khashayar Mohebali, MD, FACS
Bay Area Plastic Surgeon
4.9 out of 5 stars 11 reviews

Breast Augmentation: Local vs General?

Bright Red Flags! The surgeon you are consulting with is dodging the question. They are not certified by the American Board of Plastic Surgery and so they are trying seduce you with substandard qualifications. It just is not possible to become an expert at something by attending a weekend course. This frequently goes hand in hand with the practice of doing breast augmentation under local anesthesia. Physicians who are not truly certified by the American Board of Plastic Surgery cannot get privileges to perform plastic surgery at a hospital or surgery center, consequently they try to do the operation in substandard facilities with "local" anesthesia. This is a problem for you because it leads to compromises in the quality of surgery, and while  "local" anesthesia may sound appealing, it is actually more dangerous in an unqualified facility.

There is no shift away from doing breast augmentation under general anesthesia which is much more comfortable for the patient and is certainly safer when done in a fully certified outpatient surgical facility with anesthesia being performed by a board certified anesthesiologist. When performed under general anesthesia there are no problems of awareness with the procedure and patients wake up quickly afterwards. Injection of large amounts of local anesthesia will distort the tissues and compromises the surgeons ability to accurately dissect the implant pocket and appropriately position the implant. Although the local anesthetic will numb the tissues, the patient still requires intravenous sedation so that they are not wide awake during the procedure. If the surgeon is conducting the sedation while at the same time doing the surgery, their attention is divided between two different complex tasks and they are unable to do either one well. If the patient becomes uncomfortable during procedure then additional sedation is required which will cause suppression of breathing and can lead to cardiac arrest. It is far safer to be asleep under general anesthesia with a certified anesthesiologist monitoring your care. 

Under general anesthesia, once the surgical portion is completed local anesthetic is then injected precisely where needed so that the patient wakes up pain free. Rapid Recovery is standard procedure and patients quickly return to everyday activities. The risk of problems like blood clots is almost non-existent for this procedure when proper OR protocols like leg compression devices are followed. All patients are different and post operative pain medications are provided to ensure that each patient has comfortable recovery. 

Braden C. Stridde, MD
Kirkland Plastic Surgeon
4.8 out of 5 stars 53 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.