Thank you for your question.
Most plastic surgeons would perform your surgery under full anesthesia or MAC. That being said, it is not mandatory. One issue might be some discomfort in removing the implant capsule and scar tissue off the chest wall. This can cause pain. Another issue. This surgery may take 1 and 1/2 to 2 or 3 hours. That is a long time to lay there awake being cut on.
- Check to make sure that your plastic surgeon is a board certified plastic surgeon by the American Board of Plastic Surgery, Inc.
- Make certain that the facility you are having the procedure is a licensed and accredited surgical facility. AAAASF, JAHCO and state certified are common certifying entities.
To be sure, see two or more board certified plastic surgeons for a consultation to make sure you are a good candidate and that it is safe for you to have surgery.
I hope this helps.
First question that comes to my mind, is when did you have these implants placed? Because in the USA you have to be 22 to receive silicone implants, and I don't even know anyone who does double-lumens anymore. Secondly, it would be much wiser to have the implants removed, allow the healing to take place, at least 6-8 months, and then get the lift. Doing them in one sitting will definitely increase your chance of complications.
I would suspect, based on your question, that you have an understanding that most plastic surgeons would not recommend having the procedures you are considering done, performed under local anesthesia. I would not offer you this as an option. I believe that most patients undergoing extensive breast surgery, benefit from the use of anesthesia for many reasons; comfort, immobility, maintaining symmetry... For these reasons, I prefer the use of general anesthesia for most procedures (except for uncomplicated breast implant removal), provided by experienced board-certified anesthesiologists in a fully accredited surgery center. Ultimately, it is each individual patient's responsibility to select their plastic surgeon carefully; doing so, in my opinion, is the most important decision the patient makes when it comes to achieving the desired outcome in a safe and complication free fashion as possible. You may find the attached link, dedicated to breast implant removal concerns, helpful to you. Best wishes.
While some explants can be performed under local anesthesia alone, I would almost recommend that the procedures you're planning to have done - removal of subglandular implants with a simultaneous lift - be done under local anesthesia with sedation or general anesthesia. These procedures can take a while (several hours) and for both your comfort and the surgeon's ability to do whatever needs to be done (including adjustments of the lift, control of bleeding, etc) I would advise more anesthesia than just local alone. It might be okay to plan to start this under local as long as you're in a situation and facility that would allow conversion to any deeper forms of anesthesia that are necessary or desirable.
I hope that this helps and good luck,
Dr. Alan Engler
Member of RealSelf100