Possible to Have a Second Breast Reduction Under Local Anesthetic?

Question

I'm from UK and wanting a second breast reduction to go down a good couple of cup sizes and to have neatening up of the aerolas done at the same time.

	Is it possible to have a reduction performed under a local anaesthetic? I'm just very anxious of undergoing a general anaethetic but really want the procedure doing. In certain circumstances is this possible?

Tom J. Pousti, MD · Answer

Thank you for the question.

	Although your concerns about generalized anesthesia are common,  it would be in your best interest to have the procedure performed under general anesthesia.

	Your surgeon will want to ensure your comfort and safety  during the procedure;  this is best done if the  anesthesia is provided by a experienced anesthesiologist,  allows the surgeon to concentrate on his task.

	Best wishes.

Steven Wallach, MD · Answer

I have never performed a breast reduction under straight local, I think that it would be too uncomfortable for the patient and would not allow me to do my best work. I have done minor scar revisions under local which is very well tolerated.

Robin T.W. Yuan, MD · Answer

It is possible to use some sedation and then anesthetize the breast with local as we do with liposuction. It has to be done careful so as not to cause cardiotoxicity with the lidocaine. You should also be prepared to use general anesthesia if the local is not working sufficiently.

	Robin T.W. Yuan, M.D.

Alan M. Engler, MD, FACS (retired) · Answer

Hi anon9450,

	You know, this sounds like a really bad idea...

	I don't think it's wise to undergo this degree of surgery using local anesthesia alone.  While I've done many procedures under local (such as scar revisions and excisions of moles, etc) and routinely perform breast reductions under local anesthesia with intravenous sedation or general anesthesia, I don't think that a breast reduction under local alone is advisable.  There's just too much surgery (ie, cutting), risk of bleeding, too large an area to work on and, finally, most likely too much anxiety for you even if you could get reasonably good numbness (anesthesia!) of the surgical site.

	I would not want to do or encourage that.

	Sorry, but I hope that this helps, and good luck,

	Dr. E

H. Michael Roark, MD (retired) · Answer

If you need to be reduced "a good couple of cup sizes', local will be difficult for you and the surgeon. Local is very effective, but at times the coverage can be spotty. Have a talk with the Anesthesiologist. Your fear will be alleviated. Your safety and comfort is our greatest concern.

Possible to Have a Second Breast Reduction Under Local Anesthetic?

Answers (5)