Can a breast lift be performed under local anesthesia without being put completely 'under'?

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  In my practice, in order to optimize safety and give you the best results, I perform breast lifts under general anesthesia with a board-certified MD anesthesiologist.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

It really depends on the type of lift required to rejuvenate the breast.  If a patient has a pretty youthful looking breast, but the nipple and areola are a bit low, then a periareolar mastopexy could be potentially performed under just local anesthesia.  For other types of breast lifts, such as a vertical (lollipop) or Wise pattern (anchor) mastopexy, additional IV sedation or general anesthesia would be required.  With these lifts, skin is removed and the gland is "rearranged" to address the loose skin envelope and ptotic breast shape.  It really is a matter of body size and the extent of dissection.  There is a limit to the amount of local anesthesia that can be given as a function of body weight.  If the amount of dissection needed would necessitate a large volume of local anesthesia thereby risking toxicity (which includes cardiac rhythm problems) then the operative procedure requires some other form of anesthesia.    Know that some procedures can be performed with IV sedation, and a general anesthesia is not always necessary.  Hope this is helpful.  Consider a consultation with a Board Certified Plastic Surgeon with considerable experience with breast surgery.