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

Question

It seems as though most surgeons I've consulted with perform breast lifts (no implants) under general anesthesia. Is a breast lift a procedure that can be performed under local anesthesia, and if so, why do most doctors choose to do general? Is the outcome limited if you just do local anesthesia with a breast lift, or can you get the same results either way?

Daniel A. Medalie, MD · Answer

HI,Some breast lifts can be performed under local. The most common type in this category is a peri-areolar lift which only involves incisions around the areola. This is a less powerful lift but can be useful in certain patients who ask for areolar reduction and a small lift. Vertical and full breast lifts typically are better performed in an operating room environment with the patient asleep. This insures that the patient does not feel pain and gets the best possible results. I hope this helps.All my best,Daniel A. Medalie, MD

Kenneth Hughes, MD · Answer

Although I would not do this under local, the surface area of the breasts and the amount of skin resection as well as patient tolerance would all be important.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Christopher V. Pelletiere, MD · Answer

Depending on the extent of the lift needed, you may be able to have it done with a combination of sedation and local anesthesia.  I do many surgeries this way.  The reason some surgeons do not is that they simply never learned how to do it and so rely on general anesthesia for everything.  the risks are less under sedation and the recovery is certainly easier as well. The best thing to do is to go for a few consultations with board certified plastic surgeons and see what they recommend.  I hope this helps.

Richard G. Reish, MD, FACS · Answer

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

Larry Lickstein, MD · Answer

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.

Karol A. Gutowski, MD, FACS · Answer

Yes, in selected patients, a breast lift can be done with a local anesthetic. However, it depends on the surgeon and the patient's own breasts.

Steven Wallach, MD · Answer

I do not perform breast lifts under straight local. Patients are  best to be give deep sedation or general in my opinion.

Paul Loewenstein (retired) · Answer

It really depends on the extensiveness of the lift.  It would be possible to perform most lifts under local with IV sedation. You don't have to go out completely, but if you have an anesthesiologist administer the sedation and monitor your vital signs and EKG and oxygen level, etc, you should have no recollection of the operation and should be comfortable throughout.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  In my experience a breast lift requires general anesthesia for optimal pain control.  The breast lift requires extensive dissection on the chest wall and breast and would be nearly impossible to anesthetize all of the areas involved with local anesthesia.

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

Answers (9)

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