Is a breast lift safe and advisable under local anesthetic if the surgeon checks out to be a reputable?

Mastopexies (breast lifts) can be performed under local anesthetic. I will occasionally perform a small (circumareolar) breast lift under local anesthesia, but any substantial breast lift would probably be better with sedation or general anesthesia. If you have more than 3cm of droop, you are probably not a candidate for a circumareolar lift. Also, the implants you are considering will likely further exacerbate your existing droop... things to think about.Best of luck.

Great question!  A breast lift is a big surgery and should be done under general anesthesia.  Most patients who undergo larger surgeries like this under local anesthesia tend to have bad experiences, specifically pain control.  When you're in pain, your blood pressure rises and makes it difficult for the surgeon to control your bleeding and/or have a clear space to perform your surgery.  In the end it may not cut too much cost because it will definitely take much longer to do and facility fees are significantly higher than anesthesia fees.Best of luck and hope this information helps!
- Dr. Roger Tsai  
Board Certified Plastic Surgeon

625 cc implants weigh 1 ½ lb each.  If you need a lift now, adding the weight of another 1 ½ lbs each will require even a greater lift later.  A significant lift of that magnitude could not be done under local anesthesia.  I do not recommend attempting to do the breast augmentation first and then attempt to do a lift under local.  Unfortunately, you have not provided photographs or told us your bra size.  However, a better technique for would be The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained.  At the same time or later, fat transfers can be performed if additional volume is desired.  Implants are not lifetime devices and half are removed by 9.5 years.  Fat transfers are permanent and incorporated into the body.Best Wishes,Gary Horndeski, M.D.

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  I would recommend considering having a breast lift with implant as one surgery under genera anesthesia administered by a board-certified MD anesthesiologist.  An appropriately performed breast lift should not be done under local anesthesia in my opinion.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   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.  

Best wishes and good luck.


Richard G. Reish, M.D.  FACS

Harvard-trained plastic surgeon
 

Thank you for sharing your excellent question.  For most patients, a breast lift is performed under general anesthesia in an outpatient surgical setting.  This allows the surgeon to be more efficient and the patient more comfortable.  Discuss your concerns with your surgeon.

Thank you for your question. You will find that there are a variety of different types of anesthesia that can be utilized during tummy tuck surgery. 

I  personally perform breast augmentation/lifitng surgery in an out patient surgery center, and under general anesthesia administered by Board Certified Anesthesiologists.  I believe that this type of anesthesia provides for a comfortable/safe/immobile environment to  perform the relatively "extensive" procedure. Personally, I feel most comfortable having the anesthesiologist have full control of the patient's airway, thereby avoiding many of the potentially serious complications that may arise around the time of surgery.Make sure that you prioritize safety, not "cutting costs", as you make your decisions.
I hope this helps.

It is perfectly acceptable to perform a breast lift and augmentation either together or as 2 separate procedures. A breast lift theoretically could be done under local anesthesia but I think it would be difficult for both the surgeon and patient. I personally would not do it that way despite the cost savings. One issue that has not been addressed is implant size even though you didn't ask. If you have significant breast sagging, you presumably have stretched out the supporting structures of the breast tissue. A 625cc implant is quite large and therefore quite heavy. You should be concerned that the weight of such a large implant will cause the breasts to sag again, and it may happen sooner rather than later.