Tummy tuck without general anesthesia is of questionable benefit
The key to cosmetic surgery is safety, with a pleasant experience and smooth recovery. Certainly, general anesthesia is a risk factor, though a very small one.
Tummy tuck surgery can be done with a sedation technique depending on local blocks to the nerves along the side or flank, and using the same solution as in liposuction to numb the skin of the abdomen.
The process is published and proven, though the benefits over a general anesthesia are not.
It remains an alternative for those who wish it, and surgeons with the patience to work carefully under the local blocks. A general anesthesia, however, can shorten the time it takes to complete the tummy tuck, and most important, can make the experience very pleasant and worry free.
You need not fear the anesthesia, just confirm that the quality and accreditation of the Center you choose is up to standards. (Peter E. Johnson, MD, Chicago Plastic Surgeon)
Doing a tummy tuck awake is below standard of care in my opinion. It is a surgery that requires relaxation of the muscles and the patient asleep to do correctly. You would not want open heart surgery awake or your appendix removed awake.
So don’t cut corners when it comes to your health and safety. (Andrew T. Cohen, MD, Beverly Hills Plastic Surgeon)
Tummy tuck under Local Anesthesia
Tummy tuck under a local anesthesia, with or or without IV sedation, is a compromise. It is very difficult to obtain adequate muscle tightening, which is a fundamental part of the operation.
It is not any safer than when performed under a general anesthetic and may require very high doses of local anesthetic. To get the best tummy tuck results possible, I believe, requires a general anesthetic. (Robert M. Jensen, MD, Medford Plastic Surgeon)
I would not recommend an abdominoplasty awake for a few reasons, although this can be done. First, it would require a large amount of local anesthesia to adequately anesthetize the area, which may be dangerous. Second, because most tummy tucks tighten the muscle, muscle relaxation is important.
And finally, because of the length of the operation and the risk of aspiration, it is good to have an anesthesiologist there. I do think a mini tummy tuck can be done under local if only skin is excised. It is a much smaller area and limited to the skin. (Kari L. Colen, MD, New York Plastic Surgeon)
Anesthesia for Abdominoplasty
Yes, one can do an abdominoplasty under local (or regional) anesthesia. The question is, why would you consider it? Local anesthesia would significantly increase the time it takes to do the surgery and, thus, the cost of the OR. It also will make the surgery significantly harder, and it may be very difficult to get as good a result.
Additionally, it is no safer than well administered general anesthesia and the recovery is longer. When the gas used with general anesthesia is turned off, you breathe out the residual and are awake. When local is used, because of the magnitude of the procedure, sedation is used to keep the parts of you not anesthetized comfortable.
After surgery it takes you up to 36 hours or more to metabolize these drugs, during which time you can continue to be nauseated and feel bad. I switched to general anesthesia even on breast augmentation a number of years ago. After doing so, recovery is now in hours instead of days. (Robert T. Buchanan, MD, Highlands Plastic Surgeon)