Limiting your anesthesia may limit your results.
When discussing your anesthesia options with your plastic surgeon, be sure to let them know of your concerns and ask them if local or limited anesthesia will allow them to work on your muscles, perform an adequate dissection and give you the results that you are looking for.
When looking at plastic surgeons, always check their credentials and make sure that they have hospital privileges as a plastic surgeon. In our community we have seen many patients who were told that the procedures could/should be done under local in the office simply because the doctor was not actually a plastic surgeon and was not allowed to operate in the hospital.
You may be better served in using a board certified anesthesiologist to carefully administer the anesthesia, allowing a board certified plastic surgeon only focus on the tummy tuck, and rest safely and comfortably. (Pat Pazmino, MD, Miami Plastic Surgeon)
Tummy tuck under local anesthesia
While performing a tummy tuck may be “doable” under local I would not advise it. I think that you would be much more comfortable under deep sedation or general to accomplish your goals. (Steven Wallach, MD, Manhattan Plastic Surgeon)
Small amount of skin removal can be perfomed under local anesthesia
A small amount of skin removal in the lower abdomen can be done under local anesthesia. But a full abdominoplasty can be done with local anesthesia and deep sedation. We do that routinely. (Samir Shureih, MD, Baltimore Plastic Surgeon)
Maybe under a spinal, but not a full tummy tuck
Hello, This really depends upon how much work you need done. The best results will probably be obtained under general anesthesia. Lesser surgery like a mini tummy tuck might be do-able under a spinal. I like the results pretty tight, so I do them pretty much all under a general. Doing your surgery under a less than a general anesthetic could be painful. (John P. Di Saia, MD)
It sounds as though you need a properly done tummy tuck under local anesthesia
This is a real operation, not just a procedure, and generally is done with the patient asleep, preferably with a physician anesthesiologist. On some occasions though, it can be done under epidural anesthesia. If it is a tight, flat stomach you want, nothing compares to a tummy tuck! (Richard P. Rand, MD, FACS, Seattle Plastic Surgeon)
Don’t be afraid of local anesthesia.
It is very misleading today because of very aggressive advertising by physicians that are NOT plastic surgeons that always seem to throw in the phrase “and you can avoid the risks of general anesthesia”. General anesthesia IS safe if administered by someone with the proper training and credentials.
Other procedures that are sometimes performed under local anesthesia (ie SmartLipo) do not address the looseness of the muscle and may not be aggressive enough depending on how much loose skin you have. (I’m being honest here, because I happen to be a fan of SmartLipo). (Richard H. Fryer, MD, Salt Lake City Plastic Surgeon)
Tummy tuck and local anesthesia
A very common request is to have procedures performed under local anesthesia to avoid the fear of “going under.” Unfortunately, what many people don’t realize is that the amount of local anesthesia required to properly numb a large area such as the abdomen can be unsafe.
Lidocaine is the most common anesthetic used for local procedures, and excessive amounts can cause cardiac depression (known as lidocaine toxicity).
Although tumescent (as used in liposuction) can allow for larger doses of anesthesia over larger areas, this is in part due to the presumed removal of the lidocaine during liposuction. If the surgery is simply removing a roll of skin along a C-section scar, that is not really an abdominoplasty.
A traditional abdominoplasty involves tightening of the underlying musculature in addition to the contouring of the fat and skin of the abdomen. This procedure may take up to 3 hours or more to perform.
For your comfort and safety, I would recommend having this type of procedure under general anesthesia or a very deep sedation in an accredited facility.
If you have concerns about general anesthesia, I recommend asking to meet with the anesthesiologist several days prior to your procedure so that you may express your concerns and have a clearer understanding of what it really means to “go under.” (David Bogue, MD, Boca Raton Plastic Surgeon)
Ideal anesthesia choice for a tummy tuck
Ideally, a full tummy tuck should be done under general anesthesia. One of the concerns after a tummy tuck is to avoid clots in the legs. If the surgeon is skilled and experienced, than the length of the operation is shortened even if all the necessary deep correction is done, thus reducing likelihoods of getting clots in the legs.
In my practice in some patients we do perform a full tummy tuck under local anesthesia with sedation. If properly planned and performed, a full deep correction can be performed with this technique. It takes experience and extra effort to do this. (Boris M. Ackerman, MD, Newport Beach Plastic Surgeon)
“Gas-Less” Tummy Tuck
Abdominoplasty or “Tummy Tuck” is a general term but covers many different procedures. There is the partial tummy tuck, where the belly button is not cut and you only have a small tummy tuck incision above the private area, to an extended tummy tuck, where the a very extensive overhaul of the belly occurs.
Of course, there are procedures in between that combine liposuction. The degree of anesthesia depends on the operating surgeon’s comfort level and the patient’s comfort level. Ultimately, safety must be number one!! General anesthesia is the gold standard, but alternatives are always a possibility.
First, choose a surgeon certified by the American Board of Plastic Surgery. Second, consult with your surgeon about his or her experience with varying degrees of anesthesia. If the tummy tuck indication is closer to mini, then it is very possible to perform the procedure under local with a sedative, assuming the patient is very healthy and a good anesthesia candidate.
If the issue is truly only skin excess, which I have seen many times before, the tummy tuck procedure could even be performed under local only, in a motivated patient.
As any good general surgeon knows, even groin hernia repair can be performed under local anesthesia safely and effectively in the right patient, by the right surgeon! The bottom line: there are many choices to consider before making a decision on the subject of abdominoplasty! (Julius W. Few, MD, Chicago Plastic Surgeon)
Tummy tuck procedure: general, local or twilight anesthesia?
The most traditional way to perform the tummy tuck procedure is under general anesthesia. Tummy tuck procedure can be performed under local anesthesia, but is usually not recommended.
There are reports of using a twilight anesthesia, but it is usually not utilized when the muscle needs to be tightened (which is most likely your case because of your pregnancy). If you are young and healthy without any heart problems, the risk involved in using general anesthesia is very low.
There aren’t any other surgeries that will provide as good of results as a tummy tuck. Thermage will tighten your skin, but will not provide as noticeable improvements as a tummy tuck. (Usha Rajagopal, MD, San Francisco Plastic Surgeon)