A question about local anesthesia

[ddrop]

Hello!  I'm about to do my gynecomasti surgery,but there's just one thing: i wouldn't like it to be done under general anesthesia. My surgeon recommends general and he told me  that local anesthesia is really painful.  Is this really true? Is there someone there who did the surgery (in my case lipo) under local so you could share your experience?

[KryptoKnight]

Well the needle they use to inject the local is quite painful TBH, I was not expecting it. 

I still think doing local was much better because I got to leave right after, and it's generally much safer.

After the injections, you obviously don't feel a thing. 

Oh and it's also cheaper.

[ddrop]

Thanks,a very helpful answer! Can you just tell me how painful the needle is? Could you compare it to something? And how long does this pain last?
Cause the doctor got me scarred shitless. Obviously he'll makemore money if he does general...but still i'd like to know what other people really experienced!

[KryptoKnight]

Hmmm it's tough, I don't want to scare you either but imagine a needle digging deep into your skin multiple times.  Like I said I did not expect this, I just shut my eyes and controlled my breathing. 

I mean local is just a needle that needs to go deep enough to inject the anesthesia to the entire breast.  It's not a needle that stays at the surface since that will obviously do no good.  Most people do general for the reason of not wanting to be awake, but that wasn't bad at all.

If you still plan to do it, I recommend brining some music and even while awake, the surgery goes by in a flash. 

Like I said, it's going to be hard to find feedback on local since most everyone does it general. 

Is the pain bearable? Yes, but I'm not going to lie to you, it does sting.

[ddrop]

Is it worse than a bad stomack ache?  I figure if the pain doesn't last long it isn't at all unbearable? How long did it take for them to inject it and for the pain to wear off?


oh and by the way,mine is lipo only. which one did you have?

[KryptoKnight]

I had excision only since I don't really have much fat at all on my chest.

It's not a prolonged pain at all, just instant pain then goes away.  Like I mentioned, when he's injecting the needle is where the pain is.  Obviously once the local starts to set in the pain goes away.  It's the first few he injects that hurt the most since there's not numbness.

[ddrop]

Ohh then it doesn't sound that bad. I guess it's pretty much the same for lipo!

[KryptoKnight]

Ohh then it doesn't sound that bad. I guess it's pretty much the same for lipo!

Well assuming you didn't have any anasthesia when you were doing lipo, then lipo would probably be worse. 

What I'm saying is that it's not pain free, that is all. 

[ddrop]

So the doctor's motivation for scarring the shit out of me was probably money?

[KryptoKnight]

Yeah probs, it costs more money for general, but some of it obviously has to go the anesthesiologist. 

[DrBermant]

Hello!  I'm about to do my gynecomasti surgery,but there's just one thing: i wouldn't like it to be done under general anesthesia. My surgeon recommends general and he told me  that local anesthesia is really painful.  Is this really true? Is there someone there who did the surgery (in my case lipo) under local so you could share your experience?

I prefer local anesthesia alone for anatomic nipple reduction as seen with this patient with long nipples. For almost all other gynecomastia surgery, local anesthesia with sedation provides a safer much more comfortable method.  When 2 stages are needed, as with this problem of puffy nipples and long nipples together, I perform the first stage with local sedation, and the second with local alone.  For my upper body lift surgery, when I have to operate all around the chest - front / back, I need Light General Anesthesia.  This is still my Tumescent Technique, but adds the safety of airway protection while the patient is in the prone position.

You can find an extensive individual patients' experience with comfort and my Tumescent Technique Anesthesia for gynecomastia here.

If you prefer direct links to each of those discussions:


anesthesia and comfort in gynecomastia patient from California

anesthesia and comfort after revision gynecomastia surgery in patient from Hong Kong China

comfort and anesthesia in physician's son with gynecomastia

comfort and anesthesia in gynecomastia patient from Florida

comfort and anesthesia in gynecomastia patient from Illinois

comfort and anesthesia with gynecomastia patient from Texas

comfort after gynecomastia surgery with patient from Colorado

comparing comfort and anesthesia of my revision surgery with prior gynecomastia surgery in Florida

comfort and anesthesia in patient 4 hours from Richmond with gynecomastia

parent of teenage patient with gynecomastia commenting about comfort after surgery

comfort after gynecomastia revision surgery on patient from UK

comparing comfort of my revision surgery to prior gynecomastia surgery done in NY

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture