Tummy tuck under local anesthesia

You won’t find many references on the Internet on tummy tucks done under local anesthesia. So, there may even be professional interest in the fact that I have undergone this kind of operation under local anesthesia myself, and report my experience on this website.

I am afraid of anesthesia awareness. No, I don’t think that the risk of waking up when undergoing a medical operation under anesthesia is very high. It’s just that waking up prematurely would be such a horror.

I think that many people who undergo medical operations are not sufficiently aware of what happens when they receive full anesthesia.

Full anesthesia is a combination of two rather independent processes. The one is to knock out a patient’s consciousness. This means that he doesn’t remember the pain he experiences. It doesn’t mean that he or she would not feel the pain.

People on the operating table for whom just their consciousness was knocked out will still react on pain stimuli. It’s just that they won’t remember it from one moment to the next one. Because they still react on pain stimuli, people who undergo medical operations with just their consciousness knocked out need to be tied to the operating table, otherwise their rather violent reactions upon being cut with surgical knives would make them hit and kick around.

For operating physicians, this could be a major disturbance. So, patients who undergo medical operations receive not just drugs that knock out their consciousness, but also a muscle relaxant, such as the South American arrow poison Curare.

Receiving a muscle relaxant systemically means, a anesthetized person can do nothing for which a body’s muscle would be needed: he cannot move his limbs, and not even breath on his own, which is why he must be connected to an artificial breathing device, with a hose entered through his throat and trachea, through which air is pumped into his lungs.

For a person who is undergoing an operation under full anesthesia, the two medications he receives (the one knocking out his consciousness, and the muscle relaxant) work on completely separate pathways. You could, for example, give a patient a muscle relaxant, insert the artificial breathing devices, and conduct a ten-hour long open heart surgery on him. The person would be perfectly quiet, not move a limb.

And he would be fully conscious throughout the procedure, feeling the full pain of every cut, and hearing anything the operating physician and his team say and utter.

He would also go crazy.

Very few people in such a horror scenario live through it to tell others what has happened. Usually, they end up as zombies in psychiatric institutions.

Of course, anesthetists try to avoid it from happening unintentionally. But it does happen. After all, when a person is under the influence of a systemic muscle relaxant, he cannot say anything. He cannot move a finger, and not even an eyelash. Without a single muscle under his control, a patient that has received a muscle relaxant has no way to communicate to a physician or anybody around him that he is not properly sedated (knocked out of his consciousness).

Maybe I am paranoid. But I am also sensible. Anesthesia awareness does happen. Search for it through Google. Some people for whom it happened just for a short time during a surgical operation have managed to not become zombies and tell the world what gruesome experience they have had in a hospital operating room.

I like to be alive, but even more than that, I want to die in peace, without having been tortured, intentionally or unintentionally. This is why I am not prepared to undergo surgical procedures under full anesthesia.

And definitely not for something as unnecessary as a tummy tuck. I have enough personal discipline to reduce my weight to an almost ideal level just through dieting, and this is what I have done in my life more than once.

However, some body areas seem to be just immune against dieting, such as, on a man, his ‘love handles’, the fat deposits on his waist, above the belt line.

Tummy tucks can be beautifully effective in removing these fat deposits, much more effective than liposuction, though, of course, there will be a scar.

I have such a scar, from the removal of the love handle on my right, all the way through the frontal abdomen, to where I had my love handle removed on the left.

Of course, the scar is not attractive when I am fully naked. But I reckon that for me, when the scar is visible to a woman I love, our relationship has proceeded to a stage where it won’t matter any longer.

On the other hand, as long as I am dressed, I do derive a competitive edge from having a youthful figure, without love handles, especially when I emphasize this youthful figure by wearing tight T-shirts.

I underwent the tummy tuck at the Yanhee Hospital in Bangkok, where I have also undergone a facelift under local anesthesia, with both operations performed by Dr. Pramote, whom I recommend.

A facelift under local anesthesia has been a comfortable experience. The tummy tuck was less comfortable, as there are limits to the amount of lidocaine that can be used for local anesthesia without having a negative systemic impact. But then, I found some superficial pain around the abdomen more bearable than superficial pain around the head.

And I am definite in my decision not to undergo cosmetic surgery under full anesthesia and run the risk of anesthesia awareness because of a lapse of attention on the part of an anesthetist, or the malfunctioning of some hospital equipment.


1 Antonio Aldo Mottura, Local anesthesia for abdominoplasty, liposuction, and combined operations, Aesthetic Plastic Surgery June 1993, Volume 17, Issue 2, pp 117-124

2 Bozola, A. R. M.D.; Psillakis, J. M. M.D., Abdominoplasty: A New Concept and Classification for Treatment, Plastic & Reconstructive Surgery: December 1988

3 Rosenberg, Michael H. MD; Palaia, David A. MD; Bonanno, Philip C. MD, Abdominoplasty With Procedural Sedation and Analgesia, Annals of Plastic Surgery: May 2001 – Volume 46 – Issue 5 – pp 485-487

4 Nguyen, Thuan T. MD; Kim, K. Alex MD; Young, Rodney B. MD, Tumescent Mini Abdominoplasty, Annals of Plastic Surgery: March 1997