Cosmetic Surgery Under Local Anaesthetic & Sedation

Mr Karri performs many cosmetic surgery procedures under local anaesthetic, with or without intravenous sedation.

Many patients have concerns about general anaesthesia, notably the post-operative nausea, headaches, sore throat and generalised weakness, and would prefer to avoid them. Local anaesthetic with sedation usually causes fewer of these side effects.

What Is Local Anaesthetic?

Local anaesthetics work by temporarily blocking the way your nerves carry pain signals to your brain. After injection into an area, the area quickly becomes numb and surgery may proceed. In some cases, regional anaesthesia may be preferred. This involves injecting local anaesthetic around specific nerves that supply the area to be operated on. Regional anaesthesia, also known as nerve block, is given by the anaesthetist using ultrasound to identify and accurately inject local anaesthetic around the nerves. Only after the area is completely numb will Mr Karri start the surgery. Local anaesthetic prevents pain but you may still feel pressure and movement.

What Is Sedation?

Sedation is a way of using drugs, known as sedatives, to make you feel relaxed and less anxious. Sedation is not a general anaesthetic. However, most people remember little or nothing of the operation. As sedation does not block the nerves in the same way as local anaesthetic, local anaesthetic is given as well. There are different types of sedatives and the one chosen for you depends on the nature of the surgery and your anxiety level. For patients who do not wish to be awake during their surgery, intravenous sedation is used. With deeper intravenous sedation you will be very drowsy, and most people sleep through the operation. It is not a general anaesthetic: you keep breathing on your own, and you wake within a few minutes of the sedation being stopped. Intravenous sedation is widely used and, given by an anaesthetist with proper monitoring, is generally safe.

When sedation is used, a consultant anaesthetist is always present and stays with you throughout. Your blood pressure, heart tracing (ECG), oxygen level and breathing (the carbon dioxide you breathe out) are monitored continuously. You may also receive extra oxygen through a small tube under the nose or a mask.

Who is it suitable for?

Local anaesthetic, with or without sedation, suits many operations on the face, breasts and limbs, and liposuction, including lipoedema liposuction. It is not suitable for everyone. Longer operations on the tummy, such as a tummy tuck or body lift, are done under general anaesthetic. Some medical conditions, for example severe sleep apnoea or some heart and lung conditions, may make general anaesthetic the safer choice. Mr Karri and the anaesthetist will advise you at your consultation and pre-operative assessment.

Before your operation

With local anaesthetic there is no need to fast before surgery.

If you are having sedation, an adult must take you home and stay with you for 24 hours, and you must not drive for 24 hours.

Safety and risks

The dose of local anaesthetic is worked out for your body weight and kept within safe limits. For liposuction, a large volume of very dilute local anaesthetic (tumescent fluid) is used, and the total dose is calculated in the same way.

Risks of local anaesthetic

Allergy to local anaesthetic – very rare

Too much local anaesthetic absorbed (toxicity) – rare; early signs are tingling around the mouth, a metallic taste, ringing in the ears or dizziness, and very rarely fits or heart rhythm problems. This is why doses are limited and you are monitored throughout

Risks of sedation

Slowed breathing – breathing can become slow or shallow, which the anaesthetist watches for and treats straight away

Remembering parts of the operation – with lighter sedation you may remember parts of it; you should not feel pain

Feeling sick or drowsy afterwards

Many facial, breast and body contouring procedures can be done under local anaesthetic with sedation at Kinvara Private Hospital.

Which operations are done under local anaesthetic?

Under local anaesthetic, with or without sedation:

• Liposuction
• Lipoedema liposuction
• Arm lift
• Necklift
• Breast fat grafting
• Facial fat grafting
• Areola reduction
• Earlobe repair
• Prominent ear correction
• Scar revision
• Skin cancer surgery

Under general anaesthetic:

• Tummy tuck
• Body lift
• Thigh lift

Medically reviewed by

Mr Vasu Karri

BSc(Hons), MBBS, MRCS, MSc, FRCS(Plast)
Consultant Plastic Surgeon

Last updated 30th September 2026