Let’s talk anaesthesia: is local only for small gynecomastia cases?

Local anaesthesia is my preferred and often first option for the majority of gynecomastia cases.

It can be a common misconception that local anaesthesia is only for small gyno cases. The choice of anaesthesia is not only about size of surgery but rather a mix of patient preference, case selection and the experience of the surgical team.

For example, during my training outside the NHS, we routinely did breast surgery, facelifts, tummy tucks and 360 lipo under tumescent anaesthesia (a dilute local solution), which I still use for all grades of gyno and body contouring. With proper dosing, monitoring and counselling, quite a lot can be done safely without full GA, which has its own benefits and drawbacks.

Some patients have asked about NHS using general anaesthesia for big cases. NHS is different: big ops usually default to GA and there’s very little pure cosmetic surgery exposure/training, so many UK doctors simply haven’t seen many aesthetic cases done under tumescent/local as majority of the training is heavy on reconstructive work and big cases requiring GA.

That said, local anaesthesia isn’t the right fit for every patient. Factors such as personal preference, gyno grade, and op time all play a role. But local definitely isn’t only for “tiny” cases.

I recommend always discussing the anaesthesia choice with your surgeon, looking at the pros and cons and raising any concerns you have about pain, duration, comfort and recovery of the surgical procedure.

Ask Dr Nurein Questions on Reddit here.

If you are considering gynecomastia treatment and have questions, contact our team and book a free gynecomastia consultation with Dr Nurein here.