Mastopexy under local anesthesia: A case series and systematic review

ABSTRACT Background: Mastopexies are most frequently executed under general anesthesia. Local anesthesia (LA) on the breast tissue could make it possible to perform this type of operation without the need for (intravenous [IV]) sedation. This case series analyzes the procedure, operative pain scores, and postoperative outcomes of mastopexies performed under LA. The aim of this articles is to determine the feasibility of a mastopexy procedure under LA without the need for IV sedation. Methods: All patients, who underwent a mastopexy under LA, were retrospectively contacted and asked to fill in a questionnaire after informed consent. A systematic review was performed to identify all research available on this procedure. Results: A total of 51 patients, with an average age of 40.7 years, filled in the questionnaire. The mean Numeric Rating Scale (NRS) scores during the operation ranged from 3.47 (first intradermal injections) to 3.05 (subcutaneous injections) to 1.07 during the operation itself. Forty-five patients confirmed they would undergo the operation under LA again. Six patients did not want to undergo the same operation under LA anymore. Four patients had minor postoperative complications. Articles on mastopexy under LA without any type of IV sedation could not be found. Conclusions: This case series illustrates that mastopexies can be safely performed under LA. The peroperative and postoperative pain scores were low and patient satisfaction was high. This first-ever case series on mastopexy under LA without sedation shows promising results, which need to be confirmed in future studies. Level of Evidence: Level IV, case series.