Awake breast surgery
Awake Breast Augmentation with Lift (Augmentation-Mastopexy) in Ottawa
Augmentation-mastopexy combines an implant for volume with a lift for position, in one operation. In carefully selected patients it can be done awake, with tumescent local anesthesia and sedation.
Breast Augmentation with Lift (Augmentation-Mastopexy) at a glance
| Typical operating time | About 2.5 to 4 hours |
|---|---|
| Awake suitability | Selected patients only |
| Typical return to desk work | Desk work often within 1 to 2 weeks |
| Anesthesia | Local anesthesia with or without sedation. General anesthesia arranged if needed |
| Setting | Outpatient, with an anesthesiologist present throughout |
Times are typical ranges for planning, not promises. Your plan is individualized.
What is breast augmentation with lift (augmentation-mastopexy)?
An implant adds upper-breast fullness while excess skin is removed and the nipple is repositioned. Because both goals are addressed together, planning is more detailed than for either operation alone, and some patients are advised to stage the surgery in two steps.
Who may be a good candidate
- People with drooping breasts who also want more volume or upper fullness
- Those who have lost volume after pregnancy or weight change
- Patients who understand that a touch-up procedure is more common with this combination
Why awake breast augmentation with lift (augmentation-mastopexy) may work
A ten-year series reported augmentation-mastopexy with tumescent local anesthesia and described a safe, effective approach that can avoid a general anesthetic. A separate series described augmentation and augmentation-mastopexy under local anesthesia with intravenous sedation, with patients recovering well. These are single-team experiences, but they show an awake plan is possible when the case is well selected.
When awake may not be the right choice
This is a longer, more complex operation. If it is likely to be lengthy or complicated, or if you have health concerns, general anesthesia or a staged approach may be safer, and we will recommend that.
Your awake breast augmentation with lift (augmentation-mastopexy) journey
1. Before surgery (pre-op)
We decide together whether one stage or two is best, and plan implant size and scar pattern.
- A consultation to review your goals, health history, medications and previous surgeries, and a physical examination
- An anesthesia assessment to decide whether an awake plan is appropriate and safe for you
- Photographs, with your consent, and a written plan, quote and consent form
- Medication guidance, including when to stop blood thinners, certain supplements, and smoking or vaping
- Fasting instructions from the anesthesia team. Follow them exactly
- A ride home and an adult to stay with you after surgery
2. Day of surgery (intra-op)
Local anesthetic is infiltrated into the breast and chest wall, with measured sedation. The implant is placed, the lift is performed, and you may sit up so shape and symmetry can be checked.
- You arrive, change, and meet the surgeon and anesthesiologist, and your markings and plan are confirmed
- An IV and monitors are placed. The anesthesiologist stays with you from start to finish
- Local anesthetic is given. Expect brief stinging, then numbness, and light sedation if planned
- You can listen to music, talk with the team, and tell us at any time if you feel discomfort
- Afterward you rest in recovery, receive written instructions and go home with your driver
3. Recovery (post-op)
You are observed in recovery, given written instructions and pain-control guidance, and scheduled for follow-up. Call us or seek urgent care for fever, spreading redness, severe or worsening pain, heavy bleeding, chest pain, shortness of breath, or leg pain or swelling.
| When | What is typical |
|---|---|
| Days 1 to 3 | Soreness and tightness. A supportive bra is worn. |
| Week 1 | Desk work is possible for many within about 1 to 2 weeks. No heavy lifting. |
| Weeks 2 to 6 | Gradual return to exercise. Swelling and tightness improve. |
| 3 to 12 months | Implants settle and scars mature. Final shape emerges. |
Timelines are general and vary. Your surgeon gives you instructions specific to you.
Anesthesia options
Anesthesia options range from local anesthesia, with or without sedation, to general anesthesia. An anesthesiologist is present throughout your procedure and recommends an approach after reviewing your health, the extent of surgery and your preferences. If an awake approach is not suitable, general anesthesia is arranged. Plans can change during surgery if comfort or safety requires it, including deepening sedation or converting to general anesthesia.
Learn more: anesthesia options, levels of anesthesia, fear of intubation, and pain perception and music.
Alternatives
Staging lift and augmentation separately, a lift alone, an implant alone, fat transfer, or no surgery.
Risks
Higher complication and revision rates than either procedure alone, including wound-healing problems, scarring, asymmetry, implant malposition, capsular contracture, nipple sensation changes, bleeding, infection, and anesthesia-related risks.
Anesthetic risks include reactions to medications, breathing or airway events, the need to deepen sedation or convert to general anesthesia, and, rarely, transfer for further care. All surgery carries risk, and results are not guaranteed.
Frequently asked questions about awake breast augmentation with lift (augmentation-mastopexy)
Do I need a lift or just an implant?
It depends on how much skin excess and nipple descent you have. We assess this in person.
Is one stage safer than two?
Not always. Some patients do better with two stages. We recommend the safer option for your anatomy.
Can this be done awake?
In selected patients, yes. Published series support it, but not every patient is a candidate.
Will I need more surgery later?
A touch-up is more common with this combination. We discuss this openly.
Related procedures
- Awake Breast Lift (Mastopexy)
- Awake Breast Augmentation Over the Muscle
- Awake Combined Breast Procedures (Mix and Match)
Starting from $14,000 (CAD, before 13% HST), including surgeon, anesthesia and facility fees. Your written quote follows your consultation. See pricing and financing.
Explore your options at a consultation
References
- Ziani F, Tettamanzi M, Arrica G, et al. Safe and effective augmentation mastopexy with tumescent local anesthesia: a decade of experience. J Clin Med. 2024;13(20):6057. PMID 39458008
- Colque A, Eisemann ML. Breast augmentation and augmentation-mastopexy with local anesthesia and intravenous sedation. Aesthet Surg J. 2012;32(3):303-307. PMID 22290411
- Ditlev M, Loentoft E, Hölmich LR. Breast augmentation under local anesthesia with intercostal blocks and light sedation. J Plast Surg Hand Surg. 2023;57(1-6):271-278. PMID 35510744