During the surgery, you will get the anesthesia that best helps you to be pain-free, as well as help you to stay still during your procedure.
This means that general anesthesia, or sedation anesthesia is usually the best option for procedures like a breast augmentation, tummy tuck, and liposuction.
Normally, local anesthesia is not used unless the procedure is smaller and more limited.
A small scar revision or mole removal is a good example for local anesthesia.
Certain procedures require more surgery time, which therefore requires more anesthesia.
Especially procedures that require muscle stretching or skin rearrangement, will require more anesthesia.
Generally, doctors prefer to have a board certified MD anesthesiologist monitoring you and giving you anesthesia, and not a nurse, or the plastic surgeon himself.
Recently, there have been a significant amount of articles written about the many concerns of ineffective surgery and anesthesia.
It seems that you can save some money with non-general anesthesia delivered by someone who is not a MD anesthesiologist, but the problem is that the patient may feel more pain during and after the procedure.
Personally, the most important thing is patient safety.
It is better to be seen by your family physician, cleared by your family doctor for surgery, and then undergo anesthesia by another doctor monitoring you through the entire surgical case.
Although it may cost more, your health will be in better hands while you sleep.
Also, is the cost actually that much higher? Theoretically, a plastic surgeon could give the anesthesia himself for some plastic surgery procedures, and eliminate the cost of an anesthesiologist.
However, it will take longer for the doctor to do that particular surgical case, so any cost savings you get from no anesthesiologists fee may be eaten up by the increase operating room time.
Finally, as you are probably aware, even light sedation anesthesia may lower your heart rate, your blood pressure, and your breathing ability.
In small amounts, this can be tolerated, but if you feel anxious or pain during your procedure, you may need even more sedation.
If you have an underlying medical condition, then having more anesthesia may hurt your overall health.
The small added cost of getting a pre-surgical check-up with your family doctor, getting anesthesia from a board-certified MD anesthesiologist, and having your plastic surgery procedure in a fully accredited facility, is the safest way to go for the patient.