Please confirm that an ethics committee approval has been applied for or granted: Not relevant

Background and Aims In 2013 the lead author started carrying out breast augmentation under local anaesthetic with sedation on a day case basis in a stand-alone ambulatory surgical centre. Subsequently a total of 7 surgeons have carried out breast enlargement at the clinic using this technique. A retrospective review of the first 1019 patients was performed.

Methods Inclusion criteria for breast enlargement under LA with sedation was ASA 1 or 2 and BMI less than 32. The procedure was carried out using local anaesthetic infiltration with anaesthetist delivered conscious sedation using a combination of propofol and fentanyl and no airway management. Standard breast enlargement precautions were undertaken. Patients were contacted though Survey Monkey survey to determine satisfaction with the procedure.

Results Average age of the patients was 32.7 years. 686 patients (67.3%) had had children. 897 patients (88%) were ASA 1. None were ASA 3. 132 patients (13.0%) were smokers. Average implant size was 380cc, 327 (32%) being anatomical and 692 (68%) round. 91 patients(8.9%) had submammary implants, the rest dual plane.In t Ierms of complications 32 patients had infections which generated a positive microbiology culture. These were mostly stitch abscesses, however, 9 patients had implants removed, washed and replaced. Subsequently 2 of these implants required removal and replacement some months later and a further 2 presented with capsular contracture years later.

Conclusions Primary breast augmentation under local anaesthetic with sedation is a viable alternative to general anaesthesia. We found complication rates were low in comparison to studies quoting complication rates for general anaesthetic breast augmentation,