Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Fully Awake Breast Reduction

Filson, Simon A., M.B.B.S.; Yarhi, Danielle, M.D.; Ramon, Yitzhak, M.D.

Plastic and Reconstructive Surgery: November 2016 - Volume 138 - Issue 5 - p 978-983
doi: 10.1097/PRS.0000000000002720
Breast: Ideas and Innovations
Editor's Pick
Watch Video
Journal Club

Summary: The authors present 25 cases and an in-depth 4-minute video of fully awake aesthetic breast reduction, which was made possible by thoracic epidural anesthesia. There are obvious and important advantages to this technique. Not only does this allow for intraoperative patient cooperation (i.e., patient self-positioning and opinion for comparison of breasts), meaning a shorter and more efficient intraoperative time, there also is a reduction in postoperative pain, complications, recovery, and discharge times. The authors have also enjoyed great success and no complications with this technique in over 150 awake abdominoplasty/total body lift patients. The authors feel that the elimination of the need for general anesthesia by thoracic epidural sensorial–only anesthesia is a highly effective and efficient technique, with very few disadvantages/complications, providing advantages to both patients and surgeons.


This and Related “Classic” Articles Appear on Prsjournal.Com for Journal Club Discussions.

Haifa, Israel

From the Department of Plastic Surgery, Elisha Hospital.

Received for publication October 19, 2015; accepted June 23, 2016.

Presented in part at the International Society of Aesthetic Plastic Surgery Symposium, in Buenos Aires, Argentina, October 24 through 25, 2013.

Disclosure:The authors have no financial interest to declare in relation to the content of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the text; simply type the URL address into any Web browser to access this content. Clickable links to the material are provided in the HTML text of this article on the Journal’s Web site (

A “Hot Topic Video” by Editor-in-Chief Rod J. Rohrich, M.D., accompanies this article. Go to and click on “Plastic Surgery Hot Topics” in the “Videos” tab to watch. On the iPad, tap on the Hot Topics icon.

Dr. Filson, 20 Harakefet Street, Atlit, Israel,

Copyright © 2016 by the American Society of Plastic Surgeons