There is no easy "right" answer here that fits every patient. The right amount of anesthesia is enough to keep you comfortable which depends on many factors. Much of it depends on your pain threshold and your level of anticipated anxiety about the procedure. If you have a good pain threshold and think that you can relax on Valium and other oral sedatives, than local anesthesia should be sufficient to control your discomfort. If you think you have a low pain threshold or will be very anxious the day of surgery, then IV sedation will probably suit your better.

I'm sure your experienced and board-certified plastic surgeon will do a great job under local or IV (or general) sedation.

Good luck!

Gilad Segev