It is your choice. But your safety and your comfort are our foremost concerns. Fat grafting requires a very low amount of anesthesia, not the same depth of anesthesia as flap surgery or any other major operation. Therefore you will be under a very light level of anesthesia and you will be basically breathing on your own. But the anesthesiologists like to maintain control of your airway with a tube so that if you are too sedated to remember to breathe they can give you a couple of breaths. We have excellent Board-Certified anesthesiologists who will evaluate you prior to surgery, explain the anesthesia options, and help you decide. If you are over 40, or if you have any medical condition (such a high blood pressure or diabetes), you will need to get from your doctor at home a medical clearance for anesthesia.