Wide-Awake Hand Surgery
Carpal tunnel, cubital tunnel, and trigger finger release — and simple acute tendon repairs — done in the office under local anesthesia only. Lower risk, easy recovery, and transparent self-pay value with no facility or anesthesia fees.
Wide-awake hand surgery is hand surgery performed under local anesthesia alone — no general anesthesia and no IV sedation. Dr. Levesque performs common hand procedures right in our Austin office, which removes anesthesia risk, shortens recovery, and eliminates facility and anesthesia fees. We offer this as a transparent, value-based cash-pay service.
Please note: our wide-awake hand surgery is currently offered as a self-pay (cash-pay) service, and we are not accepting new insurance patients for hand surgery at this time. Because we perform the procedure in-office under local anesthesia, there is no facility fee and no anesthesia fee — often making the self-pay cost a fraction of what the same procedure runs at a surgery center.
Wide-Awake Hand Surgery, Done in the Office
“Wide-awake” hand surgery — also called WALANT (wide awake, local anesthesia, no tourniquet) — lets many routine hand procedures be done safely and comfortably with just local anesthetic. You stay fully awake and relaxed, the area is numbed with a slow, gentle injection, and the surgery proceeds using the same sterile technique we’d use in a hospital.
Dr. Levesque developed his comfort with wide-awake hand surgery during his plastic surgery training, where hand surgery is a core part of the specialty, and refined it further after a visiting professorship from Dr. Donald Lalonde — the surgeon who pioneered and popularized the modern wide-awake approach. That foundation is why he offers these procedures confidently in the office today.
Because there’s no general anesthesia or sedation, you can typically get up and walk out when you’re done — no grogginess, no nausea, and depending on the procedure, you may even be able to drive yourself home.
- Carpal tunnel release
- Cubital tunnel release
- Trigger finger release
- Simple acute tendon repairs (within ~2 weeks of injury)
Offered as a value-based self-pay service with no facility or anesthesia fees. We are not accepting new insurance patients for hand surgery at this time.
Safer, Simpler, and Better Value
Removing general anesthesia and sedation from a routine hand procedure changes the experience in three important ways:
- Lower risk: without general or IV anesthesia, the risks of airway problems, heart or lung complications, and blood clots effectively drop to near zero — especially valuable for older patients or those with conditions like high blood pressure, diabetes, or COPD.
- Easier recovery: no anesthesia hangover, no nausea, and a faster return to your day.
- Better value: a surgery-center case carries a surgeon fee plus facility and anesthesia fees. In our office, there’s only the surgeon’s fee — frequently one-third to one-half the total cost.
We inject a dilute solution of lidocaine and epinephrine slowly, so most patients only feel the fine needle at the very start. We then wait for the epinephrine to constrict the small blood vessels — which controls bleeding without a tourniquet — before beginning. You can read or check your phone while it takes effect.
What to Expect
✓ Medically reviewed by Dr. Andre Y. Levesque, MD · Board-certified plastic surgeon (ABPS) · Last reviewed February 28, 2026
Consultation
Dr. Levesque examines your hand, confirms the diagnosis, and reviews whether an in-office wide-awake procedure is right for you, along with a clear, up-front self-pay price.
Your Procedure
Performed in our sterile office procedure room under local anesthesia only. Most procedures take well under an hour, and you stay awake and comfortable throughout.
Recovery
A soft dressing or splint is applied, and you walk out on your own. We provide clear aftercare instructions and follow-up, with most patients back to light activity quickly.
Is It Right for You?
Wide-awake, in-office hand surgery is a good fit if you:
- Have a condition we treat — carpal tunnel, cubital tunnel, trigger finger, or a simple acute tendon injury (ideally within about two weeks)
- Prefer to avoid general anesthesia and sedation
- Are a self-pay patient looking for transparent, value-based pricing
- Want a quick, in-office experience with an easy recovery
This service is currently self-pay only; we are not accepting new insurance patients for hand surgery. Because the procedure is done in-office under local anesthesia, there is no facility or anesthesia fee — you receive one clear surgeon’s fee, quoted up front. More complex cases that need a surgery-center setting can be referred appropriately.
Frequently asked questions
Do you take insurance for hand surgery?
My wide-awake hand surgery is currently offered as self-pay (cash-pay), and I'm not accepting new insurance patients for hand surgery at this time. Because I do it in-office under local anesthesia, there's no facility fee and no anesthesia fee — just one transparent surgeon's fee, quoted up front.
Which procedures can be done wide awake?
I offer carpal tunnel release, cubital tunnel release, trigger finger release, and simple acute tendon repairs (ideally within about two weeks of the injury) under local anesthesia in the office. More complex cases I'll refer to a surgery-center setting.
Does wide-awake hand surgery hurt?
Most patients only feel the fine needle at the very start. I inject a dilute lidocaine-and-epinephrine solution slowly to numb the area, then wait for it to fully take effect before I begin, so the procedure itself is comfortable.
Is it safe to skip general anesthesia?
Yes — skipping general anesthesia and sedation removes the associated airway, heart, lung, and clot risks, which is especially valuable if you're older or have medical conditions. I use the same sterile technique as a hospital.
How much does it cost?
My pricing is value-based and quoted up front. Because there's no facility or anesthesia fee, the total is often one-third to one-half of what the same procedure costs at a surgery center.
Can I drive myself home?
Because there's no sedation, many patients can drive themselves home after a wide-awake hand procedure — it depends on the specific surgery and which hand I treated.
Frequently Asked Questions
Considering
hand surgery?
Request a consultation to confirm you’re a candidate for an in-office, wide-awake procedure and get a clear, up-front self-pay price.
Request a Consultation