Shannon, I was completely out under general anestesia. I wasn't presented with any other options, but that doesn't mean there aren't any. Put it on your list of questions for interviewing doctors and see what you can find out.
I have a funny story for you about implants and general anesthesia. I spent a long, long time figuring out what size I wanted to be with implants because I didn't want to be too big or obvious -- I just wanted to look normal. DH and I looked at before and after photos together and we both generally liked the befores rather than the afters --

-- so I really wasn't after big boobs.
So my doctor had a pretty good idea of the look that I wanted -- around a 36B. He selected a range of implant sizes to take into the OR with him and while I was asleep, he tried the different sizes on me to see which actually looked the best and the most like what I was seeking. I ended up with 240cc implants, which are almost the smallest size made and I still ended up as a 36C, but a natural looking one (I think!)
The OR nurse told me that as my doctor tried the sizes on me, they sat me up (still fast asleep), and everyone in the OR got to offer their opinion about the size being tried on. Of course, my doctor had the final say, but I still get a giggle about the OR voting on my boobs.

I'm totally satisfied with the size I ended up as, so they did a good job!