Cosmetic Surgery and Sedation Techniques

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Myrna, a senior citizen in Illinois, wanted to look younger. She turned to Dr. Thomas Mustoe —a board certified plastic surgeon and member of the American Board of Plastic Surgeons— for a brow and jowl adjustment. While undergoing the procedure, she was conscious enough to carry on a conversation with the surgeon. How was that possible?

Mustoe and his staff used conscious sedation on Myrna. Conscious sedation involves administering a local anesthetic to kill the pain and a special sedative to keep the patient from remembering.

“She's saying ‘Ouch', but she won't remember (that),” explained Mustoe.

According to him, using general anesthesia during a facelift carries a risk of a blood clot to the lung. “By doing a patient with conscious sedation, we eliminate that risk, essentially,” Mustoe said.

Types of Anesthesia

The primary function of anesthesia is to prevent pain. There are four types of anesthesia that plastic and cosmetic surgeons use:

  • Local anesthesia —to prevent pain in a specific area. The patient is awake and aware of their surroundings. The anesthesia is given by ointment, spray or injection.
  • Sedation —given through the vein (intravenously) and could be used with other types of anesthesia. There are multiple forms of this sedation including the “twilight” sedation or conscious sedation, which is a mid-level form of sedation. It produces effects similar to general anesthesia, but the patient is awake, sleepy and may not know the procedure is going on.
  • Regional anesthesia —is a block such as a spinal block administered to a surrounding nerve that produces pain signals. This anesthesia has a similar effect to sedation and can be used in conjunction with sedation.
  • General anesthesia —used for extensive medical purposes. The patient will be asleep and not aware of anything going on. These drugs are inhaled or injected into a vein.

Conscious Sedation in Plastic Surgery

Dr. Mustoe reports using conscious sedation in up to 99% of his procedures and his partner, Dr. Fine, in 70% of his cases. Why do they utilize this method of sedation more then others?

Conscious sedation turns a stressful situation into a pleasant one and allows some procedures that would have required general anesthesia in a hospital setting to be done at a day-patient facility.

This method of sedation is suitable for virtually all cosmetic surgery procedures. The goal of the anesthesiologist and your plastic surgeon is to produce a restful state of mind for the patient, to make the operation comfortable and control pain. It has advantages over general anesthesia. These advantages include:

  • No hangover feeling after the procedure—recovery time with normal activity resuming approximately 12 hours after the operation
  • Pain relief both during and after the procedure and minimal post operative nausea and/or vomiting
  • Huge cost savings—can be done as an outpatient service making the fees less
  • Fewer side effects
  • Safer—The patient's levels of consciousness, lung and heart functions are monitored. Also, computer controlled infusing pumps increase the accuracy and patients have complete control over breathing and communication is possible. If secretions accumulate in your throat, patients can swallow on their own.
  • Eliminates overnight care

Considering Conscious Sedation for Plastic Surgery

Make your decision to use conscious sedation an informative and practical decision. Get all the facts about risks and benefits from your board certified plastic surgeon, check out the facility that you will be going to, and acquaint yourself with the staff that will be tending to your case.

Conscious sedation can be used for liposuction , facial surgeries, breast surgeries and abdominoplasty, but make sure you are a wise consumer.

After her operation, Dr. Mustoe asked Myrna how she was doing and she responded groggily, “It's just wonderful,” and she did recover nicely.

(Article by: Donna Corrado)

To locate a board certified plastic surgeon near you, please contact us today.


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