Plastic Surgery and Anesthesia: Update

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Plastic surgery has been traditionally performed under general anesthesia. Yet, there has been progression regarding anesthesia and more and more plastic surgery procedures are being performed under alternatives for general anesthesia, depending upon the procedure. Two examples are liposuction and revision breast implant surgery. In fact, there are many less invasive facial approaches available that do not require general anesthesia.

Liposuction and Anesthesia:
Some plastic surgeons may perform liposuction under local anesthesia and sedation. This is more common when only small areas are being treated. When there is more than one procedure being performed at the same time or the procedure is going to require extensive time, general anesthesia is used. Sometimes both general and regional anesthesia is utilized in procedures.

Revision Breast Surgery and Anesthesia:
Revision breast surgery is most commonly performed under general anesthesia. Yet, a select number of plastic surgeons are performing revision breast implant surgery under local anesthesia and sedation. These plastic surgeons feel that reopening the incision, slipping the breast implant out and replacing it with a new one is so simple that the need for general anesthesia is not required. Instead, they perform the breast revision surgery under local anesthesia and sedation.

How Anesthesia Works:

Sedation and Plastic Surgery:
Sedation reaches your entire central nervous system to produce a calming relaxed state. Depending upon the type of sedation and the dosage, the highest level of impact for sedation can be a twilight state whereby your feel semi-conscious and are not completely aware that the procedure is being performed. Sedation for plastic surgery may be administered in one or more forms. Sedation may be oral, inhalation, or intra-venous.

Local Anesthesia and Plastic Surgery: 
Local anesthesia used in plastic surgery is often lidocaine. Local anesthesia may be injected into the surgical site prior to the procedure and may be contained in a cannula for liposuction. There are topical anesthetics which are applied to the skin as well.  Local anesthesia numbs the treatment area or the duration of the procedure and a short time thereafter.

General Anesthesia and Plastic Surgery:
General anesthesia produces unconsciousness and is used for most plastic surgery procedures. The effects of general anesthesia last longer. When compared with a local anesthesia and sedation, these two modalities allow for a person to recover more quickly on the day of the procedure. Local anesthesia and sedation are also associated with less risk than general anesthesia. Though, plastic surgeons take great precautions to avoid risks from general anesthesia prior to, during and after surgery. They usually employ board certified anesthesiologists to administer general anesthesia and their facilities are certified by The Joint Commission on Accreditation of Healthcare Organizations or by the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF).

Risks Associated with Local Anesthesia and Sedation:
One risk that may be associated with local anesthesia and sedation is that the patient will feel restless during the procedure. For example, children receiving plastic surgery are most likely to undergo general anesthesia in any procedure because they might try to move around during the procedure. The combination of medications used must be carefully explores to avoid interaction with another drug, over the counter product or natural healing remedy that you may be taking. It’s also important to note that just because the procedure is being performed under local anesthesia and sedation does not mean that it is not necessary to be in facility that is fully accredited by The Joint Commission on Accreditation of Healthcare Organizations or by the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF).




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