Can breast augmentation be done with local anesthesia
Can Breast Augmentation Be Done with Local Anesthesia?
Breast augmentation is one of the most popular cosmetic procedures. It’s not always possible, however, to get breast implants with local anesthesia. Here’s why:
Local anesthesia only affects the area where it is injected. In order for it to be effective in blocking pain during breast augmentation surgery, it must be injected directly into each breast and also into each armpit (to block pain from liposuction). Local anesthesia may be used along with general anesthesia, which will take care of the rest of your body during the procedure. In this post, we review the following: Can breast augmentation be done with local anesthesia, how much does awake breast augmentation cost, how long are you under anesthesia for breast augmentation, and can you get breast implants without general anesthesia.
Most breast augmentation procedures are performed under twilight anesthesia, which sedates the patient, but does not render them completely unconscious. The patient generally does not remember what has taken place.
Colorado Plastic Surgery Center does offer another option for Denver breast augmentation patients. While it is not for all, breast augmentation under local anesthesia is a great option for those who have a very small body structure or who are uncomfortable or nervous about being placed under twilight anesthesia and its potential side effects.
If a patient opts to use local anesthesia for her breast augmentation, she will receive doses of strong pain medication before Denver plastic surgeon Dr. Slenkovich administers a series of local anesthesia injections until the area is numb.
The main difference between having breast augmentation under local anesthesia versus twilight anesthesia is the patient if fully awake and talking to Dr. Slenkovich and the operating room staff during the procedure. Recovery time is also much shorter because the patient does not have to regain consciousness after surgery.
Breast augmentation under local anesthesia is very safe and Dr. Slenkovich has a high success rate. But in the rare case that he cannot make the patient comfortable and at ease, twilight anesthesia can be used.
Here Dr. Slenkovich discusses breast augmentation under local anesthesia with a patient, Suzanne, before she goes into the operating room. Suzanne was uneasy about the lack of control she might feel while being under twilight anesthesia, so she opted to use local anesthesia.
what type of anesthesia is used for breast augmentation
Anesthesia used in Breast Augmentation Surgery
Dr. Lenny, as he is known to his patients, has been featured in multiple publications both locally and abroad. He has been heavily sought after for his skill and experience within the plastic surgery field along with the reputation of being one of the best breast augmentation surgeons in the world.
Anesthesia used in Breast Augmentation Surgery
There are many types of anesthesia that can be used for breast augmentation surgery. The one you receive depends on the type of surgery, the facility where it is being performed, your general health and your surgeon’s preferences.
Your personal risk profile depends on the type of anesthesia used, your overall health and how you respond to the chosen anesthetics anesthesia does have some risk attached involved, but fortunately, major side effects and complications are very rare. Anesthesia should be administered by an anesthesiologist or by a nurse-anesthetist. These professionals are specifically trained to administer this medication. The categories of anesthesia used for breast augmentation are:
- General anesthesia. You are completely unconscious.
- Local anesthesia. The specific location that needs surgery is numb.
- Sedation anesthesia (conscious sedation). Your level of consciousness is altered.
- IV Sedation is complete unconsciousness.
how much does awake breast augmentation cost
The media is once again spinning with stories about “Awake Breast Augmentation”. For better or worse, some surgeons in my opinion, are using the media and internet to increase their market share by pushing the limits on safety, while losing site of the long term results of breast augmentation.
There are at least two very important concerns with regard to “Awake Breast Augmentation.” The first issue is patient safety. The advertised procedures certainly sound like a bargain. One patient was quoted to have saved almost $3000. The savings most likely come from the nonattendance of a board certified Anesthesiologist, or procedures that are not performed in an accredited surgical facility. Breast augmentation is a surgical procedure. There are risks associated with bleeding, infection, and damage to surrounding structures. In addition, this procedure adds the risk of overdosage of local anesthetics, a very real potential risk if the surgery is performed while the patient is awake.
Second, at issue is the question of the long term outcomes of “Awake Breast Augmentation” and the possible prevention of avoidable complications and revision procedures. Most patients have only a vague understanding of the short and long term risks that may be a direct result of selecting an implant that is oversized. There are guidelines that have been developed with respect to implant sizing based on quantitative measurements and the characteristics of the patient’s tissues that have been demonstrated to reduce breast implant complications such as malposition, visibility and palpability of implants, and stretch deformities. Oversized breast implants are a leading driver of revision breast implant surgeries.
The thought that a patient in the Operating Room, looking in a mirror, while anxious and certainly in some discomfort, can make an educated, well informed decision with respect to size is irrational.
The real ethical debate, in my opinion, is whether a physician has a responsibility to look out for the patient’s best interest. Does the surgeon wish to avoid increased surgical risks to the patient and limit creating potentially uncorrectable deformities due to oversized breast implants, or are they merely concerned with the short term goal of attracting new patients and the media?
(These opinions are based on the authors 18 years of experience as a breast augmentation surgeon, her publications on “Patient Education in Breast Augmentation”, as well as the peer reviewed literature.)
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Dr. Glicksman In The Media
Dr. Glicksman is one of the founding members of the Plastic Surgery Channel and is a frequent contributor, serving on their Medical Advisory Board. Frequently asked to contribute to the health section of magazines like Allure, she also contributes educational content to many courses, textbooks, and peer-reviewed journals, including filming at WebMD studios in New York City.
how long are you under anesthesia for breast augmentation
Any surgical procedure can be nerve-wracking for a patient, whether it’s a minor surgery or more involved such as breast augmentation.
Plastic surgeons typically rely on two options for anesthetizing their patients — general anesthesia, or a combination of IV sedation “twilight” and a local anesthetic.
At Emmett Plastic Surgery, we prefer twilight anesthesia with a local anesthetic. We use it for all of our operating room procedures.
Twilight anesthesia has numerous benefits to help our patients reduce their anxiety, lower their blood pressure. We want to make the surgery go by quickly without having any memories created during the surgery.
If you’re curious about your breast augmentation anesthesia options, continue reading about general anesthesia and twilight anesthesia, and their applications.
Anesthesia — General or Twilight + Local Anesthesia?
The two most common types of anesthesia used for breast augmentation and enhancement procedures are either general anesthesia or a combination of an IV sedation paired with a local anesthetic. It places a patient in a twilight state.
Both of these options place patients into a comfortable, pain-free state. The surgeon is able perform breast enhancement without causing any physical or mental trauma.
Once the surgery is completed, anesthesia will wear off, and the patient will regain their senses. You’ll then begin the recovery process.
However, each of these breast augmentation anesthesia options creates a different surgery experience that you should be aware of.
Let’s examine the differences between these two anesthesia types.
General Anesthesia
General anesthesia is the most commonly used type of anesthesia used by plastic surgeons.
Medications are injected via an IV sedation that quickly places the patient in a pain-free, unconscious state.
Because general anesthesia essentially temporarily paralyzes a patient from moving or feeling pain, a breathing tube will need to be placed in the trachea. The patient will need to breathe on a ventilator throughout the procedure.
While general anesthesia is a popular option by many plastic surgeons, there are many undesirable side effects, which can include:
For these reasons, Emmett Plastic Surgery does not use general anesthesia for any of our procedures.
“Twilight” Sedation (IV Sedation + Local Anesthesia)
Twilight sedation is a combination of IV sedation plus local anesthesia. This puts patients into a relaxed, pain-free, yet still conscious state.
There are numerous advantages over using twilight sedation over general anesthesia:
At Emmett Plastic Surgery, every procedure performed in our sterile operating rooms uses IV “twilight” sedation. We continually monitor our patient’s health throughout the procedure.
What Is “Awake Breast Augmentation”?
Awake breast augmentation means just what it sounds like — the patient is awake during their procedure and can talk to their surgeon if they need to.
At Emmett Plastic Surgery, all of our breast enhancement procedures are “Awake Breast Augmentations.”
We inject intravenous sedation that puts our patients into a relaxed, groggy, and semi-conscious state. Then we inject a lidocaine numbing solution into the breast area.
Don’t be concerned about being partially awake during the procedure, patients are heavily medicated and have no awareness of what’s happening. Patients will be medicated enough so they don’t feel pain, but can still breathe on their own.
Awake Breast Augmentation – Big Questions
Twilight sedation is designed to specifically reduce anxiety and put you into a relaxed state where you’re not aware of your surroundings.
When your surgery is over, you’ll have no recollection at all during your time in the operating room, and can begin recovery right away compared to general anesthesia, which has a lingering, hangover effect that takes days to get rid of.
Let’s answer some of the bigger questions you may have associated with awake breast augmentation:
Will I Be Completely Asleep?
Patients who receive a combination of IV sedation and local anesthesia will not be fully asleep but will be in a “twilight” stage, which is somewhere between being conscious and unconscious.
Twilight sedation is preferred at Emmett Plastic Surgery because it gives us greater control over the amount of medication our patients receive and can reduce nasty side effects associated with general anesthesia (nausea, vomiting, pain from incision sites).
Most patients under twilight sedation will feel very drowsy, and will not remember their surgery.
Will I Feel Pain During the Procedure?
Twilight anesthesia in itself does not block pain but relaxes the patient and puts them into a hypnotic state where their brain is unable to form new memories. This is why patients don’t remember their surgery.
However, IV sedation must be paired with local anesthesia to actually numb the nerves of the surgical site.
With these two combined medications, the IV sedation and the lidocaine anesthesia, the patient will not feel any pain at all during the procedure. Nor will they feel any anxiety or mental discomfort during the procedure either, which is a common concern for patients undergoing an “awake breast augmentation.”
How Long Does It Take to Wake Up After Twilight Anesthesia?
Twilight anesthesia has a much shorter recovery period after a surgical procedure than general anesthesia, and because patients are in a semi-conscious state, they’re not actually waking up, but regaining their awareness and ability to form memories.
Whereas general anesthesia can take a full day, up to a week to fully wear off, twilight anesthesia takes a few hours to wear off, so patients can recover more quickly and feel less groggy or foggy-brained.
Schedule Your Consultation at Emmett Plastic Surgery
Dr. Jennifer Emmett, M.D. is a highly skilled and experienced plastic surgeon serving the greater Denver and Centennial areas of Colorado.
Unlike most plastic surgeons who use general anesthesia, Dr. Emmett only uses a combination of IV sedation and local anesthesia for her operation room procedures, as they are proven to be safer options, and have fewer side effects for her breast augmentation patients.
She and her staff specialize in numerous plastic surgery procedures, including breast augmentation, breast implants, breast lifts, breast reduction, liposuction, facelifts, Botox, body contouring, and more.
can you get breast implants without general anesthesia
General anesthesia means fully asleep – you will have no realization that you are going to sleep, no awareness of what transpires during your surgery, no sensation of discomfort during surgery, no recollection of what went on during surgery and no recollection of waking up from surgery. Who could ask for anything more pleasant? Certainly, some people are fearful of general anesthesia, usually out of lack of understanding of what it entails. When performing breast augmentation, there are some distinct advantages to utilizing general anesthesia over other techniques. The following is a brief description of the differences between the three types of anesthesia:
General anesthesia – drugs are given intravenously to make you relaxed, all anxieties you may have will disappear, and you will slowly drift off to sleep. Once asleep, a breathing tube is gently placed through your windpipe through which oxygen and some anesthetic drugs in gas form are given to you. Your vital signs, oxygen and carbon dioxide levels are continually monitored for your safety. General anesthesia affords you the following: no perception of pain, no recollection of the period of time between when you go to sleep and when you wake up, muscle relaxation and a peaceful sleep. Your airway is protected via the breathing tube and the muscle relaxation is important to reduce post operative discomfort and facilitate the surgery (the muscles are not resisting the surgeon’s efforts). Overall, the anesthetic medications will be out of your system faster with general anesthesia than will intravenous sedation.
Local anesthesia – Medication is injected into the surgical site to make the tissues numb – so that the pain nerves in the tissues do not work. This will not afford you any degree of mental relaxation. For larger surgeries, it can be difficult to use local anesthesia because there are limitations as to how much of the local anesthetic drug you can receive before toxic doses are reached. This can pose a problem during surgery if the degree of numbing of the tissues is inadequate and more drug is required. There is also no muscle relaxation, which means that the surgeon will have to pull harder against your pectoralis muscle, resulting in more discomfort after surgery.
Local anesthesia + Sedation (oral or intravenous) – Local anesthesia is given as above, but also sedation is given to relax you. If sedation is given, you should be monitored by an anesthesiologist or nurse anesthetist as over sedation can cause you to stop breathing on your own. Proper monitoring would prevent this or at least allow immediate intervention should this be required. Sometimes if local + sedation is not working well (difficulty keeping the level of sedation at the right level), then the patient can be converted to general anesthesia. There is still no muscle relaxation with sedation. That requires special medication. Muscle relaxation means that none of your muscles are able to move, and while your pectoralis muscle will be nice and relaxed and not fighting the efforts of the surgeon, so will your breathing muscles be relaxed and not working, which is why general anesthesia is required when muscle relaxation is used.
You can read more about out anesthesia services performed by our two board certified anesthesiologists here.
Do I perform surgery under local anesthesia or sedation? Of course – all the time. however, for breast augmentation, the most optimal way to proceed for both surgeon and patient is, in my opinion, without any doubt, general anesthesia.
What is “Awake Breast Augmentation”?
“Awake breast augmentation” is a breast augmentation procedure performed using local anesthetic while you are awake. Some surgeons will also give you some sedation to relax you, some will not. This procedure requires injecting your breasts with a solution of local anesthetic (“numbing medicine”). The proponents of this procedure claim that you are “involved in the size selection” of your implants during surgery and that you will recover faster.