Cosmetic Surgery Tips

What Kind of Anesthesia Is Used for Cosmetic Surgery

Anesthesia refers to drugs or chemicals that put people in a controlled state that causes temporary sensation loss induced for medical reasons. The medications cause pain relief, muscle relaxation, pain prevention, amnesia, and unconsciousness.

In this guide, we review the aspects of:

  • What kind of anesthesia is used for cosmetic surgery?
  • How painful is body contouring surgery?
  • What type of anesthesia is used for lipo?
  • What kind of anesthesia is used for a tummy tuck?

What Kind of Anesthesia Is Used for Cosmetic Surgery

Anesthesia makes it easy and safe for doctors to perform invasive medical procedures and help patients recover faster. Anesthesiologists deliver anesthetics through injections, eye drops (for eye surgeries), or inhalation. While for most plastic surgeries general anesthesia is used, other anesthesia methods can be employed in non-invasive or minimally invasive procedures.

Local Anesthesia

Local anesthesia temporarily numbs a particular body area and is standard for minor medical procedures, such as tooth extraction. A local anesthetic prevents nerves in the location from communicating pain sensations to the brain, which allows a patient to relax and feel no pain. Patients are awake when under local anesthesia. The anesthetics are injected for numbing purposes during in-office surgical procedures such as (but not limited to) liposuction, chin implants and some buccal fat removal.

General Anesthesia

General anesthesia is a cocktail of drugs administered through an IV line prior to beginning a surgical procedure. It can also be a gas, such as nitrogen oxide, that the patient inhales. It puts a patient in a completely unconscious state to prevent the brain from responding to pain reflexes.

Usually, a breathing mask or tube needs to be placed down a patient’s throat to ensure proper breathing and to prevent any stomach acid from leeching out and entering the lungs. An anesthesiologist tracks a patient’s breathing, heart rate, and other vital functions throughout surgery to ensure a safe operation for the patient.

General anesthesia is excellent for lengthy procedures. General anesthetics are typically very safe, but after surgery, patients may experience some drowsiness and nausea. In addition, these anesthetics may have risks for elderly patients and those with chronic diseases.  Dr. Zuliani may require a surgical clearance for those patients who are passed a certain age or for those with chronic health conditions.

How painful is body contouring surgery?

Everyone wants to feel and look good and staying and remaining healthy is simple with proper nutrition and regular exercise. We all know, however, that achieving our fitness goals without the help of others can be challenging. Despite leading a healthy and active lifestyle, some people require additional assistance with trouble areas such as the waist, buttocks, and belly fat. If you decide to get a body contouring procedure, contact The New You clinic. They offer the best body contouring surgery in Hyderabad.

Keep reading to read about all the essential things to know before getting body contouring surgery.

What type of anesthesia is used for lipo?

Liposuction can be performed under either local or general anesthesia. During liposuction with local anesthesia, the patient is awake, while under general anesthesia, the patient sleeps through the whole procedure. While either technique can mean beautiful liposuction results, there are some important differences between the two.

Local vs. General Anesthesia

Tumescent liposuction remains the gold standard for liposuction techniques, and may be performed under local anesthesia rather than general anesthesia. While general anesthesia allows for larger amounts of fat to be removed at once, many patients prefer slower, more incremental fat removal under local anesthesia to the risks associated with general anesthesia.
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The Benefits of Local Anesthesia

During liposuction with local anesthesia, the patient is more responsive to repositioning or even standing up to check for the symmetry during surgery. Local anesthesia also allows patients to recover more quickly, since they don’t need time in a recovery room waiting for the effects of general anesthesia to wear off. An easy recovery is especially helpful for patients who want to resume an exercise routine as quickly as possible in order to maintain their liposuction results.

The Downsides of Local Anesthesia

Local anesthesia definitely is not the right choice for everyone. For starters, it is often more uncomfortable for liposuction patients than general anesthesia, since a doctor must be very careful not to over-inject lidocaine. Given this, there is no way for a doctor to treat mid- to large-sized areas with local anesthesia alone. This means that “touch up” treatments and small areas may be appropriate, but people who want to slim down their abdomen, hips/flanks or back with liposuction will need general anesthesia to maximize safety and results.

What kind of anesthesia is used for a tummy tuck?

If you are considering a tummy tuck surgery and consult with more than one surgeon, you will likely get differing opinions about what type of anesthesia should be used. Do you need to have a general anesthetic and should the procedure be completed in the hospital setting? Or, is it better to use a deep sedation or even a conscious sedation anesthesia? Do you need an anesthesiologist or are certified nurse anesthetists (cRNAs) safe? The answers to these questions are not always clear and certainly can be debated. Here are my thoughts.

Anesthesiologist or nurse anesthetist?

If you talk to a surgeon who routinely uses an anesthesiologist for his/her procedures, you might be told that only an anesthesiologist has the training and knowledge to keep you safe during a tummy tuck. After all, do you really want to take your chances on having a complication by using an anesthesia provider who has less than the maximum amount of schooling and training? You might also be told that there just isn’t any reason to “scrimp” on your safety by trying to save a few dollars by using a nurse anesthetist.

Such statements seem convincing at first, but do they have merit? I can tell you that these statements were given to me as “selling points” by an anesthesiologist group that wanted me to use their services for my surgeries. They told me that even though they charged more for their services, I would more than make up for the extra costs by being able to “sell” the idea that I was providing a safer and more complete service. I could even charge my patients more for the surgeries because I would be easily able to convince them that they were getting a better product.

As a board certified surgeon, I certainly do not want to offer anything less than the best service possible to my patients and I certainly do not want to do anything that would compromise their safety. So I did some research to find the facts. And the facts are that there aren’t many clear facts. In all of my research, I have been unable to find a convincing study that proves that anesthesiologists are safer or provide better anesthesia than cRNAs for outpatient plastic surgery procedures including tummy tucks. Nor could I find studies that prove that cRNAs are better or safer.

There are two facts of which I am certain. One is that there are really good anesthesiologists and there are really good cRNAs. And two is that there are also really marginal anesthesiologists and equally marginal cRNAs. There are anesthesiologists that work almost exclusively in the hospital system and almost always use a general anesthetic. I would not feel very uncomfortable with such a person providing a deep anesthesia for a tummy tuck procedure because they just don’t do it all the time. There are cRNAs that spend almost all of their time providing deep sedation anesthesia in the outpatient setting that I would feel very uncomfortable giving general anesthesia for an open heart surgery because they just don’t do it all of the time. I would never want to minimize the importance of schooling and training, but like many things, schooling and training become less important the farther one gets into their career. At some point in time, it is the daily routine and knowledge gained from hands on experience that really matter most.

So anesthesiologist or cRNA? The answer could be either. I would choose the one that is the best at what they do. And the one that is the safest and most conscientious. I would choose the one that is the most caring and detail-oriented. And the fact is that such a person could either be an anesthesiologist or a cRNA. If you ask me, I would choose either of my two nurse anesthetists because I know their skill set, their attention to detail, their insistence on safety and protocol, and their track record of over 9 years of zero anesthesia complications while working in my operating room.

Conscious Sedation

Conscious sedation is a medical procedure that involves the administration of sedative drugs to a patient to suppress their awareness and reduce their sensitivity to pain during a medical procedure. This type of sedation allows the patient to remain conscious and responsive while ensuring they are comfortable and relaxed. Conscious sedation is commonly used in various medical settings, including dental offices, outpatient surgery centers, and hospital emergency rooms.

Types of Conscious Sedation

There are several types of conscious sedation that can be used depending on the patient’s medical condition and the nature of the procedure. Some common types of conscious sedation include:

  • Oral Sedation: Involves the administration of sedative drugs in pill or liquid form.
  • Intravenous (IV) Sedation: Involves the administration of sedative drugs through a vein.
  • Inhalation Sedation: Involves the administration of sedative drugs through inhalation, commonly known as “laughing gas.”
  • Benefits of Conscious Sedation

Conscious sedation offers several benefits for both patients and healthcare providers, including:

  • Reduced anxiety and fear in patients undergoing medical procedures.
  • Improved patient cooperation and comfort during the procedure.
  • Quicker recovery time compared to general anesthesia.
  • Lower risk of complications and side effects.

Risks and Side Effects

While conscious sedation is generally considered safe, there are some risks and side effects associated with the procedure. Some common risks and side effects of conscious sedation include:

  • Allergic reactions to sedative drugs.
  • Respiratory depression or difficulty breathing.
  • Changes in blood pressure or heart rate.
  • Nausea and vomiting.

Conscious sedation is a valuable tool in modern medicine that allows patients to undergo medical procedures with reduced anxiety and discomfort. By understanding the different types of conscious sedation, its benefits, and potential risks, healthcare providers can ensure the safety and well-being of their patients during medical procedures.

Is general anesthesia needed?

Just as there are myths spread about differing anesthesia providers, there are also untruths commonly discussed about the type of anesthesia needed to perform a world class tummy tuck surgery. I have often heard that general anesthesia is preferred or even required to complete an effective tummy tuck. Such statements are, of course, mostly made by surgeons who routinely use general anesthesia for their procedures. The basis for their assumption typically references one of the following ideas.

  1. Effective tightening of the abdominal muscles during the rectus plication requires relaxation of the muscles that can only be achieved with a general anesthetic.
  2. If muscles are tightened or plicated without general anesthesia, the post operative discomfort will be worse than necessary.
  3. Deep sedation anesthesia for tummy tuck surgery is too much of an airway risk.

If I were a patient and was told any or all of these statements by a surgeon, I would be rather easily convinced that I needed a general anesthetic. And if any of the above statements were true all of the time, I would agree that general anesthesia would be preferable. But there is little, if any, evidence that these statements are always, if ever, true.

I have been using deep sedation or MAC anesthesia for tummy tuck surgery for 15 years. I purchased a general anesthesia ventilator during my first year in practice because I thought I might need it for tummy tuck surgery, but ended up giving it to a medical team in Africa several years ago because I never used it. The reason I never used it was because I was able to develop a technique for muscle tightening in which the sutures could be placed during a patients natural exhalation with deep sedation that did not compromise how tightly the muscles could be approximated. This technique allows for very effective muscle tightening without unnecessary tension on any individual suture and it does not result in unnecessary post operative discomfort. My patients, almost across the board, report that their post operative discomfort is less than expected even without the need for long acting local anesthetics such as Exparel. And I can report that in my 9 years of private practice doing more than 50 tummy tucks per year, I have never had an airway compromise during a tummy tuck surgery. The above statements simply are not true for all surgeons and certainly do not apply to my practice.

Why could deep sedation be preferable?

There are many surgeons that perform tummy tucks using general anesthesia and many that use deep sedation. I would argue that the type of anesthesia does not affect the end result of the surgery in any measurable way. Many surgeons that use general anesthesia have before and after photos with great results and surgeons that use deep sedation do as well. So why would deep sedation be preferable if the end result is likely the same?

  1. If an endotracheal tube is not placed, the risk for sore throats is minimized or eliminated.
  2. If a laryngoscope is not used, the chances of a chipped tooth or injury to the mouth is eliminated.
  3. The risk of post operative nausea and vomiting has been shown to be significantly less with propofol than with general anesthetic medications including nitrous oxide.
  4. The speed of recovery from anesthesia is significantly faster with deep sedation anesthesia than with general anesthesia.
  5. The risk of blood clots (DVTs) and pulmonary compromise (PE) and death has been shown to be lower with spinal and epidural anesthesia when compared with general anesthesia. Deep sedation anesthesia is also thought to have this lower risk when compared with general anesthesia.

For these reasons, I have exclusively used deep sedation anesthesia for my tummy tuck patients. I strongly feel that I am doing so because it is the safest and most patient friendly method of anesthesia for tummy tuck surgery when given by skilled anesthesia providers.

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