What is the best type of anesthesia for cosmetic surgery?
Whether you are considering liposuction, a mommy makeover, or a facelift, your anesthesia provider has two primary goals: keeping you safe, and keeping you comfortable. There is a lot of misinformation about anesthesia for plastic surgery out there however. Because you need to make informed decisions about your anesthesia just as you do with plastic surgery, here are a few things to know.
First, recognize that there is a spectrum of options for anesthesia, not just completely unconscious with a general anesthetic versus wide awake. Minor procedures are often done under local, with just a numbing injection into the site; perhaps oral sedatives would be considered for longer or larger procedures, and relatively small areas of liposuction may be done this way. The next step up is intravenous (IV) sedation, usually given by a qualified anesthesia provider. This can range from conscious sedation, where the patient is a little bit awake, to deeper sedation where you sleep through. General anesthesia (GA) involves placement of an airway tube so the patient is completely under.
Second, it is important to know that new drugs and technologies continue to make anesthesia safer than ever. Facilities not accredited for the full range of anesthesia options sometimes portray general anesthesia as more dangerous than local, especially for liposuction. This is inaccurate for several reasons, including the fact that general anesthesia is not usually done for lipo anyway, and that the primary risk with liposuction relates to the infusion of local anesthetic. We do most of our lipo cases with IV sedation, which can be adjusted as we go for maximum comfort. This is a case where we can focus on what is the most comfortable for the patient, because anesthesia options all afford a good margin of safety.
Similarly, a wide-awake facelift might sound like a good idea, but monitored sedation will probably give you a better experience. Use GA for tummy tucks and mommy makeovers. We will place numbing agents in before the end of the surgery so you wake up with less discomfort.
Thirdly, consider the anesthesia provider and the surgical facility. While light sedation might be done well by an RN under the surgeon’s direction, my preference is to use an anesthesia professional so that I can devote my full attention to the surgery. We use a Certified Registered Nurse Anesthetist (CRNA), though we are accredited for an MD anesthesiologist if I or the patient chooses. I have been working with our CRNA for more than 20 years and her safety record is second to none.
Though my staff and I can answer most questions about anesthesia, our CRNA makes a point to call the patient a day or two before the surgery. This helps address any concerns or fears, and helps to fine tune the anesthesia plan based on medical history and other factors. Safety is always our primary concern but you should not have to compromise on comfort.