Local Anesthesia
Breast Augmentation Under Local Anesthesia? You've Got To Be Kidding!
It seems that there is a growing trend to promote plastic surgery under local anesthesia, as evidenced by the advertising I see for plastic surgery. Only... Nothing else... cold sober. There is nothing that will make you feel relaxed, or take the edge off. Nothing that will soften or eliminate the physical and emotional reactions caused by plastic surgery. Even though I have read of "cosmetic surgeons," I do not believe that anyone offers breast augmentation in Sacramento.
I perform plastic surgery using local anesthesia almost every week as a Certified Plastic Surgery. You may need to do a little bit of scarring revision, small areas of facial Anesthesia Services contouring, or micro-liposuction. Most of the plastic surgery that I do at Advanced Concepts in Plastic Surgery in Sacramento is done under general anesthesia or sedation.
What is sedation, first? When a patient is given sedation medication via an IV, but their consciousness remains intact, this is called sedation. You can choose from a variety of drugs to put you in a happy place. You are not asleep, but you are aware of the situation. This is why you can breathe normally without a machine.
Why would you not want information about what is happening to you? Let me give you an example. A few years back, I had my wisdom tooth burst. I guess I'm a late bloomer. It was removed using local anesthesia. I felt no pain and the dentist did an excellent job. It was an unpleasant experience, however, with the grinding, rasping and pulling. My jaw and mouth were also very sore because I kept my mouth open. After three or four more, I was unable to maintain my composure. Let me now state the facts. I don't mind if I do it again. I also assume that my patients wouldn't experience this kind of discomfort after their plastic surgery procedure.
What is the best place to use strict local anesthesia? Local anesthesia is effective in very small areas and for very short procedures. What situations do you need sedation? If the procedure is longer and involves larger areas, there may be some discomfort. It can be difficult to stay in one place for long periods of time if you are having a longer procedure. It is possible for the local anesthesia to wear off, and it may need to be refreshed or it can become uncomfortable. All my patients have the same goal: to make everything as painless and easy as possible. There is always some pain when you perform it under strict local anesthesia.
Another problem is the regulation of surgery centers. California law requires that any facility performing plastic surgery under general anesthetic or sedation must be licensed by the agency that licenses them. There are currently two main ones AAHC, and AAASF. The latter is what I inspect. If your physical plant passes inspection for unique standards in organization, cleanliness accountability, safety, and safety, this means you are eligible for hospital privileges for the procedure. If the procedure is done under local anesthesia, however, you don't need to adhere to the strict standards for the plant or safety accountability.
This doesn't necessarily mean that anyone promoting "local anesthesia only procedures" is trying to avoid regulations of dangerous or shoddy conditions. But... beware.
Is general anesthesia available for plastic surgery? Some surgeries can be very stimulating even with lots of local anesthesia. Local anesthesia does not block the pain stimulus, but it does not prevent pressure, pulling, or heat. Local anesthesia is a horror story that I have heard of many times. One patient who had breast augmentation with local anesthesia and some sedation "woke up" during the procedure. He was then told to remain still, because it was time to stop. They experienced and felt more than they intended. Sometimes, you may need muscle relaxation sedation in order to perform the necessary tasks, such as putting in a breast implant, or suturing up the abdominal muscles. It is ideal for breast augmentation, mommy makeovers and total facial rejuvenation like a facelift.
For very small procedures, local anesthesia can be great. For many procedures, IV sedation and general anesthesia are better options. Local anesthesia does not always provide painless plastic surgery.
