Anesthesia for Breast Augmentation

I am considering Breast Augmentation and I've noticed that some surgeons use twilight anesthesia while others use general anesthesia. What are the benefits of one type over the other in Breast Augmentation surgery?

Doctor Answers (17)

It is better to have more MDs looking out for you

+4

When I am doing surgery, I like to concentrate on the surgery, and the result that I am trying to achieve. I do not like to be distracted by anything else (such as my patient's vital functions--breathing, circulation--and comfort with pain control). It is not that I could not manage those issues, but to do so would require that I split my concentration from the main reason that brought us to the operating room. As such, I like to use a board certified anesthesiologist to assure my patient's comfort, and maintain all vital functions. This makes my procedures a bit more expensive, as we have to pay for the anesthesiologist, but I think this is in everyones best interest and worth it.

If the patient wants to use twilight anesthesia, I have no problem with that, so long as it is provided by a board certified anesthesiologist.


Dallas Plastic Surgeon
5.0 out of 5 stars 48 reviews

Anesthesia for Breast Augmentation

+2
MAC anesthesia or general anesthesia can be administered. My preference is MAC. I always work with a board certified anesthesiologist in my accredited  surgical suite. 

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 37 reviews

Anesthesia for breast augmentation is a matter of opinion

+2

Hello,

I prefer a short general for a number of reasons:

(1) I use only MD anesthesiologists in a certified surgery center. They are very good at keeping the doses small. Nausea is a very infrequent problem.

(2) The patients are the most comfortable and it is safe.

Doing the surgery under sedation is possible, but I prefer "under the muscle" implant placement which is harder under less than a general.

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 23 reviews

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Sedation Anesthesia for Breast Augmentation

+2

Since I own my own surgicenter, I have a complete control over who my anesthesiologist is. I use exclusively MD anesthesiologists. Incredibly enough, it is hard to find an MD anesthesiologist who is proficient at Sedation anesthesia.

I myself had to learn how to use local anesthetics in an efficient and comprehensive way so as to minimize the amount of sedation given. A good team proficient in the technique will give you:

1)-Great analgesia during surgery- you will not feel anything

2) Amnesia- I have yet, in a year and a half of using exclusively sedation for breast augs, have a patient tell me they remembered anything. As a matter of fact, it is EASIER for a patient to get "light" during general anesthesia (while paralyzed with a tube down their throat) and remember stuff, than it is for a sedated patient with an anesthesiologist competent in sedation techniques. The reason is that during sedation the anesthesiologist will be better able to see and monitor the patient getting light than during general anesthesia.

3)Better analgesia AFTER surgery- Because the nerves were anesthetized BEFORE surgical injury, and because of the greater reliance on longer acting local anesthetics, the patient has less pain after surgery. There is plenty of experimental evidence backing this up.

Sedation gets a bad rep because many MD anesthesiologists learn mostly General anesthesia during their residency and don't feel comfortable with sedation. Sedation is harder and requires more concentration to find the "sweet spot". An MD anesthesiologist not proficient with sedation techniques takes the patient on a roller coaster ride where sometimes the patient is too light, then he over reacts and overmedicates and you find yourself struggling to keep the patient's airway open. An MD anesthesiologist proficient in Sedation techniques gives the patient a smooth ride ant the airway is never in question.

I did Breast Aug with General anesthesia for many years, and the best testimonials come from patients who have had both types performed. There is no question they prefer sedation. I will never go back to general anesthesia. In longer cases General Anesthesia has higher risks of pulmonary embolus and pulmonary complications, and in all cases, patients feel much worse after surgery. If it was my daughter, or wife, (or even me!), sedation is the way to go.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 38 reviews

Anesthesia for Breast Augmentation

+2

Thanks for the question Anesthesia can be performed in a number of ways and in combinations. Most plastic surgeons will perform the procedure under general anesthesia. This allows for maximum protection of your airway and provides maximum comfort of the patient allowing your surgeon to shape things perfectly. In our San Francisco office we typically do this procedure with general anesthesia but augment it with local anesthesia including pain pumps when appropriate. This allows our patients to safely have the procedure performed with the maximum comfort during and after the operation. I hope this helps.

Steven H. Williams, MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 21 reviews

Anesthesia and Breast Surgery

+1

Thank you for your question.

I prefer General Anesthesia given by a board certified plastic surgeon. 

I perform my surgeries in an out patient surgery center, and under general anesthesia only.  I use Board Certified Anesthesiologists  who monitor my patients from start to end so as to provide the safest environment for my patients.  I would recommend general anesthesia for breast surgery so that you are as comfortable as possible during the procedure.
I would suggest that you be very careful with your surgeon  selection and experience. Safety should be the first priority in every surgery.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 680 reviews

Anesthesia Options For Breast Augmentation

+1

Breast Augmentation can safely be performed with general anesthesia or IV sedation with local.  Either way, I recommend your anesthesia be performed by an anesthesiologist.   In addition, I recommend you have your procedure done in a fully accredited hospital or ambulatory surgical facility.  Accreditation, for example from AAAASF, means that the facility must meet certain standards to ensure your safety.  Talk to your board certified plastic surgeon to see what he/she recommends/prefers.

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.5 out of 5 stars 113 reviews

General anesthesia better for breast augmentation.

+1

I always use general anesthesia for breast augmentation.  You should really be asleep for the procedre for your comfort and also so the surgeon can work more efficiently.  You are also sat up to make sure the implants are even.  Being asleep is better.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 41 reviews

Anesthesia during breast augmentation

+1

During breast augmentation, I prefer to use general anesthesia.  Patients are kept comfortable, and entirely relaxed during the procedure.   Because patients are typically healthy, there is no added risk to having patients completely asleep with a general anesthetic. 

Kelly Gallego, MD, FACS
Yuba City Plastic Surgeon
5.0 out of 5 stars 31 reviews

General anesthesia is preferable

+1

Although breast augmentation can be done with local/twilight anesthesia, most plastic surgeons I know prefer general anesthesia.  I use board certified anesthesiologists.  I think having an anesthesiologist increases the safety of the procedure.  The anesthesia doctor concentrates on your airway and vital functions allowing me to concentrate on the surgical procedure.  In addition, we can relax your muscles during a general anesthetic allowing me to adjust the implant position better.

James H. Schmidt, MD
Sarasota Plastic Surgeon
5.0 out of 5 stars 5 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.