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Alternative to General Anesthesia for Breast Augmentation?

asked 3 years ago by clearcourt in mount vernon washington
Latest answer by York Jay Yates, MD
Question viewed 5,201 times

I want breast augmentation but do not want general anesthesia? Is it possible to have the surgery with conscious sedation and local anesthesia instead?

18 answers to Alternative to General Anesthesia for Breast Augmentation?

General anesthesia perhaps "easier," but NOT "better" or "safer"

Thank you for your question. I read with great interest the answers of several of my colleagues, many of whom clearly prefer general anesthesia over sedation: • You could have alternative anesthesia, but WHY • You could opt for anesthesia alternative, but should you? • Yes, but why? • It is possible, but not 100% safe • General Anesthesia is usually a better choice • Yes, but it is safer to have general anesthesia While I agree... more

Nick Slenkovich, MD
Denver Plastic Surgeon

Anesthesia with breast augmentation

Almost any surgery can be performed under IV sedation. The comfort level for the patient is not quite as good as with light general anesthetics, but it can easily be done. It is best and safest to have an MD anesthesiologist administer the anesthesia rather than the doctor himself with significant procedures. This is to ensure the maximal safety and the maximal patient comfort. It is also best to have surgery in a safe setting such as a fully accredited surgical center or a hospital. ... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

It is possible but not 100% safe

Avoiding a general anesthetic may seem "safer" but in the hands of a Board Certified Anesthesiologist, the risks are exceedingly small. Breast augmentation can be performed under sedation and local anesthesia and probably all plastic surgeons have done it this way at some time in their careers. I do know of a patient in my area though who almost died doing it this way because her doctor accidentally punctured BOTH lungs while placing the numbing injections between her ribs. My advice... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Breast augmentation with sedation and local anesthesia - video

Breast augmentation is most commonly performed under general anesthesia. That is the way that most of us were trained and comfortable with. Although I do not fault any plastic surgeon who prefers general anesthetic for breast augmentation, let me provide an alternative view. Although I initially did ALL of my breast augmentations under general anesthesia, I now prefer to do ALL of my breast augmentations under local anesthesia with deep sedation. Disadvantages of... more

York Jay Yates, MD
Salt Lake City Plastic Surgeon

Type of anesthesia for breast augmentation

Hello, Breast augmentation under local is possible but not ideal. Breast augmentation with local and IV sedation is the least that I would recommend and I would recommend that the IV sedation be performed by an anesthesiologist. You want your board certified plastic surgeon to focus on your surgery and an anesthesiologist to take care of your IV or general anesthesia. All the best, Dr Repta

Remus Repta, MD
Phoenix Plastic Surgeon

www.aaaplasticsurgery.com

Breast augmentation does not require a general anesthetic (but I wouldn't recommend that for most patients).

I used to do all my augmentations with twilight anesthesia. However, because general anesthesia is actually easier on the patient and makes the operating time less, I do nearly every patient under general. But the short answer to your question is yes, the procedure can be done with local and sedation.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon

Breast augmentation

In general, I perform breast augmentation either using general of conscious sedation as you mentioned. It is discusse with the patient by both me and the board certified anesthesiologist that works in my office.

Steven Wallach, MD
Manhattan Plastic Surgeon

You could have alternative anesthesia, but WHY

The gold standard is general anesthesia for breast augmentation. For some reason, people are scared of general anesthesia. There have been several advances in general anesthesia and in most cases, it is the safest way to go. It seems that people somehow think general anesthesia is still practiced the way it was 50 years ago. Well, it is not. It is possible to have breast augmentation under local anesthesia with sedation, but then you are moving around making the surgery more difficult... more

David Shafer, MD
New York Plastic Surgeon

www.ShaferPlasticSurgery.com

Anesthesia and Breast Augmentation

There are many alternatives but if you decide on "unders", it is my advice to proceed with general anesthesia. I have used several methods but prefer the patient to be completely at rest while releasing the muscle. This can be painful and it is difficult to achieve satisfactory pain control under local anesthesia. If you are proceeding with "overs", I believe you can achieve satisfactory control with IV concious sedation.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

You could opt for anesthesia alternative, but should you?

Breast augmentation can be performed with other types of anesthesia that you mentioned. I will never utilize them for my patients as I believe true general anesthesia is the best for patient and surgeon. Make sure your surgeon has a lot of experience with this type AND a certified anesthesiologist or anesthetist with alot of experience as well will do this for you.

Michael S. Beckenstein, MD
Birmingham Plastic Surgeon

There are options, but I wouldn't say they're better.

Clearcourt: I have many years experience in practice and I prefer light general anesthesia for breast augmentation, provided by a board certified MD anesthesiologist. Of course, that includes complementaty local anesthesia. In earlier years I have done the procedure under conscious sedation plus local. It is a reasonable alternative. Some of the surgeons I trained with use that method primarily. Other surgeon's have proposed regional nerve or epidural blocks, but I am not aware of... more

Sutton Graham II, MD
Greenville Plastic Surgeon

Yes, but...why?

Let me be up front with my bias, I think it is not a good idea. Having said that, when I was a plastic surgery resident, we did a lot of BAMs with valium, and a breast block. This involved injecting local anesthesia between the gland and muscle while the patient was sedated. The implant was then inserted above the muscle. Since 1993 I have been in private practice, and I have switched to placing the implants under the muscle because I believe that it produces the superior long term... more

Scott E. Kasden, MD
Dallas Plastic Surgeon

You should always have an anesthesiologist present.

Hi! You do not need general anesthesia for breast augmentation. You do need very good monitoring. Along with sedation, I often use either local anesthesia, or intercostal nerve block anesthesia. You should talk to the anesthesiologist before surgery and decide together.

George J. Beraka, MD
Manhattan Plastic Surgeon

General Anesthesia is usually a better choice

I see many patients in my practice who are concerned about general anesthesia. They are usually concerned about the risk of general anesthesia or about the possibility of being nauseated afterwards. Both of these problems have been nearly eliminated with modern anesthesia techniques. Anesthesia is incredibly safe these days and in fact you are safer under anesthesia than driving to the surgery center. There are new medications we use to help prevent nausea. Postoperative nausea has not been... more

John Squires, MD
Denver Plastic Surgeon

Absolutely...

This type of anesthesia has been used for decades and I, along with many plastic surgeons, were trained using this method. We had used Ketamine and Valium but there are even better drugs available now. Of course, your anesthesiologist and plastic surgeon should be experienced and comfortable with this approach. You should also be aware that you should give the authority to your doctors to proceed with general anesthesia in the event the sedation and local are not sufficiently effective. One... more

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Yes, it is possible

Hello, Breast augmenatation can be performed under general anesthesia as well as local anesthesia with conscious sedation. The most important factor is that you have a board-certified physician anesthesiologist doing your anesthesia. Some offices will try to offer a cheaper price when the surgeon "does the anesthesia also" or when one of the staff members "does the anesthesia." So make sure that an anesthesiologist is doing your anesthesia, whether it be sedation or... more

Francisco Canales, MD
Santa Rosa Plastic Surgeon

Local anesthesia/sedation for breast augmentation possible

Yes, it would be. If implants are placed above the muscle, local/sedation definitely is an option. Sub-muscular more difficult, but still possible. Consider though, with heavy sedation, one borders on the brink of general anesthesia anyway. This may complicate things as the anesthesiologist does not have formal airway control and would prefer a general. Discuss this carefully with your surgeon and potentially the anesthesiologist in attendance.

Michael A. Marschall, MD
Chicago Plastic Surgeon

Yes, but it is safer to have general anesthesia

In general, you could, but general anesthesia became so safe and simple that most doctors and patients prefer to use it. One of the key issues is airway control, which is safer with having general anesthesia.