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Can I Have Breast Lift or Reduction Without Epinephrine?

asked 10 months ago by Heather Racine in Racine, Wisconsin
Latest answer by Tom J. Pousti, MD
Question viewed 355 times
Tags: age 35-44, complication, epinephrine, options, worried

I am 37. I am seriously considering a breast reduction or a lift or both. I have had a hx of tachycardia (controlled with low dose of beta blocker) and PVCs. I have had bad experiences with locals in the past (BP drops, BAD instant headache, heart racing). Can one have these surgeries without the use of a local? The only thing holding me back at this point is a fear of dying of severe complications. I am already terrified of GA...but now fear locals as well. Thank you for your time.

16 answers to Can I Have Breast Lift or Reduction Without Epinephrine?

Surgery without local anesthetic- is it necessary

Almost all larger surgeries nowadays are performed with a combination of local and light general anesthetic. The advantage of having an anesthesiologist there during the surgery is that they can administer medications that block the effects of the epinephrine. The patient's body literally feels none of the effects of the local anesthesia. The safety of having an accredited facility with a board certified anesthesiologist is quite high. This does not mean that... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

www.drbrent.com

Breast Lifting Candidate?

Thank you for the question. Yes, breast lifting can be done without the use of epinephrine. In order to give you more peace of mind even I wish and by your internist/cardiologist prior to surgery may be helpful. Best wishes.

Tom J. Pousti, MD
San Diego Plastic Surgeon

Having surgery under anesthesia

The problems you described with local anesthesia can be easily controlled during your surgery. If you are considering having surgery, perhaps you can ask for a consultation with the anesthetist that works with your plastic surgeon to alleviate your concerns. Sincerely, Martin Jugenburg, MD

Martin Jugenburg, MD
Toronto Plastic Surgeon

www.torontosurgery.ca

Yes, breast surgery can be done without local

However it is much better if local anesthesia (even better with epinephrine) is used. There are many reasons why the use of local anesthesia is much better for you than not using it at all, many of the previous answers are missing the point ( and the scientific data), even that this surgery can be done with just IV sedation, i do believe it is much better for both the patient and the surgeon to do it under general anesthesia. The local is use mainly for pain control during and more important... more

Victor Manuel Perez, MD
Kansas City Plastic Surgeon

Breast Reduction/Uplift & epinephrine

General anesthesia is pretty safe these days , providing it is done in a controlled environment and superevised by a board certified anesthisiologist. As long as there is no history of Malignant Hyperthermia in your family you should not worry. Administration of epinephrine is not an essential part of any breast surgery . It only reduces blood loss . Breast surgeries do not need to be bloody operations. Go ahead with your surgery, make sure your plastic surgeon & their supporting team... more

Fereydoon S. Mahjouri, MD
Minneapolis Plastic Surgeon

Breast surgery without epinephrine

The surgery may be done without local with epinephrine. But it does decrease bleeding. Perhaps a cardiac clearance is in order to rule out any underlying pathology. General anesthesia is very safe with the proper MD anesthesiologist. Donald R. Nunn MD Atlanta Plastic Surgeon.

Donald Nunn, MD, DDS
Atlanta Plastic Surgeon

Can I Have Breast Lift or Reduction Without Epinephrine?

Possible but would require cardiac clearance and in hospital surgery for possible bleeding issues. Best to see a boarded PS in your area.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Concerns about general anesthesia and epinephrine

In a reputable certified outpatient facility or hospital and using a qualified board certified anesthesiologist your risk for life threatening problems from general anesthesia are very low. It is understandable to have a fear of this, however. With regard to epinephrine, it irrefutably does reduce the amount of bleeding from surgery and this has been documented by studies. I use it along with a local anesthetic in this type of case essentially always because it is effective in reducing... more

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon

Breast lift and epinephrine

Yes you may have a breast lift without epinephrine. Under general anesthesia you do not need epinephrine or local anesthetics. Some surgeons will use them anyway for bleeding and pain control but it is not mandatory. Discuss it with your surgeon.

David Nicholas Csikai, MD
Jacksonville Plastic Surgeon

No need for epi in breast lift/reduction

You certainly don't need any local anesthesia for these surgeries. I do all mine with a MD anesthesiologist under GA so no local is used at all.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Anesthesia options for Breast Surgeries

All the symptoms that you report are normal body reactions to Epinephrine. Leave anesthesia choices to your surgeon, just choose the right doctor. Most of breast surgeries are done under general anesthesia and Epinephrine can be avoided if needed. Your fear of General Anesthesia is unfounded. Choose a good surgeon and stop being your own doctor.

Vasdev Rai, MD
Dallas Plastic Surgeon

Breast lift or reduction without epinephrine

The epinephrine is used in the local anesthetic during breast lift and reduction to prolong the effect of the local medication, and to reduce bleeding and bruising. For breast reduction we use the same solution used for liposuction in the breast which allows excellent control of discomfort and permits patients to go home without any hospital stay. General anesthesia is safe as well and if you have persistent fears of dying and fear of the complications possible with reduction or lift,... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

Breast lift (or reduction) is absolutely possible without epinephrine!

We utilize TIVA (Total IV Anesthesia) without the use of inhalation anesthetics or nitrous oxide (see my article, found on the About tab on my Profile page on this site, titled: "Is TIVA (Total IV Anesthesia) or General Anesthesia Safer?) in our accredited office surgical facility. I routinely do NOT use epinephrine during my breast lifts or reductions, and patients do extremely well with little discomfort, and minimal bruising or swelling. This would be ideal anesthesia for you or any... more

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon

www.mpsmn.com

Breast lift procedures and anesthesia

Its possible to do any procedure that employs local anesthetic with medication that does not include epinephrine. 'Epi' constricts small blood vessels and is helpful for reducing bleeding, but its certainly not indispensable. I do all of my breast surgery under IV 'twilight' sedation under the care of an anesthesia provider.

Scott Sattler, MD
Bellevue Plastic Surgeon

No Need for Epinephrine During Breast Lift or Reduction

I perform almost all breast lifts and breast reductions under general anesthetic because patients are more comfortable and I can provide a better operation. I may use some local anesthetic at the end of the case to provide some additional anesthesia during the first few hours of the recovery process. This local anesthetic usually contains epinephrine, which allows it to last a little longer. However, if a patient had concerns about epinephrine use, the epinephrine could easily be omitted and... more

Kenneth Dembny, II, MD
Milwaukee Plastic Surgeon

www.mycpss.com

Breast Surgery Can Be Performed Without Epinephrine

Although I typically use a small volume of local anesthetic containing epinephrine, it is certainly possible to have a breast lift or reduction performed without using it. The only downside might be a bit more bleeding during the procedure, but this is something that should be easily controllable by the surgeon.