Is Minimal Sedation W/ Local Anesthesia Possible for Subglandular Placement?

I was told I'm a good candidate for sub-glandular. With my very active lifestyle, and enough breast tissue to cover implants etc. - I want this approach. Is minimal sedation w/ local anesthesia possible? When they say "IV with Local", the amount of drugs, numbing meds used for this procedure are just about the same as when they do sub-muscular? Thanks : )

Doctor Answers (12)

Sub glandular augmentation is rarely performed

+2

Sub glandular augmentation is rarely performed by most plastic surgeons because of the significantly increased risks of capsular contracture and rippling. Most people who are still doing sub glandular augmentation do it so they can do the surgery in their office under sedation. This is not ideal. General anesthesia is very safe. Statistically, you are safer under general anesthesia than driving on the highway for an hour. I would strongly encourage you to get some other consultations.


Denver Plastic Surgeon
5.0 out of 5 stars 48 reviews

Surgery

+1

The surgery can be performed with many combinations of anesthesia. You may not be a candidate for what you are requesting

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 11 reviews

Is Minimal Sedation W/ Local Anesthesia Possible for Subglandular Placement?

+1

I am sure you could find someone to do this, but it would not be in our office. We do not perform any major procedure (yes, this is major surgery) without a board certified anesthesiologist at the patient's side to insure the patients' safety and comfort and he charges the same to sit there or to give a good and very safe general anesthetic. If you are awake and you begin having problems with discomfort, anxiety, claustrophobia, pressure sensations, a punctured lung from the needle (yes that is a reported complication with breast surgery), etc, there is little option other than to terminate the surgery. Just because you can do something does not mean you should.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 13 reviews

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Breast augmentation and minimal sedation

+1

Yes, a breast augmentation can be performed with some sedation and local.  It really depends upon the individual patient.

Steven Wallach, MD
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Minimal sedation

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Yes it is possible, but not recommended. the most common and safest approach for breast augmentation is general anesthesia.

 

Scott Loessin, MD
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Is Minimal Sedation W/ Local Anesthesia Possible for Subglandular Placement?

+1

It is possible to perform subglandular or submuscular placement of implants using local anesthesia and IV anesthesia.  The patients wake up quickly following their surgery. Of course, appropriate monitoring is mandatory.

Thomas Guillot, MD
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Breast augmentation under IV sedation and local is a good surgical plan

+1

I've personally done most of my breast augmentation procedures using local anesthetic and 'twilight sedation' - which is monitored sedation under the care of an anesthesia provider using a variety of sedative medications. There is no breathing tube used and general anesthesia (with its attendant risks of nausea and vomiting post op) is avoided. This technique could be used for either subglandular or submuscular augmentations. I've recently started to use Exaprel, which is a long acting local anesthetic. This medication appears to improve post-operative pain control significantly.

Scott C. Sattler, MD, FACS
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Minimal sedation with local for breast augmentation

+1

Thank you for your question. This is my preferred way of doing breast augmentation. I use the tumescent technique, just like for liposuction to numb up the breast tissue once you get intravenous sedation. The advantage of the tumescent solution is that it gives you good postoperative pain control without pain pump, requires less pain medication postop. I use a similar technique for submuscular placement. All my patients are able to leave the office 15 minutes after the surgery.

George Marosan, MD
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Breast Augmentation With Local/Sedation

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It is certainly possible to perform an augmentation under local anesthesia with sedation.  Ten to fifteen years ago I did virtually all of my augmentations this way.  I think a good bit less anesthesia is required for subglandular implant placement.

John Whitt, MD
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Subglandular placement of implants is less painful

+1

Subglandular placement of implants is definitely less painful and can be done with local anesthesia and IV sedation.

W. Tracy Hankins, MD
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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.