Risks of Twilight Sedation for Breast Lift and Augmentation?

A twilight sedation for a breast augmentation is usually supplemented by nerve blocks with local anesthesia. I am aware of a situation where these were done and punctured the lungs causing serious complications. Under a light general by a physician anesthesiologist, these nerve injections are not necessary and this risk is eliminated.

Thank you for the question. There is absolutely no evidence that “twilight sedation” is safer or provides for a better experience/outcome for patients undergoing plastic surgical procedures. In my practice I prefer the use of general anesthesia provided by board-certified plastic surgeon who knows my routine well. In regards to finding a plastic surgeon in your area, I would suggest starting with the American Society of Plastic Surgery and/or the Aesthetic Society... more

While twilight is fine, probably general is safer. In twilight type of anesthesia the airway is not "controlled" and patients drift in and out of sedation which can also affect breathing.

I recommend that you focus on the anesthesia provider rather than the type of anesthesia. I insist on a board certified M.D. anesthesiologist to provide my patients' anesthesia care. Most of my patients undergo breast lift/implant surgery under LMA (laryngeal mask airway) anesthesia, but depending on their history, anatomy, etc., the anesthesiologist may recommend endotracheal intubation or a lighter form of anesthesia called MAC (monitored anesthesia care).

  There are many ways to perform a breast lift with implants. Patients that receive twilight sedation will not be aware of their surroundings and will not be completely asleep. It is important to ensure that your board-certified plastic surgeon has a great deal of experience performing this procedure with this type of anesthesia. The anesthesiologist must be very vigilant to make sure that you are comfortable but that you do not experience pain. The portion of the procedure that... more

Hi. Both twilight anesthesia and general anesthesia are very safe and equally safe for breast lift with breast implants.  The important question is WHO is giving you the anesthesia.  Also make sure you are done in an ACCREDITED operating room.

Twilight anesthesia may not be safer than general anesthesia especially if you are going to be under for a while, as you will be for a breast augmentation and breast lift. So I would be very carefull in regards to this. As long as you are healthy and have no medical problems that you may be ok for general anesthesia.

There are many issues here: 1) Some people believe twiligtht is safer. This is not necessarily the case. 2) Some believe it is less expensive Only if your surgeon is the anesthesiologist and do you want him or her to worry about the heart rate, oxygenation, and blood pressure while giving you anesthesia or do you want him/her to focus on your surgery 3) Is your implant under or over the muscle. If under the muscle, it may be difficult to adequately anesthetise the area... more

I'm also a proponent of general anesthesia...not because it can't be done under sedation, its just much more patient dependent and the chance of inadaquate anesthesia is higher than it would be with general. The point I wanted to add was to be sure its not THE SURGEON giving the anesthesia. Unfortunately, some docs recommend sedation to cut corners. They give the anesthesia AND do the surgery. Obviously, you can't keep track of both at the same time and, even with a nurse helping you, its not th more

Local Anesthesia with Sedation, or Twilight anesthesia, is a very effective and safe way to perform Breast Enhancement procedures. In fact, 95% of my patients undergoing breast augmentation with implants choose twilight sedation and respond afterward that the experience was not that discomforting. For most of my patients it comes down to the fear of "going under" anesthesia, recovery time, nausea effects afterward, and cost. The patient is given an IV sedative to relax them,... more

This procedure can be 2-3 hour procedure and involves a great deal of cutting and stitching. I am not in favor of twilight because of the length of this procedure and the complications of administering local anesthetics. I perform this procedure using light general anesthesia. There is much less risk of complication with general anesthesia and the clients are more comfortable afterwards. Local anesthesia if over used can be toxic and can lead to breathing difficulties during a surgery. more