What kind of Anesthesia is used for a Tummy Tuck or Abdominoplasty?


As a rule, your cosmetic surgeon will use general anesthesia for tummy tuck or abdominoplasty.  There are some surgeons who supplement the general anesthesia with an Epidural injection (such as is given during childbirth). While helping to reduce pain during the immediate post-operative period, some surgeons feel that epidural anesthesia might potentially cause more harm, by causing urinary retention and preventing the patient from moving around right away.


Pain Pumps are new devices that can help patients with post-operative pain. Pain Pumps are small reservoirs (the size of a “Walkman”) of local anesthetic that infuse Lidocaine or Marcaine into the wounds for the first 24-48 hours after surgery. Unlike Patient Controlled Anesthesia (PCA) which can only be administered in a hospital, Pain Pumps are sent home with the patient. Because they help keep the surgical areas anesthetized, they reduce the need for narcotics after plastic surgery, therefore, lessening the post-operative incidence of nausea. While some patients like using them, others feel that they are not that effective and are instead cumbersome and hinder their mobility.  Therefore, Dr. Younai gives his patients the choice of using a Pain Pump if they wish to have them.



You should pay special attention to the anesthesiologist who your plastic surgeon uses during surgery.  Like your surgeon, the anesthesiologist literally holds your life in the balance.  It is therefore critical that you put your life in the best hands.


Many patients have preconceived notions about the type of anesthesia that is best for them.  Unfortunately, these thoughts are often based upon hearsay, or upon informal research that has no scientific basis. While you are the final arbiter of your treatment, only an experienced physician can guide you properly in making the crucial decision about your anesthesia. 


This is not guesswork! Allow your physician to explain your safest anesthesia option.


Many facilities employ trained nurse anesthetists. However, it is optimal to have anesthesia administered by an anesthesiologist rather than a nurse. Preferably, your anesthesiologist should be certified by the American Board of Anesthesiology.


The anesthetized patient must be monitored meticulously and constantly, with consideration for all medical conditions. The best person to do this is a physician who is trained and experienced in the practice of medicine, in the specialty of anesthesia.  This is especially important in surgical facilities that operate independently. In such freestanding facilities, a nurse anesthetist might not have the adequate supervision of a physician anesthesiologist, or the support system required to properly address emergencies.

You should be skeptical about promises that extensive cosmetic surgery procedures (such as a tummy tuck) can be performed under local anesthesia in an office, procedure room, or even in an office surgery room.  Having an extensive procedure performed under local or “twilight anesthesia” is not safer than having it done under general anesthesia. On the contrary, the risks of this “twilight sleep” might be greater because procedures that take two hours under general anesthesia will take several more hours when you are inadequately anesthetized locally. The risks that your condition will become unstable will increase under this circumstance. Also, you will then have to deal with the side effects of the longer acting anesthetics that remain in your system, even after you go home.


Article by
Beverly Hills Plastic Surgeon