Can Twilight anesthesia be given instead a general anesthesia for an explantation surgery?

I appreciate your question.
Many people have concerns about the type of anesthesia that will be used during their breast surgery, this is quite common. 
In my practice, during breast surgery, including excisions, revisions, and capsulectomies, I use a gentler type of anesthesia called TIVA (total intravenous anesthesia). Using only IV medications, you will be asleep and comfortable during your procedure, but breathing on your own. This speeds up the recovery process for our breast surgery patients so much that we started calling this method "Rapid Recovery™" The advantages to Rapid Recovery™ is that TIVA medications wear off quickly and they are eliminated from your body within hours of surgery. This results in a shorter time in the recovery room, as well as a smoother experience overall. TIVA also has an anti-nausea effect, meaning you won't have that "run over by a truck" feeling after your surgery. Most of our patients are up walking around after their procedure and feel good enough to go out to dinner the next night. 
Another feature of Rapid Recovery™ is limiting pain for our breast surgery patients. I often inject Botox™ into the muscles of the chest prior to surgery, as well as a long-acting numbing medication called EXPAREL®, to speed the recovery process. 

The best way to assess and give true advice about which form of anesthesia would be best for your surgery would be an in-person exam. Please see your board-certified plastic surgeon.
Best of luck!

   

Dr. Schwartz

Board Certified Plastic Surgeon

#RealSelf100Surgeon

#RealSelfCORESurgeon

Based on the information you provided I recommend general anesthesia for the procedures you are having.  This is best for your safety and comfort, and to allow the surgeon the opportunity to provide the best outcome.  Best wishes!

I would recommend general anesthesia rather than twilight.  Older implants with Bakers IV capsules can be very difficult to remove and there is a limit on how much local anesthesia you can safely give with twilight anesthesia.  It will likely reduce the total operative time as well and allow for quicker recovery.

Most surgeons will probably recommend general anesthesia in order to avoid pain during the procedure. You may have a fair amount of scar tissue removed. Also, you surgeon can work a little faster knowing that you are asleep and feeling no pain.

This depends on the surgeon and the anesthesiologist but with a total capsulectomy, I think you would be much more comfortable under general anesthesia. It would also likely be more efficient for your surgeon as well. That being said, it is definitely worth asking. Good luck.