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

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.

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!

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.

Hi there,

A total capsulectomy, especially in the case of a grade 4 capsule could theoretically be done under 'twilight anaesthesia'.  It is however a long operation and quite technical and I think it would be much better to have it under full general anesthesia. There is a lot of tugging, a bit of bleeding and you would need to lie still for almost 3 hours. Also, you don't sound like you are in bad health so why avoid an anesthetic that is routinely performed on people in much poorer condition than you every day?

Keep it simple, have a general anesthesia so your surgeon can perform the procedure under ideal conditions and give you your best outcome possible.
Good luck

For the type of explantation you describe here, general anesthesia would certainly be best for you.  To remove implants and surgically treat a Grade IV capsule, general anesthesia is far safer and more comfortable for you.  It should also decrease your surgical time which is another safety benefit for you.  Best wishes for a safe procedure and optimal result. 

Anesthesia means "asleep" or "put too sleep" and certainly the chest area needs to be put to sleep in order to carry out significant breast surgery such as en bloc implant removal. It is quite possible to put the chest area to sleep with local anesthesia, but IV sedation and monitoring is required for such procedures and the surgeon has to be familiar and comfortable with this approach. Most plastic surgeons still use general anesthesia for such procedures. If the procedure was a simple removal of saline-filled breast implant (not en bloc removal) then it could be done with just local anesthesia. For en bloc removal or for ruptured gel-filled implants I would probably advise some type of general anesthesia unless the surgeon is quite familiar with local/IV sedation techniques.