Thank you for your question. Both types of anesthesia can provide a safe and comfortable platform for breast augmentation surgery. It is more important that you feel comfortable with your surgeon and the surgical plan as this is ultimately what you will be remembering after the procedure.
and I have experience using both. In the early days when trying to keep prices down, I used IV sedation (heavy doses of Versed and Fentanyl). Propofol is probably better. It worked fine BUT I have now transitioned to general anesthesia (tube doesn't have to go down throat - look up laryngeal airway) as it allows me to focus entirely on the procedure and not whether the patient is comfortable. It does cost more but it brings me peace of mind.
Thank you for the question.
Every surgeon will have his/her preference. I prefer the use of general anesthesia provided by a board-certified anesthesiologist. I have found that the use of general anesthesia is safe, comfortable for the patient, and predictably maintains a patient in a good position (without movement) as well as muscle relaxation during the procedure. I think the latter is important as we are trying to achieve as much symmetry is possible.
Most important will be your choice of surgeon. Physicians who are board certified in plastic surgery hold a certification with the American Board of Plastic Surgery (ABPS). This certification proves that the surgeon has graduated from an accredited medical school, has completed a residency of at least five years, has three years of experience in general surgery, is actively practicing plastic surgery for at least two years, and has passed mandatory comprehensive and written examinations. These surgeons are referred to as diplomats of the ABPS and have fulfilled the aforementioned requirements. I would suggest that you select your plastic surgeon carefully; NOT based mainly on the type of anesthesia that he/she will perform their procedure under. Then, communicate your goals carefully as well. During this consultation process, your other questions in regards to type of implants, incisions, size concerns… will be addressed. Best wishes.
Both general anesthesia and IV sedation acceptable methods for breast augmentation. However I always do breast augmentation under general anesthesia. In my experience discomfort during safe IV sedation is too great and the risk of the need for deeper anesthesia without control of the airway during the procedure is significant.
Both techniques are acceptable. If you speak with patients that have had the sedation technique most will say they wished it was a general, which is very safe. Propofol without a board certified anesthesiologist in attendance is not safe.
I think most board certified plastic surgeons use general anesthesia for multiple reasons.
Kenneth Hughes, MD
Los Angeles, CA
I personally prefer general anesthesia for breast augmentation. The muscle relaxation allows for precise control of the pocket and implant placement, and helps to ensure a favorable patient experience.
I was trained in Breast Augmentation with either general, or local anesthesia with sedation, but like most plastic surgeons, I prefer to do the procedure under general anesthesia, with you as comfortable and as safe as possible.
Personally, I would not use propofol without an anesthesiologist and at least an LMA. An LMA is miniature mask that goes into the throat after you are asleep to provide some control over your airway. It does not go through the vocal cords, so there is less of a sore throat. Under this type of general anesthesia, you can still breathe on your own, but you are unaware of of what I am doing for the Breast Augmentation. An LMA provides additional oxygen, enhances the safety monitoring and gives the anesthesiologist more options.
I have performed the procedure both ways; however, I prefer general anesthesia. I feel it provides a greater comfort level for patients. In addition, I like to sit patient up after implant placement to verify that there is excellent breast shape and symmetry and I find that general anesthesia makes it much easier to control the patients airway providing for the best possible outcome overall.
I prefer for patients to go under general anesthesia because it helps relax the muscle for submuscular placement of the implant. However, I have did the procedure both ways.