I'm about to have a breast augmentation. I don't want to go under general so my doctor told me we can use epidural anaesthesia

If comfort and safety are the primary concerns for anesthesia for breast augmentation, then usually a general anesthetic is best. It may also be reasonable to use deep intravenous sedation, but I have not heard of epidural anesthesia for breast surgery.

hello thank you for your question and provided information as well..Based on your question, ideal for breast augmentation surgeries is epidural and intravenous sedation. this will function as a regional blockade of the area, thus keeping the whole area anesthetized.My recommendation is a consultation with a certified plastic surgeon and discuss everything concerning the subject.

Tia.  It is quite unusual to use epidural anesthesia for breast augmentation because of location, that would be a very high epidural. General anesthesia is a proven and safe method for breast augmentation, and by far the best option. Seek a second opinion with a board-certified plastic surgeon regarding this matter. Good luck.

Selected patients may opt for local anesthesia with sedative rather than general anesthetic. However, only your surgeon will be able to decide if you can have the local anesthesia. Discuss with him/her your concern and his/her rationale for opting to use subdural anesthesia, which is not a routine procedure in this case.

Thank you for your inquiry.  I certainly understand and appreciate your concern about having a general anesthesia for breast augmentation.  I have been performing breast Augmentation (under the muscle) for over 40 years using local anesthesia and sedation without problem.  I encourage you to discuss this modality with your surgeon as this is easily performed and in my opinion much less complicated than having an epidural anesthetic (which would be pretty unusual for this surgery).

Personally, I would never recommend epidural anesthesia for breast augmentation because you have to block so high that if the medication migrates up, you can have trouble breathing. But that is me, my 20 years experience and my anesthesia team. If your doctor has good documented experience with it, then I can’t argue with that for him, however I would never The bigger issue I hear is patients feeling like twilight anesthesia or in your case, and epidural with ivy sedation is somehow always safer than general anesthesia. That is not the case.  With all things, it depends on the techniques of your provider.  And in many cases the amount of IV sedation necessary for twilight is far more dangerous, because you could stop breathing and not have a tube to make sure we can ventilate your lungs.  Your anesthesia provider would quickly put in a tube, unless they have problems getting one in, in which case you would die like Joan Rivers did.  Joan was having a procedure appropriate for IV sedation, it did not require massive amounts, and still she died.  In the best case scenario, If I have to give a patient a bunch more meds to keep still, then she is going to feel way worse later that day than she would have had I just put her under General. So, in my hands no, no way I do a high epidural for a breast aug.  make sure your doctor is a board ceritified PLASTIC surgeon.  Make sure there is qualified anesthesia personal to watch over you.  Otherwise, get other opinions. 

Hi. I do not ever use general anesthesia for placing implants nor for any other plastic surgery procedure. General anesthesia is far more risky than epidural. I give my patients an IV sedation and when sleep epidural ansthesia, Its being my practice for over 25 years, and is also very helpfull for the patient to avoid pain the first hours after surgery. Go for it.
International Member of the American Society of Plastic Surgeons (ASPS)                                              Member of the International Society of Aestehtic Plastic Surgery (ISAPS) 

That is possible if the anaesthesiologist has the experience. But I think any doctor can agree: It is safer the general anaesthesia than a high epidural.

It's unheard of in my experience to perform an epidural for a breast augmentation.  A better choice might be low dose iv ketamine/valium plus local anesthesia but to get you the best result I'd strongly recommend a light general anesthesia.  You'll feel like you'd only been asleep for 20 minutes and when you wake up your surgery will have been completed.  Make the safest choice and the one most likely to give you the best outcome from your procedure.Jon A Perlman MD FACS 

Certified, American Board of Plastic Surgery 

Member, ASAPS, ASPS

Extreme Makeover Surgeon, ABC TV

Best of Los Angeles Award 2015, 2016 

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