I have have been researching Breast augmentation for a while now and one of my main concerns is the surgery itself and the anesthesia risk. I am concerned about going under general because of the risk of malignant hyperthermia as I do not know the medical history on my dads side. If properly monitored by a CRNA or anesthesiologist, is twilight or unconscious sedation safer as far as major mortality risks?
Anesthesia Risks for Breast Augmentation Patient with Incomplete Medical History?
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Doctor Answers 10
The American Society of Anesthesiology published some interesting statistics that might make you feel better. When you look at all patients (including very sick patients undergoing heart surgery, etc) undergoing anesthesia, the risk of dying from anesthesia is 0.0004%. (The National Weather Service put out a statistic that your lifetime risk of getting struck by lightening is 0.02%!) For healthy patients, the chance of a problem is even less. Malignant Hyperthermia is a concern, and the rate of occurance is somewhere around 1 out of 65,000 patients. The problem that it poses is: since it is very rare, it is unlikely that your anesthesia provider has ever come across a case during their career. That being said, you should choose someone who is well qualified to deal with an emergency (the more experience the better - my preference is to use board certified anesthesiologists) and also make SURE your center is ready for MH. If they are JACHO or AAAASF certified you can feel comfortable that they have all the drugs and protocols in place for MH. (I also believe AAAHC has the same criteria, but I have not reviewed thier standards, so I am not 100% certain.)
Malignant hyperthermia is a very rare complication, very rare. I can be diagnosed prior to surgery but it rarely done unless there is something that hints toward this, from family history.
Anesthesia risks are very low
Your risk of malignant hyperthermia is not changed very much with twilight or general anesthesia. In fact your mortality risk of driving to the surgery is higher than the risk of anesthesia. Either form of anesthesia is safe if performed in an accredited institution. The accreditation requires that properly trained people are performing the procedure and anesthesia and that proper safety equipment is in place.
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Malignant Hyperthermia Risk?
Thank you for the question.
Malignant hyperthermia is a rare life-threatening condition usually triggered by exposure to certain drugs used for general anesthesia. Susceptibility to malignant hyperthermia is often inherited as an autosomal dominant disorder. Malignant hyperthermia is usually revealed by anesthesia or when a family member develops the symptoms.
The incidence is 1:5000 to 1;50,000-100,000 procedures involving general anesthesia.
Treatment involves the intravenous administration of dantrolene, discontinuation of triggering agents, and supportive therapy (directed at correcting hyperthermia, acidosis, and organ dysfunction).
It would be in your best interest to be taken care of by a board-certified plastic surgeon, a board-certified anesthesiologist, in a fully accredited facility prepared to manage any number of unusual medical emergencies.
I hope this helps.
Anesthesia risk with plastic surgery
The risk of an untoward event from anesthesia is very low. As pointed out earlier, you are safer in the O.R. then when driving to the O.R. The risk of MH is also incredibly low. Having said that, it is import hat to have all your ducks in a row. Every certified operating room has medicine and procedures for MH. I use a board certified anesthesiologist group for my procedures.
Your board certified plastic surgeon will talk to you about risks, and refer you to appropriate doctors for clearance before surgery if indicated.
Anesthesia is extremely safe in a healthy individual
You shouldn't be worried about malignant hyperthermia unless someone in your family has had MH. Most people don't know their entire family history. Make sure you go to a certified facility and use a board-certified anesthesiologist. Breast augmentation can be done using sedation (we use sedation in our operating room) but the key is to use the approach that your surgeon is comfortable with.
Anesthesia and surgery
Anesthesia is very safe today. The risk of malignant hyperthermia is extremely low and can be worked up, but does require a muscle biopsy. SInce it is very rare, this is hardly done. A good physical exam and medical clearance will discover most risks if any.
Safety of anesthesia
Anesthesia is much, much safer than many patients assume. Malignant hyperthermia is unusual, but all certified operating rooms are stocked with medication to treat this complication immediately if it occurs. Sedation is sometimes possible with breast augmentation, but your surgeon may have a preference for general anesthesia. Speak with your surgeon and ask specifically about the anesthesia services. You may be able to speak with an anesthesiologist from the facility or hospital prior to your surgery who can also address your concerns. Make sure that you are at a certified facility and that your anesthesiologist is board-certified. Best of luck. /nsn.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.