Which is better, IV sedation or general anesthesia for full Tummy Tuck & Liposuction?

Question

I'm really concerned about going under general anesthesia because of all the chief complaints about being sore after surgery

William T. Stoeckel, MD · Answer

Every surgeon is going to have their own experience. Surgeons that operate only in the hospital setting will feel that operating in an outpatient facility or private surgical suite is less than ideal. Surgeons that use only anesthesiologists for cosmetic procedures will indicate that using a CRNA for anesthesia is less safe and to be avoided. Surgeons that only use general anesthesia for abdominoplasty surgery will indicate that is can not be done safely or effectively without it. Well, I have a different set of experience than many. And I can say without reservation that abdominoplasty surgery with or without liposuction can be done safely and effectively in an accredited private surgical center using qualified CRNAs with IV sedation or MAC anesthesia. I would argue that the procedure is actually more safe with appropriate IV sedation than with general anesthesia. Patients that undergo abdominoplasty surgery with MAC anesthesia have a much quicker recovery, have less nausea and vomiting complaints, return to normal activities faster, and have lower incidence of DVT and PE. They have no risk of having a sore throat or chipped teeth from the insertion of an endotracheal tube. The rectus muscle plication can be done very effectively by fixating the sutures during exhalation. I have not seen any issues with patient anxiety, increased blood pressure, or higher incidence of bleeding. The skill set required by the CRNA to be effective is much higher and not all CRNAs (or anesthesiologists) are comfortable and effective with MAC anesthesia. But when done well, it is by far my preference. That is not to say that general anesthesia can not be used. It is also a safe and effective option. But it is just that - an option. You will need to choose a surgeon with whom you feel comfortable and then use the type of anesthesia that he/she prefers.

Thomas A. Mustoe, MD, FACS · Answer

Both choices of anesthesia are safe with an experienced surgeon and anesthesiologist.  I perform all of my abdominoplasties with or without liposuction under sedation with local anesthesia.  It reduces the risk of blood clots ( venous thromboembolism) because the patients leg muscles are not totally relaxed.  The use of local anesthesia during the operation reduces the early postoperative pain, which aids early ambulation, another factor which reduces VTE.  However, the surgeon's personal experience and comfort level out weigh other factor.  You should discuss your concerns with your surgeon.

Vincent N. Zubowicz, MD · Answer

Occasionally spinal anesthesia can be used for an abdominoplasty but the procedure is generally fairly brief and a general anesthetic is required to permit tightening of the fascia of the abdominal wall.

Ralph Trey Aquadro, MD · Answer

I perform tummy tuck and liposuction under general anesthesia at an outpatient facility.  This works well for me.  Others may have different opinions.  Please seek a consultation by a plastic surgeon certified by the American Board of Plastic Surgery.Trey Aquadro, M.D.Auburn, AL

Thomas Trevisani, MD · Answer

In my opinion, General Anesthesia during Tummy Tuck and Liposuction -- is the safest and most comfortable for patient. Once all the blood work is performed, and/or clearance is presented-- a Board Certified Anesthesiologist administers the anesthesia. Always seek a Board Certified Plastic Surgeon with years of experience!

Roxanne Sylora, MD · Answer

There are advantages to both, but with a skilled anesthesia provider, IV sedation is technically safer.  However, that depends on the skill and attention on the anesthesia personnel, as general anesthesia relies more on monitors than observation.You are well asleep and oblivious during both, so that should not change your experience either way.  I have done them under both.  In my mind, the choice is based on the skill and comfort level of the anesthesia provider and the surgeon.  Patient experience should be somewhat similar, though nausea postoperatively may be worse with general anesthesia, or it may take a little longer to wake up.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

A tummy tuck with liposuction can be done either with general anesthetic or IV sedation. It really depends on the judgment and preference of your surgeon with your input. I typically prefer a general anesthetic because the procedure is extensive and allows me to proceed comfortably knowing that you are completely comfortable and asleep.

Kenneth Hughes, MD · Answer

I perform this combination under general anesthesia so that patient comfort is maximal and chances for patient movement are minimal.Kenneth Hughes, MDLos Angeles, CA

Bill Kortesis, MD · Answer

In our practice we use general anesthesia for these types of
procedures. We believe that this gives you the best possible safety precautions
in protecting your airway during such a surgical procedure. We only use board certified
anesthesiologists and we feel that guidance under a true anesthesiologist helps
with patient safety.

Jeffrey K. Scott, MD · Answer

You will have the same degree of soreness after tummy tuck surgery whether you have IV sedation or general anesthesia. I prefer to perform my full tummy tuck procedures  under general anesthesia. This is more comfortable for the patient with minimal added risks. I would also suggest you inquire about various options to reduce post operative discomfort so as to speed up your recovery process (pain pumps, long acting local anesthetics, etc.).

Which is better, IV sedation or general anesthesia for full Tummy Tuck & Liposuction?

Answers (15)

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