How common is vomiting after anesthesia?

Question

How often is nausea and/or vomiting a common occurrence after coming out of anesthesia after breast enhancement? Are there smaller doses or strengths that could decrease the chances? I guess I’m wondering what my chances of being ill after the surgery are and for how long, never have been put under before.

Fady A. Sinno, MD · Answer

This is a great question, as post-op nausea can be the worst part of having surgery. Most surgeons are very much aware of that, and I can tell you what I have been doing to nearly eliminate this problem. A multi-modality approach is most effective.
-Since post-op nausea is caused by anesthetic gases and some intravenous drugs such as narcotics (opioids), the idea is to select the ones with the least side effects and use the absolute minimum amounts. This can be made possible by simultaneous use of adequate amounts of long acting LOCAL anesthetics (that do not cause nausea) such as Marcaine or Exparel, so the amounts of systemic drugs can be reduced. This has the added benefit that our patients wake up quickly after surgery and are relatively pain free for quite some time post-op. The need for oral opioid pain killers is also reduced or completely eliminated.
-We routinely use two different intravenous anti-nausea drugs given to patients before surgery. The preventive drugs act synergistically and are very effective.
-We apply a Scopolamine skin patch before surgery. This is what is commonly prescribed to prevent sea sickness, and was found to work well for anesthesia-related nausea.
-In patients who give history of nausea resistant to all other preventive measures, we also prescribe a relatively new drug (called Emend) given prior to surgery, and we have seen great success with that.
Despite all these measures, it is still possible to get nausea in some patients, but we are able to turn this problem from a common to a very rare event. Remember to avoid opioid pain killers after surgery, if possible. Every surgeon may have a different protocol, as there is no universal concensus. Just make sure you ask this question and be weary if there is no such system  in place. Good luck with your surgery!

Urmen Desai, MD, MPH, FACS · Answer

It is normal to have these concerns.   I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedvDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Austin Hayes, MD · Answer

It's a great question and it's important to speak with your surgeon about your concerns. Prior to your procedure, an anesthesiologist will typically call you to get ready for your procedure the following day. Inform them that you have concerns about nausea and they will discuss your options. In my office, three anti-nausea medications are given during the procedure and nausea after the procedure is typically not an issue.

Christopher T. Maloney Jr., MD · Answer

Thank you for your question. Most patients do not get nauseated after anesthesia these days which is great news. If you have motion sickness, you may consider a scopolamine patch the day before surgery and then for a couple of days after. There are also medications such as Zofran that help as well. Because the operation is so short, the chances are low. Discuss your concerns with your anesthesiologist. Best of luck.

Tom J. Pousti, MD · Answer

Thank you for the question.
There are many different types of acceptable techniques of anesthesia that can be used for the breast augmentation procedure. As long as the plastic surgeon and anesthesiologist involved are “expert” at the technique selected, patients generally do very well.
My advice to patients is: concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.
Once you have chosen your plastic surgeon carefully, everything else, including the type of anesthesia ( and most importantly SAFETY concerns)  will follow. 
Having said that, in my practice I prefer the use of general  anesthesia provided by a well experienced board-certified anesthesiologist. I find the use of this type of anesthesia provides for a safe, comfortable, and immobile patient;  these conditions are important when it comes to achieving optimal outcomes.
 
Most patients describe the experience of anesthesia as a "pleasant nap";  assuming you are working with a well experienced plastic surgeon and anesthesiologist, your "wake up" should be smooth, as well as pain and anxiety free. There are a variety of methods available to help with pain control.  These days, endotracheal tubes are usually not necessary; an LMA (laryngeal mask airway) device, placed in the mouth (not the trachea), can be used to control the airway (no sore throat).
Best wishes for an outcome that you will be very pleased with.

Jeffrey H. Lee, MD · Answer

Hi and thank you for your question!  This is a good question and a valid concern.  Side effects from anesthesia vary widely depending on what kind of anesthesia you end up getting.  If it's a full general anesthesia with inhaled gas, then you are more likely to have nausea and vomitting after surgery.  Our office uses a deep IV sedation which has an extremely low incidence of nausea and vomitting after breast surgery.  This leads to an easier recovery and our patients actually walk out the door with a little bit of assistance.  You are more likely to find this type of anesthesia in office settings and not at a hospital.  Good luck!

Curtis Wong, MD · Answer

can be made very pleasant with pre-emptive maneuvers such as the use of Emend (pricey table) prior to going to the facility and then letting your anesthesiologist know of your concerns so he/she can do everything possible to minimize your post-op nausea and the fog that sometimes comes with certain methods of anesthesia.  There are more than one way to put someone to sleep and some do have better outcomes when waking up, but they may cost a little more to administer.

John A. Kotis, DO, FACS, FACOS · Answer

That is a great question! With the advances in modern medicine, there have been less cases of nausea after anesthesia than there used to be. There are preventative measures such as Zofran(ondansetron) that help decrease the chance of nausea. I would recommend for you to discuss your options with your anesthesiologist prior to surgery. I hope this information helps!

Christine Blaine, MD, FACS · Answer

Thank you for your question.  While nausea after anesthesia used to be more common, with advances in anesthetic drugs and the short surgical time required for a Breast Augmentation it has become a rarity for my patients to complain of nausea and/or vomiting after surgery.  If you are very sensitive to anesthesia or have a history of motion sickness or vomiting with prior surgeries, I would recommend discussing this with your Board Certified PS and Anesthesiologist as they might look into prescribing you Zofran or a scopolamine patch.  I hope that this helps!

Anup Patel, MD, MBA, FACS · Answer

Your concerns are best to discuss with your surgery anesthesiologist. They will discuss your concerns with you and be able to appropriately decide what will be best for your when going under anesthesia.

How common is vomiting after anesthesia?

Answers (11)

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