Alternative to General Anesthesia for Breast Augmentation?

Thank you for your question.

I read with great interest the answers of several of my colleagues, many of whom clearly prefer general anesthesia over sedation:


• You could have alternative anesthesia, but WHY
• You could opt for anesthesia alternative, but should you?
• Yes, but why?
• It is possible, but not 100% safe
• General Anesthesia is usually a better choice
• Yes, but it is safer to have general anesthesia


While I agree that general anesthesia is a completely reasonable option, I completely disagree with the statements that "it's not 100% safe," "yes, but it is safer to have general," etc. The implication here that sedation anesthesia for breast augmentation cannot be achieved with at least equal safety as general anesthesia is FALSE.

When performing breast augmentation as a sole procedure, I elect to use "heavy" sedation in collaboration with an Anesthesiologist or Nurse Anesthetist. For my patients, I believe the benefits of sedation in combination with long-acting local anesthesia are many:


•Better postoperative pain control
•Less total amount of anesthesia required
•Lack of a general anesthesia "hangover" or fatigue that can last for days
•Lower risk of blood clot
•Equally as safe, if not safer, than general anesthesia


Safety in aesthetic plastic surgery is paramount. Every patient should receive a detailed preoperative workup and risk-assessment in preparation for surgery.

I have seen breast augmentation patients that have had surgery under general anesthesia in tears in the recovery room from pain. Under general anesthesia, there is no feedback to the surgeon during surgery about how well their local anesthesia block, if any, has worked. With my approach, I have become very experienced with the with getting an excellent local anesthesia block such that by far the most common sensation felt by patient in the recovery room is "pressure," not pain.

Bottom line: I prefer sedation anesthesia for breast augmentation.

Hope this helps.

Thank you for your question.  Most breast augmentation should be performed under general anesthesia. General anesthesia is extremely safe when performed by a board-certified anesthesiologist in an accredited operating room facility.

Yes, it is possible to use local anasthesya in this surgery. And there may be benefits in both approaches, if performed by high skilled and very experienced surgeon. But at the same time there are many points which made us consider general anesthesya more safe and more comfortable for both - the patient and the surgeon.We used to combine local and general anesthesia when perform our Breast augmetation. You will be fully asleep and completely unaware of anything; during your sleep, your condition will be controlled by various sophisticated monitors to ensure that you are fully comfortable.You will not feel any pain, while your surgeon will have enough time to perform the surgery.The anesthesia begins with the insertion of an intravenous line by the anesthetist, through which you will be given medication to relax you and to put you to sleep, also you we will get liquid and any necessary medication through it. The general anesthesia is maintained by gases that you will inhale through a tube. We inject local anesthetic into the breast area, so that when you wake up from the general anesthesia your breasts feel frozen and you have minimal discomfort.Blocking nerves around the ribs and numbing the muscle itself also helps to minimize the amount of general anesthetic, and when the surgery is over and the gas is swithed off, you will start to wake up over the next 60-100 seconds.Our patientsthat have had surgery under general anesthesia are never "in tears" from pain in the recovery room, they don't feel sick, and are quite comfortable.