Breast implant removal and lift under local or general anaesthesia - which one is safer?

Question

Hello. I thinking to do my breast implants removal without replacement of a new implants next year with lift. I have done three surgeries before in 2019/2022 under general anaesthesia. However, surgeons told me it will be perform under local anaesthesia which I've never tried before. I am Constantly worrying about death during the surgery next year. It been 2years now I am worried about death/coma or won't wake up. I am very worried something will go wrong.Which anaesthesia is safe? I smoke too

Randal Haworth, MD, FACS · Answer

There are three main types of anesthesia: local anesthesia, regional anesthesia, and general anesthesia. Local anesthesia numbs a small area of the body and is often used for minor procedures. Regional anesthesia involves numbing a larger area of the body, such as an arm or a leg, and may be used for more complex procedures. General anesthesia involves putting the patient to sleep and is typically used for major surgeries.

The type of anesthesia used for your breast implant removal surgery will depend on various factors, such as the complexity of the procedure, your overall health, and your medical history. Your surgeon and anesthesiologist will work together to determine the most appropriate type of anesthesia for you.

Smoking can increase the risk of complications during surgery and anesthesia, such as lung problems and difficulty breathing. It's important to quit smoking before surgery to reduce the risk of these complications. Ideally, you should quit smoking at least six weeks before surgery to allow your body to heal and reduce the risk of complications.

It's understandable to have concerns and fears about surgery and anesthesia, but it's important to discuss your concerns with your surgeon and anesthesiologist. They can address your concerns and answer any questions you may have. They can also provide you with information about the risks and benefits of the procedure and anesthesia, as well as any alternative options that may be available.

Ultimately, the decision about which type of anesthesia to use will depend on your specific situation and needs. Your healthcare providers will work with you to develop a personalized plan that is safe and effective for you.

I hope this helps,
best of luck !

Alan Gonzalez, MD, FACS · Answer

Hello @TokiyoC, thank you for your question. It is always safer to use general anesthesia for a surgical procedure. General anesthesia has been used safely in hundreds of thousands of surgeries each day, with very few adverse events being reported. In fact, many studies have suggested that using general anesthesia for major procedures such as this one can actually reduce the risk of complications compared to using local anesthesia. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP).

Shaher W. Khan, MD · Answer

Hello, thank you for your question. It's completely understandable to feel anxious about surgery and anesthesia, especially if you’ve had previous experiences with general anesthesia. It’s important to address your concerns, and I'll try to give you a clear understanding of the differences between general and local anesthesia and how each can affect your surgery, recovery, and safety. Please see the video attached below to answer your question in detail. It’s still important to communicate openly with your surgeon and anesthesiologist to ensure all your specific concerns are addressed. If you have any doubts, don’t hesitate to ask for more detailed information or even consider getting a second opinion to ensure you feel as confident and informed as possible about the anesthesia choice.

Raffy Karamanoukian, MD, FACS · Answer

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Daniel Barrett, MD · Answer

Dear TokiyoC,
it is hard to tell for sure without an examination. Generally speaking, implant removal can be done under local anesthesia but general anesthesia is a better option for lift. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Sean T. Lille, MD · Answer

Dear TokiyoC,   I prefer using general anesthesia with my patients. It is very safe with a board certified anesthesiologist at your head and the technology today picks up the slightest changes in blood pressure etc. even before a human would. Statistically about 6 persons a day die from general anesthesia, 106 people a day die from car accidents and 1300 people a day die from smoking. I would be more afraid of the smoking.

Farbod Esmailian, MD · Answer

The most important thing here is to assess your health status.  As long as you don't have underlying medical issues then general anesthesia is the way to go.  The anesthesiologist has complete control and can manage you better than local or local with sedation.

As far as the smoking, that to me is more of an issue as it affects your breathing as well as wound healing.  I want my patients to be smoke free and nicotine free, so that includes patches, gum and vape for at least 4 weeks before surgery and 4 weeks after.

Hope that helps.

Reza Nassab, FRCS (Plast) · Answer

Thank you for the question and this is a very common concern among many patients. The risks from general anaesthetics are usually very low these days especially if you are in good health. For implant removal and an uplift we would usually recommend a general anaesthetic since this can be a long procedure. If any capsule work is required during the removal then a general anaesthetic is again preferred to reduce pain or discomfort.

Shana Kalaria, MD · Answer

Because of smoking, local anesthesia is safer, but most surgeons do not perform explantation and breast lift under local anesthesia. If this procedure is being performed under local anesthesia, you may not be getting a true breast lift. I would recommend stopping smoking for at least 4 weeks before and after surgery and doing the surgery under general anesthesia. You have already undergone general anesthesia without serious issues, so it is safer for you than in a patient who has never had surgery. Please visit with a board-certified plastic surgeon for your surgery. Good luck!

Camille Cash, MD · Answer

If you are wanting implant removal with a lift you will need to consider general anesthesia.  This is for your comfort and safety.  You will need to be nicotine free several weeks prior to surgery as well as during your recovery.  Nicotine can negatively impact your healing.  I encourage you to discuss your concerns about anesthesia risk with a board certified plastic surgeon.