I am looking for doctors that can do my breast augmentation procedure under local anesthesia. I will like to awake during the procedure because I am worried that I will react to general anesthesia. I have a brother that died of cardiac arrest just to find out he might have had a history of heart arrhythmia even though none of his 2 year check ups found it. I don't want to take any chances so does being under local anesthesia reduce my risk of reacting to anesthesia?
Answer: BA under local Thank you for your question. Clearly the advice here is overwhelmingly against doing a BA under straight local anesthesia for all the reasons mentioned. What no one has said is the fact that most of the doctors (notice I didn't say surgeons) who do BA's (and other cosmetic surgery procedures) under local are not properly trained or qualified to do the procedure. The reason for this is that by doing procedures under local they are able to do them in their offices and and are not required to have ORs that meet any type of standards, let alone be accredited. This is because in California only those office based surgery facilities that use IV sedation or general anesthesia are required to be accredited. When it comes to doing cosmetic surgery under local anesthesia it is really the Wild West....anyone with an MD can take a weekend course and start doing surgery in their office as long as only local is used. If you think your legislators care about your safety when it comes to this issue, think again. Hopefully you will heed the advice given here and seek out a plastic surgeon certified by The American Board of Plastic Surgeons and also preferably a member of the California Society of Plastic Surgeons and The American Society for Aesthetic Plastic Surgery. A requirement of membership in these Societies is that we only do surgery in accredited facilities. Should you still want to do your surgery under local just be sure that your surgeon meets the above criteria or you could find yourself having your breast implants put in by a Family Practitioner or ER doc.
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Answer: BA under local Thank you for your question. Clearly the advice here is overwhelmingly against doing a BA under straight local anesthesia for all the reasons mentioned. What no one has said is the fact that most of the doctors (notice I didn't say surgeons) who do BA's (and other cosmetic surgery procedures) under local are not properly trained or qualified to do the procedure. The reason for this is that by doing procedures under local they are able to do them in their offices and and are not required to have ORs that meet any type of standards, let alone be accredited. This is because in California only those office based surgery facilities that use IV sedation or general anesthesia are required to be accredited. When it comes to doing cosmetic surgery under local anesthesia it is really the Wild West....anyone with an MD can take a weekend course and start doing surgery in their office as long as only local is used. If you think your legislators care about your safety when it comes to this issue, think again. Hopefully you will heed the advice given here and seek out a plastic surgeon certified by The American Board of Plastic Surgeons and also preferably a member of the California Society of Plastic Surgeons and The American Society for Aesthetic Plastic Surgery. A requirement of membership in these Societies is that we only do surgery in accredited facilities. Should you still want to do your surgery under local just be sure that your surgeon meets the above criteria or you could find yourself having your breast implants put in by a Family Practitioner or ER doc.
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Answer: Breast augmentation under local with sedation There are ASAPS accredited plastic surgeons who regularly do breast augmentations under local with sedation. A paper in our white Journal by Dr.Eisman of Houston explains the methodology. I have all my patients take valium 1 hour before surgery, we have an IV for fast acting Valium (Versed) and then give a local block. I prefer to do it under general anesthesia without paralysis which is with an LMA tube with an Anesthesiologist. In both of these scenerios you are breathing for yourself during the entire procedure. Discuss these options with a board certified plastic surgeon who is an ASAPS member. Good luck...
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Answer: Breast augmentation under local with sedation There are ASAPS accredited plastic surgeons who regularly do breast augmentations under local with sedation. A paper in our white Journal by Dr.Eisman of Houston explains the methodology. I have all my patients take valium 1 hour before surgery, we have an IV for fast acting Valium (Versed) and then give a local block. I prefer to do it under general anesthesia without paralysis which is with an LMA tube with an Anesthesiologist. In both of these scenerios you are breathing for yourself during the entire procedure. Discuss these options with a board certified plastic surgeon who is an ASAPS member. Good luck...
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June 23, 2015
Answer: Local anesthesia the reason general anesthesia works better for breast augmentation, is that most implants are placed under the muscle. This type allows for muscle relaxation.Under local anesthesia may require too much of the numbing medication which can also lead to heart arrhythmia's. As someone who sits on the patient safety committee for the american society of plastic surgeons, I can tell you that your chance of something going wrong when oersted on by a board-certified plastic surgeon in an accredited surgical facility with an MD anesthesiologist is very minimal.The best way to assess and give true advice would be an in-person exam.Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.best of luck!Dr Schwartz
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June 23, 2015
Answer: Local anesthesia the reason general anesthesia works better for breast augmentation, is that most implants are placed under the muscle. This type allows for muscle relaxation.Under local anesthesia may require too much of the numbing medication which can also lead to heart arrhythmia's. As someone who sits on the patient safety committee for the american society of plastic surgeons, I can tell you that your chance of something going wrong when oersted on by a board-certified plastic surgeon in an accredited surgical facility with an MD anesthesiologist is very minimal.The best way to assess and give true advice would be an in-person exam.Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.best of luck!Dr Schwartz
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June 23, 2015
Answer: Anesthesia Death Hello,I am so sorry to hear about your brother, but his sudden death does not portend to your risks of general anesthesia. Most reputable plastic surgeons that are certified by the ABPS and are members of the ASAPS operate in surgery centers that are accredited by organizations that ensure strict adherence to patient safety, including proper pre-operative medical clearance of all patients. You should have a thorough conversation with your surgeons you consult with to discuss in more detail the risks of anesthesia. In general if you are in good health, you are safer under general anesthesia than you are driving in a motor vehicle. Best of luck!
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June 23, 2015
Answer: Anesthesia Death Hello,I am so sorry to hear about your brother, but his sudden death does not portend to your risks of general anesthesia. Most reputable plastic surgeons that are certified by the ABPS and are members of the ASAPS operate in surgery centers that are accredited by organizations that ensure strict adherence to patient safety, including proper pre-operative medical clearance of all patients. You should have a thorough conversation with your surgeons you consult with to discuss in more detail the risks of anesthesia. In general if you are in good health, you are safer under general anesthesia than you are driving in a motor vehicle. Best of luck!
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June 23, 2015
Answer: Breast augmentation procedure under local anesthesia? As you can see from the previous answers, there's more than one anesthesia way besides general for breast augmentation. I agree, I would not do this procedure purely under local anesthesia. This might require lots of local (with maximum absorption and serum peak level when you are home). Too much local anesthesia can lead to seizures and even death. I prefer to do my augmentations with intravenous sedation (conscious sedation) and local; you do not have a tube down your throat, breath on your own, have your protective gag reflex, but not feel any pain or discomfort. See a board certified plastic surgeon for an in person consultation/evaluation to discuss your concerns. Good luck.
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June 23, 2015
Answer: Breast augmentation procedure under local anesthesia? As you can see from the previous answers, there's more than one anesthesia way besides general for breast augmentation. I agree, I would not do this procedure purely under local anesthesia. This might require lots of local (with maximum absorption and serum peak level when you are home). Too much local anesthesia can lead to seizures and even death. I prefer to do my augmentations with intravenous sedation (conscious sedation) and local; you do not have a tube down your throat, breath on your own, have your protective gag reflex, but not feel any pain or discomfort. See a board certified plastic surgeon for an in person consultation/evaluation to discuss your concerns. Good luck.
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