Breast augmentation with sedation and local, what is the safest option?

Question

I'm looking to do a BA with local and sedation, I would like a professional opinion on which type of sedation and local is the best, I don’t mind being awake and I don’t want to interfere with breathing, I see people using propofol but that seems to be a type of general anesthesia? Please provide your opinion on the safest methods you recommend Asthma and weaker lung efficiency as to favor the local with IV, thank you.

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  I do not recommend having a breast augmentation under local or oral sedation.  General anesthesia in my opinion is the safest way to do this procedure.  I would suggest seeing a Board Certified Plastic Surgeon in person to evaluate you and discuss your options.  Best of luck to you.

Casey Anderson, MD, FACS · Answer

I do not perform breast augmentation under sedation and local as it is safer for my patients to be under a general anesthetic.

As always, be sure to research who performs your surgery to ensure the best likelihood of a positive result.

Linda Fiumara, MD · Answer

Definitely advisable to proceed under General Anaesthesia, which is much safer than Sedation. 
The reason is that when under General Anaesthetic you are intubated and ventilated, your airways are constantly under control of the anaesthetic machine and of the Consultant Anaesthetist. 
On the contrary, sedation involves being more or less unconscious, but you will be breathing spontaneously. Should any breathing problems occur during sedation, these can be serious and lead to the closure of your airways, which requires extreme emergency resuscitation measures.  
Moreover, the sad and untold truth, is that sometimes surgeons suggest sedation in order to reduce the anaesthetic costs and gain more financial profit from the surgical procedure.

Martin Jugenburg, MD · Answer

Hello! Before being considered for cosmetic surgery it is important to ensure you a healthy and stable. Your chosen surgeon would go through a detailed medical checklist. Breast augmentations done under local at our clinic consists of a few things; Firstly we would give you oral medications to help you relax and make you feel a bit drowsy. Then we would administer local anesthetic directly to your breasts; this will ensure you do not feel anything sharp\painful. It numbs the area.This option removes the risks of general anesthesia but still does come with a few risks to consider as any surgery would.  Everyone does "local" surgery differently. Be sure to consult with a board certified plastic surgeon to discuss your options. Best of luck.

Ronald J. Edelson, MD · Answer

In my opinion profofol should only be administered by an anesthesiologist. Breast implants can be done under local anesthesia with sedation but I prefer an anesthesiologist to be present, especially if profofol is used.

Kenneth Hughes, MD · Answer

Hello, thank you for your question. It is possible to do breast augmentation under local anesthesia with sedation or general anesthesia, and you will find surgeons who have experience, expertise, and comfort with both.  That being said, my preference is general anesthesia because it allows the surgeon to completely focus on the breast augmentation and procedure while the anesthesiologist takes care of you.

Daniel Barrett, MD · Answer

Dear Bright845671,
a combination of local anesthesia and IV sedation can be used for BA but some plastic surgeons might not be comfortable doing the surgery. General anesthesia is also a very safe option. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Harry T. Haramis, MD, FACS · Answer

Breast augmentation should NOT be done with only local and oral sedation.In my experience, whether IV sedation or general, a Board Certified anesthesiologist keeps our patients comfortable and safer for best outcomes.Whether over or especially under the muscle, bleeding, discomfort, muscle contraction, etc can compromise results and increase serious risks with consequences.An exam and consultation with a plastic surgeon is recommended to further discuss this as well as your options and expectations. We are also offering virtual consultations.

Christopher V. Pelletiere, MD · Answer

Doing a breast augmentation with a local/ IV sedation is very straightforward, easier on the patient, and has lower risks then general anesthesia.  I use local/ IV sedation with versed / Valium in 95% of my breast augmentations and almost all of those are in the sub-pectoral/ dual plane position.  It is simply a myth that you can’t go under the muscle without general anesthesia.  The reason some think that you can’t is that most were never trained how to do surgeries under local/ IV sedation.  I have been doing in this way for fifteen years now. The best thing to do is to have a few consultations with board certified plastic surgeons who are comfortable doing the surgery this way and see what will work best for you.  Please see the below link for examples of breast augmentations done under local/IV sedation.  I hope this helps.

Gloria Rockwell, MD, MSc, FRCSC · Answer

I suggest you find a surgeon who works with an anesthesiologist while performing surgery.  The anesthesiologist is responsible for your safety while under sedation or general anesthetic (GA)  This allows the surgeon to completely focus on your operation.  I typically ask my anesthesiologist what they prefer and in some cases they prefer the control/safety of a GA.  Even with sedation and local blocks there are situations where the patient requires such deep sedation for comfort that a GA would be safer, more controlled, and be associated with less drowsiness after the surgery.  Anesthesia is an art as much as surgery is and you want an expert in both areas present while you have an operation. 
Kindest regards.

Breast augmentation with sedation and local, what is the safest option?

Answers (14)

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