Up/down Pulse and Hypertension, Would General Anesthesia or Local with Sedation be Safe for me While Getting Chin Implant?

A holtor monitor showed my heart rate rises into the high 140s and falls into the low 40s throughout the course of the day. My cardiologist said that my heart was fine after a full work-up, even though no explanation was found. Pre-op EKG showed my heart rate at 46. I take low dose (1/2 pill) metoprolol 1x/day + Catapres for hypertension. Is it safe for me to go under general anesthesia for a chin implant and submental lipo, or would local (with sedation?) be safer for me? Thanks...

Doctor Answers 8

Medical issues and chin augmentation

Any patient with a history of hypertension and/or cardiac problems must be medically stable and be cleared by the cardiologist prior to surgery. The blood pressure must be stable and the procedure can be performed in the office based surgery suite or in an ambulatory center either under local or sedation. Given your underlying conditions, I would prefer to have the anesthesiologist available, although this would add to the cost, even if the procedure was scheduled under local.

New York Plastic Surgeon
5.0 out of 5 stars 42 reviews

Evaluation of Heart Rate and Blood Pressure before Chin Implant

I do believe in specialization. It sounds like your  cardiologist has done a thorough evaluation; as your surgeon I would consult with your cardiologist and my anesthesiologist to determine what is best and safest for you. With your history, I would have my anesthesiologist present to monitor you even if I  did the surgery with only local anesthesia.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Hypertension and chin implant surgery

Sedation is all that you need for the procedure you are considering.  During the procedure, there is an anesthesiologist who can treat a fast heart beat, should it become necessary.

So in summary, please understand that this procedure is performed with local anesthesia and sedation (NOT General Anesthesia !)  You can go home afterward, and would be monitored throughout the operation.

Darrick E. Antell, MD
Manhattan Plastic Surgeon
4.7 out of 5 stars 34 reviews

Up/down Pulse and Hypertension, Would General Anesthesia or Local with Sedation be Safe for me While Getting Chin Implant?

A full written cardiac clearance is needed. Than I recommend local with sedation for chin implantation. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Chin implant

You do not need to have general anesthesia to have a chin implant. It is a relatively short operatiuon , 30 to 40 minutes. Your viatal signs, pulse rates and blood pressure should be monitored while local anesthetic is providing numbness in the chin area. It is a good idea to have a medical clearance from your primary M.D. before undergoing any elective procedures anyway.

F.Mahjouri M.D. 

Fereydoon S. Mahjouri, MD
Minneapolis Plastic Surgeon
4.9 out of 5 stars 16 reviews

High pulse and best anesthesia type

It sounds like you've had a thorough evaluation of your hear symptoms. Your cardiologist would probably be the best person to give the go ahead to have anesthesia (general or sedation). The local anesthesia typically has epinephrine in it which can lead to a temporarily increased heart rate on its own.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Chin implant

Regardless of the type of surgery or anesthesia, you need a full cardiac work up for abnormal heart rythm. then you need a full cardiac clearance for surgery. As for your high blood pressure, it should be totally under control, and be with in normal limits. Then you may consider surgery.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Chin Augmentation: Anesthesia Risk

Local anesthesia is always safer. Your cardiologist/internist or anesthesiologist would be the best one to let you know about specific risks relating to general anesthesia
Chin augmentation is an outpatient procedure typically done in the plastic surgeon’s office or in a surgery center. It is usually done under local anesthesia with oral sedation or intravenous sedation, but can be done under general anesthesia if requested.


Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 159 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.