Is an Epidural and IV sedation normal procedure for a Tummy Tuck and Brazilian Butt Lift?

Hello! I'm having surgery in mexico on march 28th. I talked to my ps yesterday and he told me he will be using epidural and IV sedation for my Tummy tuck, lipo and fat transfer to buttocks. Is this a regular procedure or is it too much? Also is it ok to get an epidural? I'm kinda confused and scared now. As it is I was already nervous of getting blood clots. Why use an epidural?? Thank u in advance for taking your time and answering my questions :).

Doctor Answers 14

Epidural and IV Sedation for Tummy Tuck and Brazillian Butt Lift

Thank you for seeking out advice on this subject. To echo the other doctors that have answered you, traveling to a foreign country for surgery is never a good idea. You have little recourse in the event that you have complications or require follow up treatment. You also have no way of knowing just how closely any facilities you are being treated in are regulated. We have all known for years not to drink the water in Mexico, so why have surgery there? To directly address your question, the epidural is not the preferred method for operative control in an abdominoplasty because it doesn't address relaxation of the muscles that are being tightened, and it can be difficult to get the pain control  high enough for muscle repair in the upper abdomen. These are some of the reasons why general anesthesia by a Board Certified Anesthesiologist is the commonly used method. Make an appointment with a Board Certified Plastic Surgeon in your area to be evaluated. Saving a few dollars is not worth the risk you are taking.


Seattle Plastic Surgeon
4.9 out of 5 stars 111 reviews

Anesthesia for Tummy Tuck

I concur with the opinions of many of the other surgeons who have answered regarding having these procedures performed in Mexico. There are a number of highly skilled, Board Certified Plastic Surgeons in the Bay Area. Saving a few dollars is not worth the potential safety risks. Best of luck to you.

Mark Deutsch, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 29 reviews

Hmmm...... What?!

It is not recommended to get a spinal anesthetic for a tummy tuck and liposuction!  Typically, body contour surgery is done with either IV sedation or general anesthetic. These are safe anesthesia treatments. The United States is one of the most regulated countries in the world in regard to standards of medical practice.  Please keep that in mind.

Earl Stephenson, Jr, MD, DDS, FACS

Surgery and anesthesia

Hi Dear:


It is possible to have epidural and IV sedation, for those surgeries. For me it is very safe and I also do all my procedures with this type of anesthesia.  The important thing is low time of surgery, it does not matter of what type of ansthesia. 
be sure that your doctor is certified. Best luck. Regards


Dr. Silvia Aviles
dominican Certified Plastic Surgeon

Silvia Aviles Terrero, MD
Dominican Republic Plastic Surgeon

Tummy tuck anesthesia

Thank you for your question. Though regional (epidural) anesthesia can be very useful for pain management during and after major lower body surgery, my preference for abdominoplasty (tummy tuck) is general anesthesia. Only general anesthesia allows for complete relaxation of the abdominal muscles which is required for tightening of the abdominal muscle. If done by a certified anesthesiologist in a certified operating facility, general anesthesia is extremely safe. In my experience post operative pain has not been a large issue. If present, it can be controlled with longer acting local anesthetics and/or "pain pumps."

There is a risk of blood clots following any abdominal surgery. Many precautions are taken to minimize this risk. Taking a long airplane or car trip closely after abdominal surgery is a risk. Please discuss this with your surgeon. For patients traveling to have surgery, it is important to clarify your surgeon's plans to handle any potential problems. Though cosmetic surgery is very safe, there is always a chance of problems, so one should have an idea how complications would be handled once you've returned home or while you are in the surgeon's city. If hospitalization were required, does your surgeon have hospital privileges, and would your health insurance cover this.

Please note Dr. Minniti's comments below. I agree with his concerns about traveling for surgery.

 

William McClure, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 5 reviews

Bad Idea

Hello,

Aside from the fact you are traveling for cosmetic surgery, which is always a bad idea when it comes to patient safety and proper follow up care, you are mistaken that epidural and IV sedation is somehow safer than general anesthesia in any regard, including deep venous thrombosis (DVT) or pulmonary embolus (PE). 

Veno-thrombotic events (VTE) are fortunately rare, thanks to proper risk assessment and prophylactic measures utilized by accredited surgery centers that specialize in elective surgery.  However, what's most important in minimizing risk is proper patient selection; if you're at high risk for VTE's, then you should not have any elective surgery, especially a combined abdominoplasty, liposuction and fat transfer, regardless of anesthesia technique.

Beyond that, abdominoplasty is a surgery that requires muscle relaxation to allow proper muscle repair.  Unless your epidural is at the thoracic level (which it won't due to potential paralysis of breathing muscles), your abdominal muscle will not be relaxed, nor will you be anesthetic in the mid and upper abdomen, where you'll definitely need it.

Depending on the study, abdominoplasties have a risk of seromas (pocket of fluid under the skin) between 5 % to 25%, that requires multiple office visits to drain and heal.  There are many entries on RealSelf.com of women with post operative problems looking for surgeons in the US after having plastic surgery abroad.

I suggest you rethink your trip to Mexico and visit a few highly qualified surgeons certified by the ABPS who are also members of the ASAPS.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

Anesthesia for Tummy Tuck and Brazilian Butt Lift

Dear Minnie78,

Tummy tucks are most commonly performed under general anesthesia. However, intravenous sedation, epidural anesthesia, and even local anesthesia in very select cases are also options. 

Generally speaking, modern anesthesia administered by a Board Certified Anesthesiologist in a fully accredited ambulatory surgery center or hospital setting is typically considered safe for healthy patients. Each type of anesthesia has its own advantages and disadvantages, which you should discuss with your surgeon and anesthesiologist.

As others have echoed, be wary of medical tourism.

Warmest wishes,
Larry Fan, MD




 

Larry Fan, MD
San Francisco Plastic Surgeon
4.3 out of 5 stars 15 reviews

Is an Epidural and IV sedation normal procedure for a Tummy Tuck and Brazilian Butt Lift?

If you are already worried about complications, why are you going to a country that has poor regulations for cosmetic surgery? Sounds like you need to have some serious reconsideration of this risky plan.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Medical Tourism

It is not unreasonable to use epidural anesthesia for the procedures mentioned, provided it is administered by a Board Certified Anesthesiologist and not just by the surgeon him/herself. Anti-embolic prophylaxis is certainly advisable. However, I agree with the other respondent in condemning medical tourism. The qualifications of doctors, the accreditation of facilities and the capacity to take care of complications are all difficult to assess at a distance. Living in LA, I have frequently had to treat individuals with severe complications following medical tourism abroad. It can be very costly if hospital admission is required and many plastic surgeons will refuse to see you. Furthermore, your ability to sue the doctor for malpractice is greatly diminished.

J. Brian Boyd, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 5 reviews

TT under regional anesthesia

We use very commonly the peridural anesthetic procedure and sedation because it is very safe procedure to perform long surgeries like BBL or TT or association of both, because mainly of postoperative pain control (for general anesthesia as soon you are awaken you are in pain and will be needing very strong painkillers which is very well known in the US) and also because we can use pain pumps for several days after surgery. 
Sedation will help you to eliminate anxiety and keep up sleeping through surgery. Regional anesthesia is not associated to blood clots. 
So feel confident that the anesthetic procedure will be effective and safe. 
Be encouraged. 

Dr. Cardenas 

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.