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

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 

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

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!

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.

Having done a large number of tummy tucks and Brazilian buttocks lifts using fat grafting, I would recommend that you do this procedure with general anesthesia simply because the overall control of the airway is significantly better. We do all of our abdominoplasties and Brazilian buttock lifts with general anesthesia. We have excellent board certified M.D. anesthesiologists and our patients are fully monitored during this procedure. Any procedure of this magnitude that does not have full monitoring and satisfactory airway control is less than satisfactory.

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.

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. RegardsDr. Silvia Avilesdominican Certified Plastic Surgeon

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. 

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 

Absolutely!However this requires good skills and training from the anesthesiologist.It is not only safe, but it also helps greatly with postop pain, as the anesthesiologists puts medication in the epidural, and that helps reducing pain for 2-3 days.With general anesthesia you would need to take stronger oral pain medication plus it usually makes people nauseous afterwards, which in the case of a tummytuck we want to avoid, because of the risks of ripping a suture or have a hematoma develop.