Epidural Anesthesia During Breast Implants?

Is this do-able?? I've heard horror stories of patients waking up during general anesthesia, and that scares me. Why don't all doctors do this, & what are the risks & complications?

Doctor Answers 9

Epidural Anesthesia During Breast Implants?

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An epidural is not appropriate for breast implant surgery, since the "level" required would be too high (the epidural "numbs" everything below where it's placed).  However, this procedure can and routinely is performed under local anesthesia with intravenous sedation, and if that's an option you'd consider you should speak to your PS to find out if that can be done.  General anesthesia is not required for routine breast implant surgery (more complication procedures, revisions, and lifts, however, may benefit from that anesthesia, depending on specifics of surgery, including the surgeon's preferences).

I hope that this helps and good luck,

Dr. E

Epidural Anesthesia for Breast Implant Surgery is not standard of care

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If your surgeon is suggesting that you have an epidural placed for your breast augmentation, I highly recommend obtaining a second opinion from another board certified Plastic Surgeon. Epidural anesthesia is not safe, nor the standard of care for intraoperative pain management during breast augmentation. General anesthesia is completely safe with an extremely rare likelihood of recall after surgery.

Thank you for your question. Best of luck!

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 178 reviews

Alternatives to general anesthesia during breast augmentation

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It is best to have your augmentation done with general anesthesia or a deep sedation. An epidural can work well for surgery on the belly and lower. It simply will not work high enough for you....without blocig the nerves that control your lungs! A board certified plastic surgeon and a board certified anesthesiologist will be able to provide the proper care and prevent you from waking up in the middle. Patients always worry about this, but I have never seen it happen!

Epidural vs general for breast augmentation

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I do not think that an epidural will be adequate for a breast augmentation.  I think that you are better off with general or deep sedation and local.  Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Epidural for breast augmentation

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Though the idea might seem safer than general anesthesia or IV sedation for breast augmentation, an epidural just won't reach high enough to work for breast augmentation.If the facility you choose is accredited you should have little to fear about your anesthesia.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Epidural inappropriate for augment

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Epidurals are used below the waist, in lay terms. An epidural high enough to numb your breasts would paralyze your diaphragm, making it impossible to breathe. I have found less nausea with general anesthesia than with sedation, which involves a drug cocktail administered intravenously. I have been a physician fir 35 years and have never had a patient who reported consciousness while under general.

Patients to not wake up during general anesthesia.

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Epidural anesthesia is not used for breast augmentation. Intravenous sedation and local anesthesia sometimes none but the vast majority of patients have a general anesthetic. This is extremely safe in reports of patients waking up during general anesthesia are extremely rare.

Breast Augmentation and Epidural Anesthesia

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      Breast augmentation is most commonly performed with general anesthesia to assure that the patient is the most comfortable and not awake.  To be totally asleep, you need a tube to help you breathe.  Anything else has a greater potential for the patient being aware and awake.  Epidural anesthesia can be used for procedures lower on the body.  Kenneth Hughes, MD Los Angeles, CA

Breast Implant anesthesia

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Breast Implants can performed under a variety of anesthesias. In my office I use a very deep sedation (TIVA or Total IntraVenous Anesthesia) which is controlled by a board certified anesthesiologist. This seems to give the least chance of nausea post op and because of the medications patients do not remember the operation at all. Local anesthesia is given along with this so you have no pain either during the operation or when you wake up. Epidural anesthesia may not be as safe because you need to go very  high with the epidural on your chest and this may inhibit your breathing. In addition, many patients with an epidural may be awake during the procedure so this wiould not alleviate your fears of being awake anyway. Most importantly, be sure not to only check out your surgeon to sure they are board certified in plastic surgery but also to know that anesthesia person is also board certified.

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.