General Anesthesia Vs. Iv Sedation for Breast Augmentation?

There are many comments from Board Certified Plastic Surgeons regarding your question as well as a similar question asked previously on RealSelf.com, "Alternative to General Anesthesia for Breast Augmentation?"

I have performed many hundreds of under-the-muscle breast augmentations over many years under IV sedation, and for me this technique has many benefits:


Dramatic reduction in postoperative pain and recovery. The anesthesiologists and CRNAs I have worked with over the years 100% agree that by thoroughly blocking the breast with long-acting local anesthesia, patients have a profound improvement in comfort.

Significant reduction in chances of post-op nausea and vomiting.

Significant reduction in general fatigue as is always seen to some degree with general anesthesia.


I performed this procedure yesterday under IV sedation while a Plastic Surgeon was visiting from Europe. This surgeon regularly uses general anesthesia and he was quite surprised to see that at the conclusion of the procedure, our patient was awake, talking, smiling and reporting "no pain" and "just a little pressure, maybe a one or a two." 

Bottom line is this: both General Anesthesia and IV Sedation are options for Breast Augmentation, and both can be safely performed. As Dr. Dabbah mentioned in response to your question, the more important issues are being certain that your are selecting a reputable Board Certified Plastic Surgeon and are having your procedure performed in a Licensed and Accredited surgical facility. 

I recommend selecting a Plastic Surgeon that is a member of the ASPS and ASAPS. A surgeon with these credentials has board certification by the American Board of Plastic Surgery, advanced education in aesthetic surgery and signifies that they will only perform surgical procedures in an accredited surgical facility.

***With apologies to the surgeon stating that general anesthesia is "the way to go" for breast augmentation, I do not believe there is any evidence to support this claim and believe that both IV sedation and general anesthesia can be safe and effective options.

Hope this helps,

Nick Slenkovich MD, FACS

The video below is a patient of mine undergoing breast augmentation under Local anesthesia -- which can also be an option for carefully selected patients. This video is about 3 minutes long, and clearly demonstrates that I can thoroughly make sensation to the breast go "to sleep," which has major benefits for post-op recovery.

Concerns about anesthesia are common for many patients.  I have performed breast augmentations with both types of anesthesia. They both work, but over the years I have found that I prefer using general anesthesia for breast augmentations.  The patients are completely asleep and have no memory of the surgery and experience no discomfort. During general anesthesia, an airway is placed which allows the anesthesiologist or nurse anesthetist to better control the patient's airway and breathing.  Local anesthetic is also injected which means our patients wake up quickly from the anesthesia and they are very comfortable.  

I prefer and always have preferred General Anesthesia as the safest and most reliable way to achieve patient's comfort during Breast Augmentation. In the hands of a Professional Anesthesia Provider- safety and efficiency are more reliable.

Hi there. Thank you for the post. It is well documented that general anaesthetic is much safer than sedation and it is always worth ensuring that the facility where your surgery is planned has the capability for general anaesthetic. Good luck

Thank you for your question.  While some doctors might and, as you have seen, can argue that both general anesthesia and sedation are safe choices, I will only perform a breast augmentation procedure under general anesthesia provided by board certified anesthesiologists.  With general anesthesia patients are completely asleep and feel no discomfort while in surgery.  Because the amount of time that patients are under general anesthesia during a breast augmentation is relatively short, patients wake very comfortably and recover from this anesthetic quite quickly.  I would recommend choosing your surgeon based upon experience, expertise and results.  Find a board certified plastic surgeon with whom you are confident in and who is well-experienced in breast augmentation procedures.  I hope you find this helpful and best of luck.

Thank you for your question. Both types of anesthesia can provide a safe and comfortable platform for breast augmentation surgery. It is more important that you feel comfortable with your surgeon and the surgical plan as this is ultimately what you will be remembering after the procedure.

I would have to ask you which surgeon do you prefer? Then I would have to ask is the center that he/she is performing the surgery accredited for general anesthesia; and who would be giving you the general anesthesia.  If the center only gives IV Sedation are they only accredited for IV Sedation, who gives it and what happens if something goes wrong?  These are the questions you should ask.  Our center is accredited for General Anesthesia.  I use it for the majority of my cases.  It is administered by an anesthesiologist. If my patient would prefer IV Sedation it is available to them; also administered by an anesthesiologist.

Different doctors have differing opinions on which type is best. This is probably not the most important factor in your choice of surgeon, although it is still something to consider. What's most important is that you can feel confident and comfortable with the plastic surgeon you choose. They should be highly experienced and board certified with an excellent track record of delivering safe, beautiful results, and you should feel as though you're on the same page in terms of your goals and expectations for this procedure. If you do not have a preference and there is no medical reason that either type is not suitable for you, don't let this get in the way of choosing the best surgeon for you.

Different surgeons prefer different techniques.  You should choose the surgeon that you trust and let them use the technique that they always use.  It is best to fit yourself into their system, because it is what works for them.  I prefer to use a board certified anesthesiologist who administers general anesthesia.  The operation is relatively short and the risk of anesthesia are low.  If you are asleep then everything goes very smoothly.

The type of anesthesia is not as important as who is doing
the anesthesia for your procedure. You
want to make sure that a board certified anesthesiologist is doing your
anesthesia whether it is sedation or general. I personally do all of my breast augmentations
under general anesthesia.



Questions to ask:



1.Where is the surgery performeda.Is the procedure performed in an
accredited surgery center or hospital?



2.Who performs the anesthesia for
the procedure?a.Is an anesthesiologist performing
the anesthesia?

I hope this helps. 

         It’s possible to
perform breast augmentation utilizing either I.V. sedation or general
anesthesia. Each approach has advantages and disadvantages and both approaches
have advocates.

         It’s important that
the anesthesia be administered by a board certified anesthesiologist,
irregardless of the type of anesthesia utilized. This is an important point,
because I.V. sedation is occasionally administered without an anesthesiologist
as a cost cutting maneuver. When this happens, your surgeon is also your
anesthesiologist.

         I generally prefer
general anesthesia for a variety of reasons. I typically place implants beneath
the muscle and feel that general anesthesia makes the experience more
comfortable for my patients. With newer anesthetic agents, patients tend to
recover quickly with less nausea and fewer side effects.

         It’s important to
discuss these issues with your plastic surgeon before proceeding with surgery.
It’s important that both of you are comfortable with the choice of anesthesia.
In some cases, it might also be helpful to meet with the anesthesiologist
before proceeding.