General Anesthesia Vs. Iv Sedation for Breast Augmentation?

Im getting Breast implants and dont know what time of anesthesia will be better to use for this procedure. If it helps im a small girl weight 95 to 100 pounds height 5'2 and really healthy I talk to 2 doctor and 1 uses general anesthesia and 1 uses iv sedation Im scare to go for one of the doctors and be the wrong decision. I asked each doctor about every anesthesia and all of then bring down what they are not using in a bad way meaning complications. So i cant make up my mind. Please help!

Doctor Answers 46

***IV Sedation is clearly "The Way to Go" for Breast Augmentation

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There are many comments from Board Certified Plastic Surgeons regarding your question as well as a similar question asked previously on, "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.

General or local anaesthesia for breast augmentation?

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You should ask yourself if you would prefer general or local anaesthesia. As you can see from the other responses, both are acceptable ways of doing the procedure.  As long as the surgeon is comfortable using that type of anaesthesia, I am sure you will be fine.

If you do not have a strong preference, then go with the surgeon who you preferred as this is more important than distinguishing between the anaesthetic.  Good luck. Jonathan Staiano

General anesthesia vs. sedation for breast augmentation.

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The choice of anesthesia is based upon the facility, your anesthesiologist, your medical history, and the procedure type. Both are safe, reliable choices. For a short duration procedure such as a breast augmentation, general anesthesia recovery is very quick.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

General anesthesia recommended for breast augmentation

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You obtained 2 different answers in consultation and surely can see a dichotomy in views of other plastic surgeons who have responded to your question. Both can clearly be performed for a breast augmentation. However, for several reasons, I strongly feel that general anesthesia is a better way to go though with some minor caveats. With this approach, you are totally asleep, you don't feel anything during the procedure which can progress without concerns of patient discomfort which does occur during the twilight anesthesia approach. A patient's airway is controlled with this approach while it is not with twilight sedation should an untoward event arise. The anesthesiologist performing the general anesthesia must be experienced in using quick acting agents for these procedures so that there is little sequela following surgery; that is, waking up virtually immediately with few after effects. This is different than what is used for other non-cosmetic in hospital procedures where patients may be staying for days.

All my breast augmentations are performed using general anesthesia and I have not had patients complain of experiencing pain during surgery. I have seen many patients over the years who came to me for secondary breast procedures who had the sedation approach and still vividly recalled years later the severe discomfort that they experienced during their breast augmentation. They never wanted to risk that again.

Regardless of which approach you choose, make sure that you are using a board certified anesthesiologist.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.7 out of 5 stars 33 reviews

General Anesthesia Vs. Iv Sedation for Breast Augmentation?

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GREAT question! I use LAM + IV Sedation + Local. But it is a surgeons preference, as you can read from all the answers posted. There is no wrong way. 

Patient Should Choose Between General And IV Sedation

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Individual patients should choose the type of anesthesia with which they are most comfortable.  I have used both types and feel both are safe if given by appropriate practioners.  You should have either type of anesthesia administered by a board-certified anesthesiologist or a CRNA with a BC anesthesiologist in attendance.  Be wary of a plastic surgeon who assumes responsibility for both the operation and the anesthesia.

John Whitt, MD (retired)
Louisville Plastic Surgeon

In breast augmentat5ion, the type of anesthesia used for the procedure is less

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important than who is giving you the Anesthesia.  If you are young and healthy you can safely have the procedure done under either local anesthesia with sedation, or general anesthesia.  Make sure that there is an Anesthesiologist presnet to supervise your anesthesia, and that you have a frank discussion with him or her regarding the type of anesthesia and the risks and benefits of each approach.  As long as the person in charge is familiar and able to sue either anesthetic technique, you will be in good hands and can safely and comfortably have the procedure done. 

Michael H. Rosenberg, MD
Mount Kisco Plastic Surgeon

Anesthesia for breast augmentation surgery

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Both general anesthesia and IV sedation are safe forms of anesthesia when administered by a board certified anesthesiologist.  The type of anesthesia will vary by the doctor, facility, and equipment available.  Although I have used both kinds of anesthesia I personally prefer general anesthesia.

Breast augmentation under local anesthesia

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Breast augmentation under local with IV sedation or general anesthesia, can both be safe. I think those that cannot perform the procedure under general anesthesia because they do not have hospital privileges inflate the risks of general anesthesia, which is very safe. Local anesthesia can have risks, for example I have seen punctured lungs occur when local injections were being done for a breast augmentation. I prefer general anesthesia as I feel it is safe and very comfortable for the patient. The amount of nausea after the surgery depends on the amount of medication used, and can happen with both IV or general anesthesia.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Breast augmentation and type of anesthesia

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I was trained and is always done my augmentations under general anesthesia. The reason why is because when you use general anesthesia the patient is intubated and the airway is controlled. There is less movement of the patient so I can do a more controlled surgery.

Augmentations are relatively quick surgeries so the risk of general anesthesia are very low. And also the shorter the time of the surgery the faster the recovery is after extubation.

Wendell Perry, MD
Miami Plastic Surgeon
4.8 out of 5 stars 234 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.