I take lexapro and birth control. How safe is general anesthesia for a rhinoplasty?

Question

In the next few months I'm hoping to get a rhinoplasty to get rid of my dorsal hump. I'm in the process of researching doctors and am speaking with my mom who is also a doctor, and from what I've read general anesthesia is much safer than sedation. I am anxious about any potential complications such as death from anesthesia. Could the fact that I take lexapro and birth control pills cause any complications?

Jeffrey Joseph, MD, FACS · Answer

I would discuss your medical history and all medications  with your anesthesiologist prior to your surgery.  With general anesthesia for rhinoplasty, your anesthesia will have complete control, and is my preferred method of anesthesia for rhinoplasty.

Larry Weinstein, MD · Answer

Depending on the extent of your rhinoplasty general anesthesia would be preferable. If shave of your sprain is all that is needed without septal work local anesthesia maybe enough. Good luck.

Ronald J. Edelson, MD · Answer

General anesthesia is extremely safe provided it will be administered by an anesthesiologist which I assume it will. It is normal for people to be Nervous about the anesthesia. You are safer in an operating roomUnder general anesthesia than you are driving in a car.

Eric M. Joseph, MD · Answer

General anesthetic is extremely safe, and the likelihood of death from general anesthetic is around 1:10,000. If you have a family history of allergy to general anesthetic (pseudocholinesterase deficiency or malignant hyperthermia), this should be brought to the attention of your surgeon. Insofar as Lexapro (escitalopram), this may not affect your outcome and would likely be taken as normal. BC pills with synthetic estrogen may increase one's likelihood of DVT (deep venous thrombosis) and pulmonary embolus. We ask our patients to stop BC pills 2 weeks before rhinoplasty. Some surgeons do not stop BC pills, and others recommend stopping them for 1-2 months. GREAT questions! Dr Joseph

David C. Pearson, MD · Answer

In young, healthy patients, today's general anesthesia is incredibly safe. It's also usually more comfortable for the patient (compared to sedation) and provides a very safe way to control the patient's breathing.Birth control pills can increase the risk of deep vein thrombosis (clots in the deep veins of the legs) but steps are taken during surgery to minimize that risk such as using SCDs (devices that massage the legs while you sleep) and having you up and moving around immediately after surgery.Lexapro is only an issue if the anesthesia team weren't told that you were on it. Lexapro can interact with a common pain killer called fentanyl to create a dangerous condition known as serotonin syndrome. As long as your doctors are aware of your medications, they can use other pain killers.Hope that helps,--DCPPearson Facial Plastic Surgery®

Keith M. Blechman, MD · Answer

General anesthesia does give more control to the anesthesiologist and can be thought of as being safer in this way.  Every medication could potentially interact with others but the risks from lexapro and birth control are small.  Our board certified anesthesiologists would be happy to speak to you more about what the risks are if you wish to schedule surgery with us.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. It is very safe to have general anesthesia when administered by a board certified MD anesthesiologist. You should have medical clearance by your primary care physician prior to surgery regarding your medications. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon. If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon. Best wishes and good luck.

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Cem Payasli, MD · Answer

Hello,
  
Thank you for your  question. 
  
Your plastic surgeon and anesthesiologist should be aware of medication.  You should refuse medicines  which could affect blood coagulation before surgery.  Neither escitalopram nor contraceptives have a significant effect on the hematopoietic system. Also keep in touch with doctors who have prescribed these medicines..Best of luck and take care!
  
Best Regards, DR CEM PAYASLI 
  
MEMBER OF INTERNATIONAL SOCIETY OF AESTHETIC PLASTIC SURGEONS.

William Portuese, MD · Answer

General anesthesia is the preferred method of anesthesia when undergoing a rhinoplasty procedure. It's very important to protect the airway so the blood does not pool down into the lungs. In our practice we use a board-certified physician anesthesiologist for patient safety and comfort. We do not recommend IV sedation or local anesthesia for a rhinoplasty procedure

Robert J. Paresi Jr., MD, MPH · Answer

Thanks for the question.  In most cases, I recommend general anesthesia for rhinoplasties.  General anesthesia allows for protection of your airway which is particularly important when working on your nose.  This prevents any blood or fluid from entering and compromising your airway during surgery.  In a minority of rhinoplasty cases when small changes are being made, local anesthesia or sedation can be used.  General anesthesia from a reputable provider in an accredited facility has a very low risk profile.  Birth control pills are associated with a higher risk for blood clots but if you have no other medical issues you are low overall risk.

I take lexapro and birth control. How safe is general anesthesia for a rhinoplasty?

Answers (12)

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