Mira dry one treatment efficacy, is it enough, Other anesthesia options and long term side effects? (photos)

Question

I had Mira dry 16hrs post treatment.I was traumatized and thinking not doing the second treatment. Site is bruised, painful, tenderness on both lateral side of my breast, taking ibruprofen, ice with a little help. Had adverse reaction with the anesthesia during the procedure.Tremors,palpitations, numbeness all over up to my face, coughing, throat tightnessinform my dr of my symptoms.After,dizziness, lightheadness, nausea vomiting. If I have to do it again. I'm definitely going to a different doctor.

Raffy Karamanoukian, MD, FACS · Answer

Miradry is a non-invasive procedure that requires anesthesia. Lidocaine can cause the symptoms you described in some cases. I would consider speaking to your practitioner about the concerns and then choose an expert who can minimize recurrence. Best, Dr. Karamanoukian Los Angeles

Sheila S. Nazarian, MD · Answer

You may have had the old treatment protocol with MiraDry.   You should get re-treated with the new treatment protocol using tumescence.

Young R. Cho, MD, PhD · Answer

It is very important to understand the safety limits of using lidocaine for office based procedures for miraDry. miraDry often uses more than 50% of the safe dose of lidocaine. In the state of Texas you need special certification to be able to provide this level of local anesthesia in an office-based setting.  I would definitely ask your miraDry provider how comfortable they are with the use of lidocaine or if they are even aware of what the safety limits of using such medications are. You should be able to have the procedure safely without exceeding the toxic dose

Allison Readinger, MD · Answer

You may get by with just one treatment. With older protocols about 50% of patients were satisfied with just one treatment. With newer protocols for treatment settings we may see more patients satisfied with just one treatment. I do use 1% lidocaine with epinephrine. You probably are very sensitive to the epinephrine.  I sometimes use slightly less volume per injection site in this case or do one underarm at a time in very sensitive individuals. Breaking up the treatment into two sessions instead of just one allows me to use half the volume I would normally use. However, this does raise the cost of the procedure a little because another biotip (the disposable hand piece we use on the machine) has to be used for the second treatment.  Just so this is clear this is basically the same as one treatment broken up into two sessions (different from the two treatments of both underarms like we mentioned above).

Hratch Karamanoukian, MD, FACS · Answer

During tumescent anesthesia (HVA) only 0.1% lidocaine is used. Unfortunately, some physician providers give 1% (10 times stronger) local anesthesia, reaching the higher limits of safety for patients. Local anesthetics are given by a calculation of weight (patient weight) as they can cause heart palpitations, chest tightness, facial and body flushing, hypotension ... You know you have given too much lidocaine when patients complain of numbness in the mouth or tongue or have problems with speech, as it gets to the dangerous levels. Fortunately, local anesthetics are metabolized quickly (within hours) and nothing untoward happened that is permanent. These are well described side effects of using lidocaine during awake patients. In our practice we use HVA and have never had this problem. My background as a CV surgeons helps with such side effects. Read my ebook on miraDry.

Mira dry one treatment efficacy, is it enough, Other anesthesia options and long term side effects? (photos)

Answers (5)

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