What is the difference between twilight anesthesia and general anesthesia?

Question

I'm super confused trying 2 get as much information as I can. So I'm getting a breast augmentation & I'm trying to do ANYTING but general anesthesia, my god I'm terrified of general anesthesia. But I did some more research & found out there's something called twilight sedation?! So like is it general anesthesia or like is it a light does of anesthesia & is it safe? & if I was under twilight sedation would I feel the pain while I'm getting my breast surgery I'm so confused? I need answers please

Badar Jan, MD · Answer

Many patients have questions regarding anesthesia, so youre not alone. General anesthesia  requires mechanical ventilation and a breathing tube because its a deep anesthesia. Twilight anesthesia uses a combination of sedatives and local anesthesia to comfortably perform the procedure. The main advantage of general anesthesia is more precise development of the pocket if the implant is being placed underneath the muscle. I place the majority of my implants underneath the muscle because it gives a more natural appearance. I dont think there is anything wrong with twilight anesthesia for a breast augmentation. Your plastic surgeon will be able to guide you as to which anesthetic would be superior for your specific needs.
Best wishes,
Dr. Jan

Lawrence Iteld, MD · Answer

Anesthesia can be scary for some people who are excited about their upcoming cosmetic surgery. Rest assured, anesthesia is EXTREMELY safe when performed by a board-certified anesthesiologist or their CRNA in a properly accredited facility.There are lots of different ways to delivery anesthesia. General anesthesia means that you are completely asleep and a machine assists with delivery of oxygen and some anesthetic medications (gases). This can be done with you breathing on your own or with the machine assisting breathing depending on your surgery. Also, this can be done with a breathing tube or with a special mask that rests inside your mouth called and LMA.Twilight anesthesia, also known as conscious sedation, differs from general anesthesia in that the anesthesia machine is not used, but rather medications are delivered only through your veins and you breath oxygen through your mouth or nose on your own. Patients do not remember their surgical experience with either method.Both types of anesthesia are very safe and effective but your surgeon may prefer one or the other based on the surgery being performed. Please discuss your concerns with your surgeon prior to surgery so you can have all of your questions answered to your satisfaction.

Alejandro J. Quiroz, MD · Answer

In the case of general anesthesia normally
you need the support of the machine to maintain you stable in the case of  twilight anesthesia medications are given IV
and you are monitor and normally local anesthesia is apply.  Twilight anesthesia I normally  used it for my facial surgeries and works
perfect in the majority of the cases.

George Volpe, MD · Answer

Twilight anesthesia usually refers to a technique in anesthesia where one becomes sedated but not fully asleep. General anesthesia usually means one is completely asleep for the procedure. With twilight anesthesia local anesthetics are also used to minimize discomfort. I find this can be more difficult one policing implants in the sub muscular position. Although both techniques are safe, it is wise to discuss with your surgeon the risks with each, your surgeon's experience and his or her recommendations.

Young R. Cho, MD, PhD · Answer

Thank you for your question. The difference between twilight and general anesthesia is really whether you have a breathing tube and device that breaths for you (general anesthesia) or where you breathing on your own but are sedated (twilight).   Both are very safe methods to have surgery and the decision is something you should discuss with your surgeon.

Nelson Castillo, MD · Answer

Thank you for your questions and photograph, and I can understand your apprehension.  Both methods of anesthesia are safe, though most plastic surgeons prefer general in order to maintain patient comfort.  General anesthesia involve placing you fully asleep, with a tube placed to maintain and protect your airway.  Twilight anesthesia does not place a tube to help you sleep, and instead only IV medications are administered in order to manage your pain and keep you rested.  I would voice your concerns with your surgeon, and their anesthesiologist, in order to make the safest decision for you.

Vincent N. Zubowicz, MD · Answer

General anesthesia requires placement of a tube in the trachea to manage the airway which is necessary because of the depth of sedation with this technique. Twilight anesthesia is done with intravenous medications and no intubation allowing the patient to breathe on their own. General anesthesia is generally preferred for breast augmentation. It's faster and probably safer.

Scott Chapin, MD, FACS · Answer

It is common for patients to have concerns about anesthesia when preparing for their procedure.  The most critical component is to ensure your doctor has a board-certified anesthesiologist or a CRNA at an accredited facility. 
  
General anesthesia is the most popular option for breast augmentation surgery.  Under general anesthesia, a machine allows the patient to fall into a deep sleep so as not to feel pain in surgery, while delivering both oxygen and anesthesia.  Depending on the surgery, the patient may or may not be breathing on their own. 
  
Twilight anesthesia or conscious sedation utilizes medications that are delivered by IV to ensure that there is no pain, though the patient is not completely asleep and may be able to respond to commands. Oxygen is delivered to the body normally, via the patient’s nose and mouth throughout the procedure. 
  
Regardless of the method used, the patient does not recall their surgical experience.  Although both types of anesthesia are very safe and effective, your surgeon may prefer one or the other. It is best to discuss your concerns with your surgeon prior to surgery.

Richard Chaffoo, MD, FACS, FICS · Answer

Hi and thanks for your question. The difference between these anesthetic techniques is best addressed with your plastic surgeon and the anesthesiologist your surgeon uses. The most important question is who will do your anesthesia. Make sure it is a board certified MD anesthesiologist. This physician is the expert and can answer all your questions. Best of luck.

Ernest Layton, MD · Answer

I usually make that decision based on the patient and how well I feel that they would tolerate sedation as well as the length of the procedure and the relative potential for discomfort for that procedure. For breast Augsburg I prefer general anesthesia. For this procedure I think general is the safest way. The problem with sedation is that you have to get enough medication to make you comfortable and not be tense and moving during the procedure. This much medication may depress your ability to keep your airway open and breath. If this occurs the procedure must stop and maintaining your oxygen level becomes an emergency sometimes requiring a general at that time. This is because your airway is not secured (your means to breath) in the beginning as with a general anesthetic. Who needs this stress, by the time all of this occurred you could be in the recovery room waiting to go home and I could be in the lounge sipping coffee.

What is the difference between twilight anesthesia and general anesthesia?

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