What is considered to long to be under anesthesia?

Hi there, Thank you for your question. For an elective procedure I do not like to plan procedures that will last longer than 5 hours. Best, realdrsix

That's really a god question.  I won't perform cosmetic surgery for more than six hours at a time on one patient.  Over six hours the risks go up substantially.  If surgery will take longer than that I prefer to separate the procedures and do them at separate times .

Obviously the shorter the time, the better and articles will talk about 5-6 hours as being the cutoff but I've done 7 hours without any adverse problems and I think if the patient is healthy, precautions are taken to prevent blood clots, and the patient is kept warm, 7 hours can be easily tolerated.  But if  you want the safest options, then consider breaking up procedures if it will exceed 6 hours.

There are no absolute standards when it comes to duration of anesthesia; I think that it is best to individualize patients care based on several factors. For example, the type of procedures being performed, the amount of blood loss anticipated, the potential for fluid shifts, patient medical conditions, qualifications of anesthesia provider…are all examples of factors that may come into consideration.In other words, It is best to evaluate each patient's suitability for combination surgery on an individualized basis. During this consultation process, after a complete history and physical, the SAFETY  of combining these surgical procedures becomes of paramount importance.  Plastic surgeon, anesthesia provider, duration of surgery, surgery facility all important  considerations. Your best bet: choose your plastic surgeon very carefully;  make sure that he/she is a board-certified plastic surgeon (not "cosmetic surgeon") and can demonstrate a lot of experience achieving the types of outcomes you would be pleased with, with an excellent safety record.  Everything else including  good judgment/advice/planning, anesthesia provider and safe surgery facility will follow. Best wishes.

For elective cosmetic surgery I limit my cases to 6 hours under general anesthesia typically.  If longer then I have the patient in an overnight stay with a nurse for monitoring.

Obviously, the shorter the better. However, in healthy patients, I have done cases up to 18 hours (all trauma and necessary) without any problem related to the anesthesia. I also have done cosmetic cases, even in older healthy patients, up to half that without any problem. However, anyone that I go over about 4 hours I generally keep them over night. By the next morning, the anesthesia has worn off and they are almost back to normal.

For elective cosmetic procedures most surgeons adhere to the 6 hour rule as long as your health is good. That is they want to keep the anesthesia time less than 6 hours. 

Dear Ms. Cmvilla45,
Thank you for your questions.
Simply stated the length of anesthesia is only one of the factors related to a safe surgical experience. It's not unheard of having anesthesia greater than 24 hours (detox patients, head injury, separation of conjoined twins, major reconstruction, etc)!
General anesthesia can be compared to flying in a commercial airliner: the most risk is the take off and landing not the absolute time of flight.  A 2 hour flight can be very dangerous in bad weather as can a 2 hour surgery in a unhealthy patient or with major blood loss.  Conversely, with a well trained and experienced pilot (Anesthiologist) in a well maintained plane (certified surgical center), monitoring the plane and weather conditions (Anestheologist monitoring the vital signs, blood loss, etc) 6-10 hour flight in clear weather  (healthy patient and standard procedures followed) is extremely safe.
However, in general for elective Cosmetic Plastic Surgery most Plastic Surgeons try to limit the surgical time to approximately 6 hours.
There are four main groups of complications that can occur with any surgery1) bleeding= stop all aspirin and NSAIDS (ibuprofen, Alleve , etc 2 weeks prior to surgery)2) infection= take antibiotics as directed3) anesthesia= local vs general 4) inherent risks= scars, irregularities, secondary surgery and rarely ultimate compilation of death 
Nothing substitutes for a personal evaluation, a review of your medical history/medications and a face to face discussion of your options, goals and desires.  Realistic expectations and clear understandings of what will be done and in what ordershould be agreed upon in the event that the the procedure time should need be shortened.
Ask your chosen Plastic Surgeon:1) are his/her Anestheologist Bd. Cert.?2) does he/she work in a fully accredited Surgical Center?3) what arrangements have been made if a transfer from the surgery center to a hospital if necessary?4) how far away is the surgery center away from the hospital with a transfer agreement? 
I recommend that you schedule several consultative appointments with Plastic Surgeons who are experienced and Certified by the American Board of Plastic Surgery. In addition ideally a members  of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).
I wish you my best and success,
R. A. Hardesty, MD, FACSDiplomate and Certified by the Am. Bd. of Plastic Surgerywwwimagineplasticsurgery.com4646 Brockton AveRiverside, Ca 92506(951) 686-7600