Do you recommend getting a mommy makeover under deep sedation? Why or why not?

Question

I’m a healthy 42 year old woman, mom of two and want to speed up my recovery. I had breast augmentation in 2004 under general anesthesia and was very nauseous and had a bad sore throat for days…it was so hard to eat.

Thomas A. Mustoe, MD, FACS · Answer

I have been doing mommy makeovers and abdominoplasty exclusively under deep sedation for over 20 years with a very positive experience of accelerated recovery and minimizing risks of blood clots.  The technique requires skill in getting effective local anesthesia and close cooperation with the anesthesiologist and works very well and predictably.

Caner Kacmaz, MD · Answer

We almost always prefer performing surgeries under general anesthesia. It is the use of medicines to make a person go to be unconscious for a medical procedure. General anesthesia makes it possible to have medical procedures that would be too painful and stressful to have while awake. Side effects like you experienced are common, but serious reactions are extremely rare.

Chet Mays, MD · Answer

Greetings!
There is no way to speed up the healing and recovery, General anesthesia allows the surgeon to undermine the skin and plicate "tighten the muscle". The recovery is the same regardless. You may want to speak with the anesthesia providers and possibly have a TIVA anesthesia.

Daniel Barrett, MD · Answer

Dear Stormy1221,
mommy makeover is a major surgery that can last several hours, so general anesthesia is the best option. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Adam Tattelbaum, MD · Answer

Thanks for your question. Mommy makeover can mean a lot of things and may include tummy, breast liposuction and even other surgeries. Even if were just a tummy tuck these things would be dangerous to do under local. Too much local anesthesia can be toxic.

If you are having more surgeries let your PS and anesthesiologist know about your prior experience. In some cases extra medications can minimize post op nausea. In some case A laryngeal mask can replace a tube in the trachea that causes a sore throat.

Your team will have to do what is safest for you but the discussion is worth having.

Best wishes.

Richard Baxter, MD · Answer

A mommy makeover with tummy tuck is a much bigger operation that breast augmentation alone, and it would be more challenging to keep you completely comfortable during the procedure. Nausea can be minimized a number of ways including Emend, a medication taken prior to anesthesia.

Zoran Potparic, MD · Answer

We are using scopolamine patch for patients who have history of postoperative nausea and vomiting. Patch is placed behind the ear 2 days before and replaced with new one for another 2 days after surgery. This has helped our patients significantly; I do not remember anybody not responding to this treatment; other medications like corticosteroid, antinausea meds are given in the course and after the surgery. Doing breast and abdominal surgery, possibly liposuction is possible  in deep sedation providing that anesthesia and surgical team are comfortable and well trained in that type of anesthesia.. Hope this helps. Good luck.

John Michael Thomassen, MD · Answer

IV sedation can be done safely for mommy makeovers including breast augmentations and tummy tucks combined.  This can reduce risks like postop nausea/vomiting and deep venous thrombosis.

Nelson Castillo, MD · Answer

Thank you for sharing your question. In most cases for patient comfort and safety it is best to do a tummy tuck or any mommy makeover that involves a tummy tuck under general anesthesia.

Sean Fisher, MD · Answer

This surgery requires a general anesthesia for a number of reasons. Depending on your anatomy and surgical needs, it may be necessary to start in a face-down position that can only be done safely with a secure airway. Additionally, diastasis repair is a common aspect of tummy tuck surgery. This typically involves using a short-term paralytic to allow the muscles to relax, which could not be done under general sedation. Compared to a breast augmentation, it is a much larger operation. For all these reasons, I recommend patients do so with a general anesthetic and a qualified anesthesia provider. 
Sean M Fisher MD

Do you recommend getting a mommy makeover under deep sedation? Why or why not?

Answers (17)

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