Epidural versus GA?

Question

If my procedure is performed after another surgery 2 weeks prior (may just be coming off anticoagulants), would epidural or GA for this procedure be considered safer?

Burcak Tok, MD · Answer

Hello, although it is important what kind of anesthesia your previous surgery was performed with, I recommend you to choose epidural anesthesia. It will be safer.

Irena Karanetz, MD · Answer

Hello and thank you for your question. 
Labiaplasty procedure is typically performed under local anesthesia or general anesthesia.
I suggest that you discuss your questions and concerns with a Board-Certified Plastic Surgeon specializing in Labiaplasty, especially in the setting of another surgery and being on blood thinners.
I hope this helps.
Best regards, 
Dr. Irena KaranetzFellowship-TrainedBoard Certified Plastic Surgeon

Mark N. Scheinberg, MD · Answer

If you are still under the effects of anticoagulants you should avoid epidural anesthesia. You can get a bleeding time (lab test) to see if you are still being effected. I suggest waiting to do your surgery to minimize surgical blood loss.

Christine Rodgers, MD · Answer

Hi Whatever,

You should definitely be off anticoagulants before having the labiaplasty. What is the reason for the anticoagulants? Did you have a blood clot during the surgery. If so , you need to follow the directions of the doctor who put you on the anticoagulants.
 In terms of the surgery itself, it is considered to be safe to have another GA after about 6 weeks with another elective surgery. You can have a labiapalsty under local anesthesia, but again, please be off anticoagulants if it is safe to do so. Again, you need to consult with the doctor who put you on the anticoagulants.

Hope this helps,

Best,

Dr. Christine Rodgers

Marco A. Pelosi III, MD, FACOG, FACS · Answer

If you are just coming off of anticoagulants, you might not be ready for cosmetic surgery yet. Nonetheless, local is the safest anesthesia for labiaplasty because it is limited to the area being worked on and has no systemic effects in the tiny doses typically used for this procedure. Epidural anesthesia, similar to the type used for cesarean sections, would be extremely dangerous in someone recently anticoagulated. General is used by some surgeons who are not trained or skilled in local anesthesia techniques and has more risks than local. Local with IV sedation conducted by an anesthesiologist is safer than general for patients who simply wish to sleep through the procedure.

Oscar A. Aguirre, MD, FPMRS · Answer

I'm not sure I understand your question, but I'll give it a try.
Are you concerend about the risk of an epidural after coming off of anticoagulants? Once you are off the anticoagulants there isn't an increased risk of bleeding more than normal for any procedure.
Both, epidural and general anesthesia seem excessive for a strightforward labiaplasty. These procedures could be done under IV sedation in a  surgical center, or under local anesthesia an an office setting. 
I've been performing labiaplasty in the office for over 15 years. 
Go to the link below to see hundreds of B/A photos of these procedures. You will likely find some examples that are quite similar to you. From that link you may schedule a virtual consult via phone or zoom, at which time we can discuss in-depth your anatomy, expectations, and concerns. Women from all over the world travel to my Center for their Intimate Makeover under local anesthesia.
Best of luck,

Epidural versus GA?

Answers (6)

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