Twilight/ IV for Augmenation? Do I Have to Be Completely Asleep?

I am a little bit afraid of being put under general and being completely asleep. I am 175 lbs and 5'3 (Yes, I am overweight but I lost alot and this is my thinnest since high school). Do I have to be completely asleep to get an augmenation? Also, I am planning on a Saline Implant filled between 525-625 cc. Is this too much for my first Augmenation? I am naturally wider. My hips are 42 inches (mostly muscle though) and my waist is 32 inches, I am going for a full DD currently a low B/C cup.

Doctor Answers 11

Sedation for augmentation surgery

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The type of anesthesia used for a breast augmentation depends on the anesthesiologist and surgeon. Certainly IV sedation can be done, but I prefer general anesthesia, especially when placing the implants under the muscle. As far as the size, discuss this with your board certified plastic surgeon to come to an agreement on what is best for you.

Anesthesia preferences will vary

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Hi there-

Your surgeon's recommendations for your anesthesia will vary...  

If placing your implants under your muscle, my opinion is that your outcome wil suffer if not done under general anesthesia, as this is the only anesthetic that allows relaxation of the muscle.

IV sedation is a good alternative for breast augmentation

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General anesthesia or IV sedation can be provided for breast augmentation.  It is important that a local anesthetic be used with either as this allows the anesthesiologist to give you less medication and it will decrease your discomfort afterwards.  Your questions on implant size requires a careful evaluation of your breast tissue, breast width, your height, and your goals to answer accurately.  Be careful on going too big.  Its always better to be 10% too small than 10% too big.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 170 reviews

Sedation for a breast augmentation

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The type of anesthesia that you get for a breast augmentation is really dependent upon you and the anesthesiologist.    Iv sedation is certainly possible. As for size, a consultation is essential to determine what would be best.

Twilight/ IV for Augmenation? Do I Have to Be Completely Asleep?Answer:

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Yes it is possible but I prefer not to. I have never had a problem with patients under Gen Anesth. It is so safe nowadays, and in fact, when I review records for my state Medical Board, I actually see more problems with IV sedation!!! The patient drops her respiration and nobody notices!! But find the right doctor, and you should do very well. As far as your implant size, it’s BIG…But really depends on your measurements that I’m sure your surgeon has done…Many women can do fine with that size.

Anaesthesia for breast augmentation

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this is up to the surgeon.. make sure he is board certified and use a board certified anaesthesiologist.

if the implant is going over the muscle  it is much easier to block the breast for pain  but either technique is possible


IV sedation for breast augmentation

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No, you don't.

But.......general anesthesia administered by a board-certifed anesthesiologist has proven over time to be safe and effective. This allows the plastic surgeon to focus on making your breasts look good, and the anesthesiologist to focus on keeping you stable and safe during the procedure.

If you have serious reservations about general anesthesia, then it can be done with IV sedation and local anesthetic and/or intercostal blocks.

Ask your plastic surgeon what he/she offers. Good luck.

Breast augmentation anesthesia

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The type of anesthesia used in breast augmentation depends on whether the implants will be placed over or under the muscle. Sedation is fine for procedures performed above the muscle; however, dissection of the muscle is painful and in those cases general anesthesia is the preferred approach. As to implant size, the implants you are proposing are large but the question cannot be answered with impunity without assessing skin laxity and your appearance.

Different doctors have different preferences.

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Doctors have different preferences in terms of anesthesia. I prefer to do mine under a light general anesthetic as I find patients are more comfortable, especially when putting large implants under the muscle. If I am going over the muscle it is very simple to do under sedation anesthesia. Speak to your plastic surgeon to discuss your concerns and chose the doctor more importantly than the anesthesia. Good luck. Dr. Schuster from Boca Raton.

Anaesthesia for breast augmentation

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Thank you for the question.  In terms of anaesthetic, I prefer to always work with a board certified anaesthesiologist.  All of our patients are assessed by him and then he and they make a decision that all of s are comfortable with in terms of safety, patient concerns and the surgical procedure.  The majority of the time, it breast surgery is under general anaesthesia.  I would encourage you to talk to your surgeon and his or her anaesthesiologist to come up with a safe solution.

It is difficult to comment on your implant size without examining you and assessing your tissues, measurements etc.  Larger implants (more than around 350cc) are associated with higher complications, both in the short and long term, and again this is something you should discuss with your plastic surgeon.


Good luck with your surgery!

Peter A. Lennox, MD
Vancouver Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.