How is the airway supported during a BBL?

Question

If a life threatening event were to happen, ie. PE, Fat embolism, how soon after would symptoms present? During or after surgery?

Nathan Eberle, MD, DDS, FACS · Answer

Renee this is a great question.A BBL is most commonly performed under general anesthesia with traditional endotracheal intubation(a breathing tube), not something like an LMA(laryngeal mask airway). The reason for this is because during the BBL you will go from a supine to prone position and this is the only "safe" airway to move a patient from one position into the next. As for life threatening events, a PE on the table would be an uncommon event unless you have multiple risk factors, a DVT/PE is typically something that comes up days later. A fat embolism could indeed happen on the table and the anesthesiologist/surgeon would know immediately what is going on, if the procedure was not being performed in a hospital setting you would be rapidly transferred to a hospital. I hope this answers your questions,  a properly performed BBL is a safe procedure. Good luck.

Samir Shureih, MD · Answer

With your question of airway control you bring a very important topic which must be discussed here, which is patient safety. The anesthesia provider is as important as the skilled surgeon.BBL involves multiple site liposuction abdomen, flanks and back. During some of these procedures the patient is on her stomach. Airway control is very important in that position. There should be an endotracheal tube if heavy sedation and general anesthesia is used. Some feel that with iv sedation the patient in the prone position must have an endotracheal tube . There should be an anesthesia provider ready to handle severe emergencies. Therefore general anesthesia is safer when the patient is prone.As for the risks of blood clots and pulmonary emboli and fat emboli, it is more important to calculate the individual risks and try all preventive measures before a pulmonary embolus or fat embolus occur.After major surgery like BBL the risk of pulmonary emboli, blood clots, extends up to 30 days after surgery in a healthy person. some studies have shown the risk extends to 90 days after surgery.

How is the airway supported during a BBL?

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