Your Guide to Anesthesia During Plastic Surgery

What to Expect  if You’re “Put Under” During Plastic Surgery

Anesthesia is the general term for the use of drugs to block pain sensations. There are two types of anesthesia used in plastic surgery “general” and “local”.

During the use of local anesthesia, the patient remains conscious – although they may also be given a medication to make them feel relaxed or sleepy. Local anesthetic induces a temporary loss of sensation in the “numbed” area, but the patient is still conscious.

General anesthesia refers to drugs that “knock out” the patient, inducing sleep or amnesia, preventing any awareness during surgery, and stopping the patient from feeling any pain.

Today, many plastic surgeries can be performed with advanced, minimally invasive techniques – so only local anesthetic is needed. However, more complex, or more invasive plastic surgery procedures still require the use of general anesthesia.

Local Anesthetic for Plastic Surgery

Local anesthetics are most often administered by injection – but they can also be sprayed on or applied “topically” in cream form. This type of anesthesia blocks pain sensation to the part of the body where it has been injected. It can be used on any part of the body, including face, neck, limbs, buttocks, breast, back and abdomen.

Depending on the type of local anesthetic it may take up to twenty minutes or longer to fully take effect. So there may be some waiting during the pre-op period. During this time the patient may also be given oral medications to help them relax or even sleep during their procedure.

The effects of local anesthetics can last for up to 90 minutes or longer depending on what type your plastic surgeon uses. But the patient will be conscious and know what is going on the whole time – unless they have received a sedative as well. Sometimes patients will feel sensations of pressure under local anesthetic – but they will not feel pain.

General Anesthesia for Plastic Surgery

General anesthesia is a drug that is used to make you unconscious and unable to feel pain during surgery. It also helps to reduce anxiety and stress and gives the patient amnesia (no memory) of their plastic surgery procedure.  The patient will also not remember anything about the surgery or treatment after it is completed if they are under general anesthesia.

In some cases, general anesthesia can be provided by intravenous injection of drugs into a vein (intravenous anesthesia) vein through an IV line in your arm or hand. In many cases general anesthesia is administered during plastic surgery or by inhalation from a mask placed over the nose and mouth (inhalation anesthesia), that puts the patient almost instantly to sleep.

Anesthesia can also be injected into the spinal canal (spinal anesthesia) – but this is rarely used during plastic surgery. Spinal anesthesia (“a spinal block”) is, however, commonly used during childbirth.

General anesthesia usually takes effect within 1 to 2 minutes and lasts for about 1 to 2 hours. An anesthesiologist will administer the anesthetic and continue to monitor your responses and vitals during the plastic surgery, to ensure that you “stay under” during the entire procedure. If more anesthetic is needed for a longer procedure, the anesthesiologist will administer it.

Will I Need General or Local Anesthesia During Plastic Surgery?

It is important to note that not all plastic surgeries require general anesthesia, but some do. Minimally invasive plastic surgery, such as an eyebrow lift, only requires local anesthetic. Facelifts, tummy tucks, and other plastic surgeries with larger incisions typically require general anesthesia.  Breast augmentation, may  be performed with local or general anesthesia.

Preparing Your Body for Anesthesia during Plastic Surgery

When you are about to undergo surgery, there are a number of things that you should do before the procedure. Your doctor will provide specific instructions for your surgery, but in general, you should:

1) Eat a light meal 2-3 hours before your surgery. Do not eat after that in case the anesthesia makes you nauseous.

2) Drink plenty of water on the day of your surgery. Your plastic surgeon may or may not also allow you to drink clear fluids.

3) Take any medications prescribed beforehand by your plastic surgeon, as directed. However, it is extremely important to discuss any other medications you are taking with your surgeon at your consultation to make sure they will not interact or interfere with the anesthesia.

4) Avoid caffeine on the day of your surgery. Avoid alcohol for at least two weeks before your surgery. Avoid any over the counter medications such as Nyquil, Benadryl that make you sleepy as well. And ask your doctor about any other OTC meds or supplements that you take.

5) Bring someone with you who can drive you home after your procedure.

6) Arrange for a family member or friend to stay with you for 24 hours following the procedure, just in case any rare complications arise.

Every patient is different. Patients may be confused, drowsy, “loopy”, talkative, dizzy, very quiet, or nauseous after general anesthetic. It may take them a couple hours to fully wake up and become alert. This is normal and actually beneficial, as it means that the anesthetic is still in their system numbing any pain!

For the first 24 hours after general anesthesia patients may continue to be sleepy, and their judgment, concentration and reflexes may still be affected. So, always have a responsible caregiver stay with you for at least a day after receiving general anesthesia.

Plastic Surgery | Birmingham, MI

Modern anesthesia technology is extremely safe if you work with a board-certified plastic surgeon and anesthesiologist. Do not be shy or embarrassed to ask your plastic surgeon about the type of anesthesia he will be using – and the credentials of the anesthesiologist who will be administering your general anesthesia during your plastic surgery.

Dr. Ali is a skilled and experienced Birmingham, MI board certified plastic surgeon. He will answer all of your questions about the anesthesia or anesthetic required for your plastic surgery procedure – and ensure you have a comfortable and pain free plastic surgery.