Anesthesia and Plastic Surgery

Reviewed by Ronald E. Iverson, MD, FACS

For many people, the greatest concern when it comes to surgery is anesthesia. This is probably because one of our greatest fears is to have no control while our lives are in the hands of others.

Anesthesia has evolved substantially since its early uses. Plastic surgeons use anesthesia for numerous procedures, including breast augmentation and eyelid surgery. It is important to openly communicate with your surgeon about any fears you might have so that he or she can properly address them and put you at ease regarding anesthesia and other components of your selected procedure.

Anesthesia Types

The primary function of anesthesia is to prevent pain. There are four types:

  • Local anesthesia is used to prevent pain in the specific area that requires surgery. During local anesthesia, you are awake and aware of surrounding activities. This type of anesthesia may be an ointment, spray or injection.
  • Sedation is administered intravenously (through a vein) and may be used with other types of anesthesia during surgery. Sedation includes a combination of medications that help prevent pain and anxiety associated with medical procedures. There are multiple levels of sedation. For example, "twilight" sedation is a common term that refers to a mid-level form of sedation. There are also deeper levels of sedation that produce effects similar to general anesthesia. Generally speaking, during sedation, you are awake but sleepy, and you may not recall or sense that the procedure is being performed. It is important that you understand the sedation level to be used in your procedure.
  • Regional anesthesia is a "block," such as a spinal block that is administered to the surrounding nerves that may produce pain signals. Regional anesthesia produces effects similar to those of sedation, which may be used in conjunction with regional anesthesia.
  • General anesthesia is used for extensive medical procedures. General anesthesia will put you to sleep. General anesthesia prevents any pain, and you won't remember the procedure afterward. The drugs included in general anesthesia are inhaled or injected into a vein.

Anesthesia Complications

Regardless of the type of anesthesia, equipment is used during surgery to monitor your heart rate, circulation, temperature, blood flow, body fluids, oxidation and adequate ventilation. The monitoring is designed to reduce the risk of complications. Advances in the field and in the technology have paid off. In fact, during the decade ending in 2006, deaths due to anesthesia fell from one in 10,000 to only one in 250,000, according to the Mayo Clinic.

The most common complication of anesthesia is nausea or vomiting. Medication can be administered to reduce this risk.

List of Health Factors

The decision for the appropriate type of anesthesia involves your doctor, your anesthesiologist and yourself. Before any surgery you need to prepare a list of information about your health to help choose the appropriate type of anesthesia. This list should include:

  • Medical history
  • Medication list
  • Supplement list
  • Smoking and alcohol consumption
  • Allergy list
  • Previous experience with anesthesia
  • Adverse reactions to anesthesia
  • Family member reactions to anesthesia

Your doctor will review this list during your consultation and immediately before the procedure, when he or she will also ask what time you last ate or drank. You may be asked to restrict food and drink intake for a specific time period before the procedure. In the case of general anesthesia, this time period is typically eight to 12 hours.

Anesthesia Recovery

After surgery, the effects of anesthesia will be reversed as you are monitored in the recovery unit of the surgical facility. If you experience pain, it is important to tell your doctor or nurse, who usually can give you medication for an easier recovery.

Depending on the type of anesthesia used, anesthesia recovery can take one to six hours. After this period, you will still need to have someone drive you home. After any form of anesthesia used in outpatient surgery, doctors will recommend that you have someone stay with you for at least 24 hours.

Restrictions may also include no driving, no operating equipment and no legal decisions for 24 hours. Rest is the key. The directions vary depending on the procedure.

Your doctor will also provide a postoperative instruction list that you must follow to reduce the risk of complications.

About the Reviewer of This Article

Ronald E. Iverson, MD, FACS, is a board-certified plastic surgeon, a member and former president of the American Society of Plastic Surgeons, a member of the American Society for Aesthetic Plastic Surgery, and an American Medical Association delegate. Dr. Iverson received his medical degree from the University of California, Los Angeles, and performed his residency at Stanford University Medical Center, General Surgery and Plastic and Reconstructive Surgery.