The goal was simple: Improve recovery from breast augmentation procedures. General anesthesia using inhaled gas and a breathing tube (endotracheal tube or LMA) is an incredible tool that allows the plastic surgeon to perform invasive procedures without the patient feeling or being aware of pain. I have performed, and continue to perform a number of breast augmentations under general anesthesia and I consider it extremely safe . But there are two major drawbacks to general anesthesia: 1. Many patients are so scared of general anesthesia that they change their mind and decide not to have breast augmentation, and 2. General anesthesia can leave the patient listless, groggy, and often nauseated a few days after surgery. By performing breast augmentation under IV sedation we can alleviate many of the fears patients have regarding general anesthesia and improve their recovery from surgery. The medications used during IV sedation breast augmentation are strong sedatives and pain relievers that carry the added benefit of being short-acting. A submuscular or dual plane breast augmentation procedure takes between 30-45 minutes to complete, such that I can finish the procedure just as the meds are wearing off. We limit the amount of IV narcotic sedatives used, such as fentanyl or morphine, and this significantly improves the risk of postoperative nausea. During breast augmentation under general anesthesia or IV sedation I inject 200-400cc of tumesecent fluid per breast. This tumescent fluid contains long- and short-acting agents (lidocaine) which numb the tissues and it contains epinephrine, a strong vasoconstrictor, which prevents bleeding during and after surgery. Proper infiltration of tumescent fluid beneath the muscle and around the breast is the key to performing breast augmentation under IV sedation.
The cosmetic results of breast augmentation under general versus IV sedation are identical. The type of anesthetic (general versus sedation) does not limit or change the plastic surgeon’s ability to create a precise submuscular pocket and to release the inferior and medial borders of the pectoralis muscle to place the breast implant in the correct position. We have seen less postoperative nausea and much quicker surgical recovery from IV sedation as compared to general anesthesia. When asked, our patients resoundingly report that they would prefer surgery under IV sedation. We enjoy offering patients the option of IV sedation for breast augmentation, especially for those who are concerned about general anesthesia and for those who desire a quicker recovery from surgery.
For more information on procedures offered by Dr Paul McCluskey at the Plastic Surgery Institute of Atlanta visit: