Anesthesia options for plastic surgery

It is hard to imagine what the practice of surgery was like before the discovery of anesthesia; before ether was first demonstrated in the mid-1800’s, the main measure of a surgeon’s skill was speed. (It had been known for some 500 years that ether could induce painless sleep in animals before someone thought to try it on humans.) But despite the tremendous advances in anesthesia over its 150 year history, it remains a worry for some and a source of confusion for many. A glaring example is the promotion of tumescent liposuction as a safer alternative than general anesthesia; just as bad is the heavily advertized franchise facelift that is done in an hour under only local anesthesia. Is that really an advance or a step back to the nineteenth century? Here are a few things to keep in mind when considering anesthesia options for plastic surgery:
First, know that there are actually several choices. For example, with liposuction, a numbing solution is always used, often called “tumescent” technique. For small areas of lipo, it may be perfectly reasonable to do it this way wide awake. For many patients, sedation with intravenous medications will help to make the procedure a better experience, and IV sedation by a qualified anesthesia provider is probably the most common method. General anesthesia is used if there is another procedure such as a tummy tuck done at the same time, but may be considered for lipo only. The bottom line here is that all are safe when done under the right circumstances in an accredited surgical facility.
Secondly, consider who will be providing the anesthesia. For deep IV sedation or general anesthesia, this can be appropriately done by either an MD anesthesiologist or a Certified Registered Nurse Anesthetist, or CRNA.
Finally, do your part by discussing your medical history with the anesthesia provider before the procedure. Many herbal supplements and medications can interact with anesthesia medications, so it is important for your anesthesia provider to know what you are taking. Recreational drug use is another potential confounder, along with alcohol.
For all of these reasons, anesthesia planning is an important aspect of surgical planning. Your surgeon may be able to better focus on the job at hand if he or she doesn’t have to be constantly worrying about patient comfort. That way, everyone rests easier.