Cosmetic surgery anesthesia – IV anesthesia is great

I have previously written about the types of anesthesia used in cosmetic surgery. The various types of anesthesia include local anesthesia, various types of IV sedation (where you breath on your own), and general anesthesia (assisted breathing with a tube).

I perform all of my major procedures, including multiple procedure makeovers with IV sedation.

The use of IV sedation offers several advantages over general anesthesia:

  1. less nausea than general anesthesia
  2. quicker recovery immediately following the surgery
  3. dramatically reduces the risk of pulmonary embolism which is a major concern with general anesthesia

To illustrate how well patients can do with IV sedation, two of my patients agreed to be filmed in their immediate post operative period in the recovery room for the purpose of this blog.

The first patient had a two hour breast procedure, and you can see that she is extremely alert after just 30 minutes out of the operating room.

The second patient had a multiple procedure case (Tummy tuck, Breast lift with implants,  and a Thigh lift) which involved 9 hours of operating room time. I have filmed my patient in the recovery room just 40 minutes after she was transported from the operating room. Although she is definitely sleepy, she is remarkably alert enough to recall the facts of her procedure. She is tolerating fluids.

This would NOT be the case if she had the 9 hour procedure performed under general anesthesia. I now realize that many patients I admitted to the hospital for overnight stay in the past needed to be hospitalized because of the anesthesia recovery, not because of the surgery.

It is a myth that long multiple procedure cases can not be performed under IV anesthesia. I perform 8-9 hour multiple procedure cases every week.

The truth is that for procedures lasting longer than 4 hours, the patient is much better off with IV anesthesia. With general anesthesia, the risk of pulmonary embolism increases with the length of the surgery.

In IV sedation, you are using your own muscles to breathe on your own. Under general anesthesia, a ventilator blows air into your lungs, altering the dynamics of blood flow throughout your body. As the duration of general anesthesia increases, so do complications related to it. This includes pulmonary complications as well as risk of blood clot to the lungs.

To learn even more about why IV anesthesia is a better experience than General anesthesia for cosmetic surgery, see Dr. Hobelman, a board certified anesthesiologist talk about the advantages of IV sedation.

* A big thank you to my patients for allowing me to share their experiences with you!

By Dr. Ricardo L. Rodriguez MD
Board Certified Plastic Surgeon
Cosmeticsurg Baltimore, Maryland
Ricardo L Rodriguez on American Society of Plastic Surgeons

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