Anesthesia in Cosmetic Surgery
Patients often ask Dr. Slupchynskyj if they can undergo light sedation more than once or twice over the course a year and if there are any risks associated with doing so, versus how much they receive during one procedure. Patients will be relieved to know that there are no limits on light sedation used during surgery, also known as Local Anesthesia.
Anesthesia is derived from the Greek word “anaisth sia” (lack of sensation). It is described as a drug or gas induced state of unconsciousness that results in the general loss of the senses of feeling, touch, temperature and pain.
Local Anesthesia is commonly known as I.V. sedation and results in an easy awakening and speedy recovery time for the patient. Close monitoring by the Anesthesiologist will sometimes be provided, to help keep the patient comfortable during a medical procedure, along with other drugs to help relax the body.
Generally, Local Anesthesia causes the patient to forget the surgery and the time immediately following the procedure. It is used for a variety of surgical procedures. Just like General Anesthesia, Local Anesthesia is designed to help a patient feel more comfortable and to minimize pain associated with the procedure being performed and to let the surgeon to practice without interruptions. Local sedation does not carry the same attendant risks as General Anesthesia.
General Anesthesia is a treatment regimen adapted during surgical procedures that use a combination of inhaled gases and intravenous drugs that puts the patient into “temporary or transient” sleep (there is no memory of the surgical procedure performed). The sleep induced by General Anesthesia is distinctively different from regular sleep in that the brain (in an anesthetized patient) does not respond to any pain stimulus or surgical maneuvers. The patient’s breathing is controlled through artificial ventilation (intubation). Intubation and assisted breathing are not required with light sedation.
General Anesthesia is usually adapted in surgical procedures that are of very long duration, require the patient to be in an uncomfortable position for a lengthy time preventing the body muscles from relaxing, and can potentially affect respiration, such as in Cardiac Surgery.
On the other hand, light sedation is pharmacological (drug)-mediated transient suppression of consciousness, mostly adapted to control agitation or anxiety of the patient undergoing a minor surgical procedure, such as Cosmetic Facelift Surgery, Rhinoplasty Surgery, Neck Lift Surgery, or Eyelid Lift Surgery. Patients on light sedation maintain their pain and touch sensation, and are capable of verbal communication. They might lack cognitive function and coordination post-administration, much like one’s inability to read after getting an eye dilatation at a visit to the Ophthalmologist.
Having any kind of surgery under Anesthesia comes with a certain amount of risk, and every prospective surgical patient should be completely informed, and aware of what risks or complications can develop from the use of Anesthesia during Facelift Plastic Surgery or any Plastic Surgery for that matter. Some of the complications of General Anesthesia are due to a patient’s medical condition prior to being the Anesthesia being administered, such as someone who is obese, has a lung disease, or heart problems.
Medical history and the all medications the patient is taking, including oral contraceptives and hormone-replacement therapy, and past experience with Anesthesia must be discussed during a comprehensive consultation process.
Patients undergoing Plastic Surgery with General Anesthesia cannot breathe without the aid of a ventilator since the Anesthesia paralyzes the diaphragm. Intubation is the process where an endotracheal tube in inserted into the mouth and airway so the patient may breathe through a ventilator.
Many people fail to realize that under General Anesthesia, after the patient is “put under”, the airway may become irritated by the Anesthesia. A spasm of the vocal cords is a reaction to the irritation, causing the airway to become blocked, if that happens then an endotracheal tube is inserted in the patient’s windpipe, opening the patient’s airway, and the Anesthesiologist monitors the patient’s breathing.
Generally, if the surgery lasts longer than four hours, the chances of complications from General Anesthesia increase dramatically. Blood can pool in the veins if the patient is immobilized for a long period of time. The chance of blood pooling in the veins, and causing a blood clot increases with the use of General Anesthesia and the amount of time in surgery. A blood clot that moves could cause a fatal heart attack, or may cause a stroke if it moves to the brain. In addition, patients undergoing Liposuction have a greater risk of blood clots.
Various Anesthesia and specifically General Anesthesia inhibit your body’s ability to keep food in your stomach. This is the reason it is important to follow pre-operative instructions on when to stop eating and drinking prior to your surgery. Under General Anesthesia, a patient may vomit during surgery. Instead of going through the esophagus and out the mouth, the vomit may end up in the patient’s lungs. Aspiration, or vomit in the lungs can cause an infection, a persistent cough or pneumonia. This is typically not the case but is a risk of this type of Anesthesia.
A sudden drop of blood pressure during surgery may be caused by an excessive loss of blood, or blood pooling in the veins. If not monitored correctly, or addressed immediately, the drop in blood pressure may develop into an irregular heartbeat in the patient or even a heart attack.
A patient’s blood pressure, heart rate and body temperature may increase to hyperactive levels during surgery. This is rare, and it may be an inherited condition, but if it does occur, the surgeon and Anesthesiologist must react to it quickly, otherwise it could lead to death.