Anesthesia is a very important and necessary part
of your cosmetic surgery procedure. Your body reacts to pain by
increasing your heartrate and respiration, and other autonomic
responses such as salivation, tearing, etc. Anesthetics block
the pain associated with surgery and also cause amnesia so that you do
not remember any discomfort. Depending upon how deeply you are
anesthetized, you will also be rendered immobile so that your surgeon
can perform your surgery without any involuntary or conscious
movement. Your anesthesiologist is highly trained in
administering just the right amount of medications to alleviate your
pain and control your body's natural reactions. Although many
people feel that anesthesia is the most frightening aspect of their
surgery, anesthesia is very safe.
Your Choices In Anesthesia
Although not all
surgeons may offer you a choice in the type of anesthesia that will be
used for your procedure, some do. Even if your surgeon prefers
one anesthesia type over another, it is important to understand how
anesthesia works and which type of drugs are used, and how they may
affect you. There are varying degrees of consciousness which are
achieved with certain anesthetics. There are also several types of
delivery systems, from oral, to gaseous, to intravenous (IV) sedation.
There are also topical, local and regional (nerve blocks) anesthetic
methods which may be used in conjunction with gaseous and IV during
your liposuction procedure. Lighter forms of anesthesia may be used during small, in-office
revisions or procedures.
Topical anesthetics, such as
mixture of local anesthetics
rarely used in surgical liposuction procedures, but are sometimes used
in injectable fat ablation procedures, such as with Lipodissolve.
an anesthetic (often llidocaine, benzocaine, or prilocaine) to numb
the skin surface using a cream, aerosol/spray, gel, etc. delivery
agent. The cream is simply applied to the treatment area with a
wooden depressor, or swab, or even a gloved hand, and the anesthetic
takes about 45 minutes to reach its peak of effectiveness. It is doubtful you will use a
topical for any liposuction procedures (except for Lipodissolve). Although this
anesthetic is in topical form and may seem very simple, it is not
without its risks. Improper use, such as excessive product usage over
large areas of the body during one sitting, or covering the topical
anesthetic (such as with plastic wrap) to increase its effectiveness
is not recommended and can result in serious injury, or death in
some cases. Use as directed.
If you have ever had an injection to numb the immediate area of your
body, you have had a local anesthetic. Anesthetics such as
lidocaine or xylocaine are almost always used in conjunction with epinephrine
for liposuction procedures.
The epinephrine narrows the bore of the blood vessel which in turn
prohibits much bloodloss and helps minimize the amount of
anesthetic that enters your blood stream. Local anesthetics are used in
combination with IV sedation or even gaseous sedation for liposuction. Local
anesthesia only may also be used for in-office procedures such as
micro-lipo, or finesse liposuction.
Conscious Sedation, or Twilight Anesthesia
(Intravenous (IV) Sedation)
Twilight Anesthesia, is commonly used for
liposuction surgery. Anesthetics such as Versed (midazolam),
Diprivan (propofol) are delivered directly into the
bloodstream along with a saline bag by the use of an IV catheter.
It only takes a few seconds for the anesthetics to take effect.
If the amount of anesthetics given are light enough, the doctor is
actually able to give you instructions (such as moving to one side)
yet you feel sleepy and relaxed. You will not feel any pain but are
not rendered completely unconscious such as with General Anesthesia
and are able to breathe on your own. However, depending upon the
amount, you may not move much at all, or be conscious of anything.
Discuss with your surgeon the level of consciousness you will have.
General anesthesia is also common in liposuction surgery.
General Anesthesia uses a combination of medications either
intravenously or via gas you will breathe during surgery. General
gaseous sedation is administered via a tube down your throat and also
with a medication which will be delivered via an IV, depending upon
your needs. The tube will keep the airway open and free and
clear and your breathing is monitored and stable. You will be intubated after receiving Twilight IV sedation so that you are unaware
of the intubation procedure. You will only fall asleep and wake
up just as you were when you were put under, unaware of the entire
process. General sometimes causes nausea post-operatively,
however there are medications which care administered either
beforehand or during to alleviate most patients of their nausea.
What Does Anesthesia Feel Like?
Some patients experience anxiety before, so please tell your
anesthesiologist if you are feel this way. Medications can be
administered, or you may be given a prescription or medications to
take before you ever get to the surgery center. After being
administered medications it will feel as though you are very sleepy.
You may also feel loopy, humorous and say funny things you may be
reminded of later. This is all the better, as you should see
your surgery as a positive experience and nothing to fear. You
are in great hands with your surgical team and they will care for you
from beginning to end.
Recovery From Anesthesia
Your recovery and any side effects (such as nausea) depends upon
your own body and if any medications were given to counteract the
nausea. Normal recovery includes sleepiness, amnesia, lethargy
and generally a relaxed state. If you become nauseated, it should
not last very long. The aftereffects of anesthesia may last up
to a week, although the nausea normally resides in just a few hours.
You will find that you
don't remember much about when you woke up and the first few days of
recovery. This is normal and is actually a plus in passing of the
downtime. Many patients find it difficult to take it easy, but
know that it is very important that you set aside time from work and
household responsibilities to give your body adequate time to heal.
Risks Of Anesthesia
Anesthesia is not without its risks. It is very important to
disclose all prescriptions, over the counter (OTC) medications and any
supplements you may be taking or have been taking in the last 2
months. It is also very important to disclose any pre-existing
diseases or disorders, or any family history of diseases or disorders.
Tobacco use (nicotine patches and Vapor Cigarettes included), alcohol
consumption, and any illegal drug usage must also be disclosed.
These inherent risks of
undergoing anesthesia may include, most listed are related to gaseous
- Lidocaine toxity
- intubation injury
- pulmonary edema
- respiratory arrest
- asthma flare-up
- Cardiovascular complications may include:
- myocardial ischemia/infarction
- myocardial ischemia
- myocardial infarction
- cardiac failure
- cardiac arrest
- hereditary disorders
- malignant hypothermia: Malignant hyperthermia
(or hyperpyrexia) is when a patient's temperature rises rapidly
(105F and above) when anesthetized with inhaled general anesthetics
and can be fatal if not treated immediately and adequately.
This disorder is inherited and is sometimes unknown if other family
members have never been anesthetized under general. Patients
should advise their surgeon and anesthesiologist of any unexplained
deaths in their family while the patient was under anesthesia. This
disorder is very rare (between 1 occurrence in 5000 to 1 occurrence
in 100,000 patients) but there are tests which can help determine if
you are at risk.
Tobacco & Illegal Substances
"- Smoking increases risk of airway
irritability, bronchospasm, or cough during sedation. "Adapted
from the American Society of Anesthesiologists;
Guidelines on Sedation and analgesia by Non-Anesthesiologists, source: www.GasNet.org