When considering elective plastic surgery, most patients spend a great deal of time researching their surgical procedure. A slightly smaller percentage of patients will also carefully research their plastic surgeon. But an unfortunately small number of patients actually look into the two other variables that will determine the safety and success of any elective procedure- the anesthesia provider/technique, and the facility in which the procedure will be performed.
Quite often, because patients are nervous about having surgery under general anesthesia, they seek other options they believe will be safe and less intimidating. One procedure that might pique the interest of many is known as the “Awake” breast augmentation.
Right now, there are more than 100 doctors nationwide busy doing breast augmentations only under local anesthesia. These advocates believe that having the patient awake during the procedure will allow for a more satisfactory outcome because the surgeon can communicate with the patient during surgery and receive feedback from the patient regarding the desired breast size.
Because the surgery is done while “awake”, patients falsely believe that it must be safer than undergoing general anesthesia- Unfortunately, this couldn’t be more wrong.
The truth is that the majority of “providers” performing cosmetic surgery under local anesthesia (and telling their patients that it is “safer” than general anesthesia) are doing so because they simply are not able to offer other options legally.
In order to perform surgery under sedation or general anesthesia in most states, you must have a licensed anesthesia provider and be performing the surgery in an accredited facility. In order to satisfy the requirements of most state medical boards, surgery centers, and reputable anesthesia providers, you must also be able to prove that you have privileges to perform the same procedure in a hospital and that you have completed residency training in the procedure in question.
If you do not have, and cannot get, the credentials necessary to perform cosmetic surgery in an accredited facility under a safe level of anesthesia, but you (and your accountant) really want to do breast augmentation (or liposuction), your only chance is to offer to do the surgery in your office under local anesthesia. But you need to convince your patients that it is safer to do so…
Lawrence S. Reed, president of the American Association for the Accreditation of Ambulatory Surgery Facilities, is concerned that some doctors are using local anesthesia to get around having to be an accredited facility.
If your surgeon were a board certified plastic surgeon wouldn’t they want everyone to know that they were operating in an accredited surgical suite and not a makeshift operating room that also doubles as the office lunch room?
Overmedicating is also a great safety concern when doing major surgeries under local. Indeed, multiple women across the country have lost their lives over the past few years after experiencing local anesthesia toxicity- a problem for which there is no cure, and which occurs only many hours after the patient has left the doctor’s office.
Breast Augmentations are not the only surgery offered as “awake” procedures. Tummy tucks and liposuction are also being performed- and reported to be just as safe as when under the care of a licensed anesthesia provider- when in fact the opposite is most likely true.
At the end of the day, your goal should be to have a procedure that would make you look and feel better, but not at the expense of your safety. Choose only surgeons Certified by The American Board of Plastic Surgery.
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