Some non-plastic surgeons use “awake option” for augmentations

Breast augmentation and abdominoplasty performed on patients given only sedatives and local anesthesia allows doctors to perform the procedures in unaccredited offices without incurring anesthesiology charges. “Patients can scream and you would know, I can’t be doing that, I can’t be putting my needle there,” said Dr. Anil K. Gandhi, who performs such awake procedures. Critics, including many plastic surgeons, charge that offering local anesthesia for such surgeries is a risky gimmick, noting that patients are not competent to make medical decisions while drugged and that improperly administered tumescent anesthesia can cause seizures and arrhythmia. (An excerpt from the New York Times Article featured here http://community.nytimes.com/comments/www.nytimes.com/2010/04/08/fashion/08skin.html

In response to the recent New York Times article that seems to glamorize performing breast augmentation surgery under a local anesthetic, I can only tell you that “things aren’t always as they seem”.  On first glance, it would seem as though having any surgery under local anesthesia would be a plus.  I can tell you with no uncertainty, that the subspecialty of anesthesia medicine exists for a reason.  That reason is to allow patients to have surgery more comfortably and more safely.  Breast augmentation surgery should not be taken lightly.  Typically, this surgery is done most commonly on a thinner woman where the proposed breast implant pocket is very close to vital structures. Furthermore, most breast augmentations are placed in the submuscular pocket.  When this is the preferred placement, it is imperative that the muscle and the patient is relaxed.  Finally, one should never underestimate the potential side effects of larger volumes of local anesthetic and benefits of having another healthcare professional in the room that is highly trained in caring for the patient’s physiology.  This in turn allows the surgeon to concentrate on the anatomy and the surgery at hand.

 

 

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