Cosmetic Surgery: General or Local Anesthesia?

In cosmetic surgery, general and local anesthesia encompass a range of techniques designed to eliminate (or significantly reduce) the pain associated with a surgical procedure. The type of anesthesia used depends on the specific operation (duration, area of the body, instruments used, etc.). Generally, for minimally invasive procedures affecting limited areas (e.g., fillers, blepharoplasty, rhinoplasty), surgeons prefer local anesthesia, keeping the patient semi-conscious. Conversely, for more extensive procedures (e.g., breast lift, liposuction), general anesthesia is preferred, inducing unconsciousness for the duration. However, even with these more extensive procedures, general anesthesia is usually light for these shorter procedures, allowing patients to regain consciousness and leave the hospital within a few hours.

 

Is General Anesthesia Necessary in Cosmetic Surgery?

General anesthesia is a complete anesthetic procedure achieving several desired effects simultaneously, particularly useful for complex operations. These effects include anesthesia (absence of pain), hypnosis, myorelaxation (muscle relaxation), and amnesia (absence of memory). In general anesthesia, the patient doesn't breathe spontaneously but is assisted by a ventilator via a tube in the trachea or a laryngeal mask.

 

Modern general anesthesia used in cosmetic surgery is very light, employing a cocktail of medications at low concentrations and low toxicity, suitable for same-day surgery. General anesthesia allows for the performance of all complex plastic, cosmetic, and reconstructive surgeries.

 

What is the Goal of Anesthesia in Cosmetic Surgery?

The introduction of general and local anesthesia in surgery has significantly reduced patient suffering and pain. Historically, pain reduction methods were rather rudimentary. Simply administering sleep-inducing substances wasn't sufficient.

Modern surgical techniques minimize or eliminate pain during procedures, including cosmetic surgery, allowing patients to approach the operation and recovery with greater serenity.

 

When is Topical Anesthesia Used?

Topical anesthesia is used for quicker, less painful cosmetic procedures. This simplest form involves applying an anesthetic ointment (lidocaine and prilocaine) to the area approximately 30 minutes prior to treatment, allowing slow penetration and reducing superficial skin sensitivity. For mucous membranes and lips, a rapidly absorbing spray (usually lidocaine) is more effective, ideal for lip augmentation and filler treatments.

 

How Does Local Anesthesia Work?

Local anesthesia involves subcutaneous injection of an anesthetic (lidocaine, bupivacaine, mepivacaine, ropivacaine, etc.), often with a vasoconstrictor (e.g., adrenaline) to reduce bleeding. It's the primary anesthetic technique in cosmetic surgery, used alone or in combination with intravenous anesthesia. The solution's dilution, drugs, and volume injected vary depending on the procedure. Local anesthesia is used in day hospitals and for major cosmetic procedures of the face, breast, and body (often supplemented with sedative anesthesia).

 

What is Locorregional Anesthesia?

This specialized local anesthesia is administered by the surgeon or anesthesiologist. The anesthetic isn't injected directly into the surgical area but "upstream," around the nerve transmitting pain sensations from that area to the brain. Locorregional anesthesia numbs large areas with a few targeted injections. It's particularly useful for complex cosmetic procedures (blocking infraorbital, supraorbital, and mandibular nerves), palmar hyperhidrosis treatment, and hand surgeries (blocking ulnar, median, and radial nerves).

 

In What Cases Should Spinal Anesthesia Be Chosen for Cosmetic Surgery?

Spinal anesthesia numbs the lower abdomen and lower limbs, suitable for surgeries like abdominoplasty, thigh lifts, and extensive liposuction of the torso and thighs. This is performed with the patient awake, under anesthetic control.

 

How Long Does it Take for the Effects of Anesthesia to Wear Off?

The time for anesthesia to wear off (general or local) varies depending on the procedure. However, surgeons generally prefer less invasive medications allowing patients to resume normal activities (with precautions) and return home quickly.

 

What is the Elimination Time of the Anesthetic Product?

Anesthetic elimination times are short (about 2-3 hours). However, patients may experience discomfort (nausea, dizziness) or mild pain in the affected area (treatable with analgesics).

 

Is Anesthesia Completely Eliminated from the Body?

Unlike decades ago, even general anesthesia is eliminated within a few hours. However, given its slightly more invasive nature, monitoring for 6-8 hours is advisable. Side effects (chills, nausea, vomiting, muscle aches) are common and temporary.

 

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