Genreal Anesthesia Is Not Necessary for Cosmetic Surgery
Skin care and cosmetic enhancement/cosmetic surgery
Edward B. Lack MD
President, MetropolitanMD
Chicago’s Cosmetic Surgery Center
The first tenet of ethical and compassionate medical care is “do no harm”. One would think this direct statement is unequivocal and easy to follow, yet that is not true. Physicians and surgeons are human and are subject to their individual beliefs and prejudices. A case in point is the use of general anesthesia in cosmetic surgery which I oppose with specific exceptions. For the last half of the 20th century surgeons performed their tasks with patients asleep. Risks were known, but the need for complete anesthesia outweighed those concerns. As a result surgeons became comfortable operating on patients who were asleep and did not move. Recent studies have shown that general anesthesia doubles the risks of death and injury for a given surgical procedure. Twilight sleep or IV sedation greatly reduces that risk. Local anesthesia, specifically the tumescent technique of local anesthesia, completely eliminates that risk. Liposuction, breast surgery, face lifts, hair transplants, eyelid surgery to name a few can all be easily and comfortably performed without general anesthesia. Yet many surgeons are uncomfortable with a patient who can talk or move and they reject learning how to do pleasant surgery on a patient who is partially or fully awake. Besides the increased safety, an awake-patient can turn and give the surgeon more artistic opportunity to sculpt or fashion tissue. And the patient feels better when they return home and walk around without the risks of falling or feeling ill due to after effects of anesthesia. Surgeons have the same prejudices when using post-operative narcotics instead of early walking and exercise- but that is a subject for another blog. Suffice it to say that patients have a choice of whether to add another risk to their contemplated cosmetic surgery. At the least everyone can seek a second opinion when their surgeon tells them they will need general anesthesia for cosmetic surgery.
Edward B. Lack MD
President, MetropolitanMD
Chicago’s Cosmetic Surgery Center
The first tenet of ethical and compassionate medical care is “do no harm”. One would think this direct statement is unequivocal and easy to follow, yet that is not true. Physicians and surgeons are human and are subject to their individual beliefs and prejudices. A case in point is the use of general anesthesia in cosmetic surgery which I oppose with specific exceptions. For the last half of the 20th century surgeons performed their tasks with patients asleep. Risks were known, but the need for complete anesthesia outweighed those concerns. As a result surgeons became comfortable operating on patients who were asleep and did not move. Recent studies have shown that general anesthesia doubles the risks of death and injury for a given surgical procedure. Twilight sleep or IV sedation greatly reduces that risk. Local anesthesia, specifically the tumescent technique of local anesthesia, completely eliminates that risk. Liposuction, breast surgery, face lifts, hair transplants, eyelid surgery to name a few can all be easily and comfortably performed without general anesthesia. Yet many surgeons are uncomfortable with a patient who can talk or move and they reject learning how to do pleasant surgery on a patient who is partially or fully awake. Besides the increased safety, an awake-patient can turn and give the surgeon more artistic opportunity to sculpt or fashion tissue. And the patient feels better when they return home and walk around without the risks of falling or feeling ill due to after effects of anesthesia. Surgeons have the same prejudices when using post-operative narcotics instead of early walking and exercise- but that is a subject for another blog. Suffice it to say that patients have a choice of whether to add another risk to their contemplated cosmetic surgery. At the least everyone can seek a second opinion when their surgeon tells them they will need general anesthesia for cosmetic surgery.
posted by Edward Lack MD at 12:48 PM
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