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Paul Vitenas, Jr., MD, FACS

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Home / Blog / Understanding Anesthesia: What Are Your Options During Surgery?

Understanding Anesthesia: What Are Your Options During Surgery?

02/01/2018 by Dr. Vitenas

Understanding Anesthesia: What Are Your Options?

Anesthesia — just the word itself can be enough to make some people reconsider plastic surgery. But the truth is, not all types of anesthesia are the same. More importantly, the types of anesthetics used today are much safer than those used in the past.

While you don’t get much of a choice when it comes to the type of anesthesia a surgeon uses during a procedure, it’s worth knowing that not every type of plastic surgery requires the same type of anesthetic. For some procedures, the doctor might only have to numb the area he will work on. For other, more complicated surgeries, you may have to be fully asleep during the process.

A discussion of your anesthetic options is usually a part of the consultation process before surgery. Your surgeon can answer any questions you have about anesthesia and explain to you why one choice might be a better than the others. Learn more about your options below.

Topical Anesthesia

A topical anesthetic is the least “invasive” form of anesthesia. When your doctor gives you a topical anesthetic, such as a lidocaine gel, only the area directly in contact with the anesthetic becomes numb.  The anesthetic is applied to the skin, typically in the form of a cream or gel.

It’s highly unlikely that a surgeon will use a topical anesthetic during surgery or that a surgeon will use a topical numbing product as the only form of anesthesia during a procedure. Instead, topical products are usually reserved for non-invasive treatments, such as Juvederm injections or Botox. Even then, whether or not you receive the topical anesthetic depends on your comfort level. Some people tolerate getting injections without any type of anesthetic.

Local Anesthesia

Like a topical anesthetic, local anesthesia only numbs a particular area of the body. You’ll have feeling elsewhere and you’ll be alert and awake. While a topical anesthetic is often rubbed onto the skin, a local anesthetic is usually injected.

Local anesthesia is usually reserved for  very minimally-invasive procedures. For example, some surgeons will perform an eyelid lift using only local anesthetics. A procedure such as fat transfer, which involves removing fat from one area of the body, purifying it, then injecting it into the face or buttocks to restore or add volume, can also be performed with only a local anesthetic.

Twilight Sedation/Monitored Sedation

For many people, the idea of knowing what’s going on during the surgery and being able to have a conversation with their surgeon while he is working is disconcerting. In some cases, a procedure might be moderately non-invasive, but may take longer than an hour.

In either of these situations, twilight sedation or monitored sedation might be the best anesthesia option. Twilight sedation involves the use of a local anesthetic to numb the area being worked on. It also involves a mild sedative, which makes you sleepy and not really “with it” during the surgery. You won’t be completely unconscious, but you also won’t remember what happened during the surgery after it’s all over.

Twilight sedation might be used during a necklift, liposuction or other moderately invasive procedure. Compared to general anesthesia, it has fewer side effects and wears off more quickly.

General Anesthesia

General anesthesia is the type of anesthetic people most often associate with surgery. Usually, it’s administered by a trained anesthesiologist. You might receive a combination of inhaled general anesthesia and injections, depending on the doctor and the type of surgery you are having.

While the idea of general anesthetic can be scary for patients, it is very safe, thanks to advances in technology and administrations of the drug. It’s also the type of anesthesia that’s most comfortable during long, involved surgeries such as a breast lift or breast augmentation.

Under general anesthetics, you are completely “out of it.” You won’t remember the surgery at all. It will feel as if you’ve gone to sleep and woken up later. While you’re under general anesthesia, your breathing and other functions will be monitored and controlled.

Anesthesia Precautions and Concerns

The type of surgery you are considering often determines which anesthesia is the best option. However, there are other factors to keep in mind as well. Some people are allergic to anesthetics, which might limit candidacy for certain procedures. If you’ve ever had a reaction to an anesthetic, you must let your surgeon know for your own safety.

It’s also important to let your doctor know about any medical conditions you have. Some conditions can influence which type of anesthetic is appropriate for you.

In Houston, Texas, Dr. Paul Vitenas performs a variety of plastic surgeries and offers a variety of anesthesia options, based on the surgery. To learn more about your surgical and anesthetic options, call 281-484-0088 to schedule a consultation today.

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