What kind of anesthesia should you get?

Your choice of anesthesia will depend significantly on your procedure, your surgeon, and your general health. You'll want to talk to your plastic or cosmetic surgeon about what options will be best for you.

It’s not uncommon to think of plastic surgery in one of two ways: the results and the pain. Unfortunately, many people are turned away by the pain—they don’t think they can handle the discomfort of surgery or of recovery. But we have new ways of thinking about and talking about anesthesia that may be helping. Indeed, the decision of which anesthesia to choose—and choosing the best anesthesia—can be difficult and tiresome. But surgeons are working to make it easier, to make the decisions more efficient, and the procedures are comfortable as possible.

How Do I Choose My Anesthesia Type? Local Anesthesia vs General Anesthesia

When we think about plastic surgery, we usually think about two distinct aspects of it. On the one hand, we think about the results—how great we’re going to look and how nice it will be to final get rid of those wrinkles (or the excess skin or get those larger breasts or whatever). But on the other side, we also think about the pain. Plastic surgery, as is the case with any surgical procedure, involves some pain and recovery.

Now, modern plastic surgeons have gotten very good at mitigating and controlling pain. They’ve also gotten very good at making procedures be less invasive—smaller incisions mean less pain and faster recovery. But the fundamental nature of surgery means that there will always be some kind of incision. That said, not all surgery is alike. In fact, many surgeons are turning from general anesthesia procedures to local anesthesia procedures.

That runs counter to what most of us would assume. When we think about pain, we think, “Just put me to sleep. I don’t want to feel it.” But local anesthesia has many advantages, and it’s becoming more and more effective.

Local vs. General Anesthesia

It might be helpful to first define a few different terms. When we discuss local anesthesia, we’re talking about a medical or numbing agent that treats the area targeted by the procedure. If you’re getting surgery on your leg, that means the local anesthetic will be applied to your leg. General anesthesia is what they call the anesthetic type that basically knocks you out. You wake up in the recovery room with the procedure complete. To many patients, this might seem preferable.

But general anesthesia has a few drawbacks. First and foremost, it increases recovery time. This is primarily due to things such as nausea or other feelings of illness. However, when you’re put under for general anesthesia, you go into a “sleep” state which lowers your blood pressure. As you come out of anesthesia, your blood pressure increases, which can cause bleeding issues. This is avoided with the use of a local anesthesia.

In some cases, local anesthesia will be paired with a sedative in order to keep the patient motionless—something you might consider to be quite important when the results can be delicate. This is true whether you’re seeing a plastic surgeon in Orange County or someone in Virginia.

Variables Include the Procedure in Question

To some degree, personal preferences will determine whether local or general anesthetic is the way to go. After all, you will be the one experiencing the recovery period. On the other hand, your procedure will also have a lot to do with whether local or general anesthetic is the way to go. The bigger and more intense the procedure, the more likely your surgeon is going to insist on general anesthesia. There are some procedures, such as tummy tuck, that will almost always require general anesthesia.

But there are other procedures, such as some less invasive facelift and brow lift procedures, that do not require general anesthesia and can be done with a local. Some surgeons are even trying out full facelifts using only local anesthesia, using new devices and techniques to administer the local more evenly throughout the layers of skin.

Anesthesia at a Glance

Whether you get local or general anesthesia will likely depend on at least some of the following:

  • The procedure to be performed
  • The size of the incision
  • The comfort of the patient
  • The setting of the procedure
  • The preferences of the surgeon and the patient
  • The desired recovery period

It’s Between You and Your Surgeon

Patients often have a preference when it comes to whether or not general or local anesthesia should be used. And that preference is important. But it’s also important to listen to your surgeon, to take the years or experience and expertise into account. Your surgeon will likely have performed that particular procedure countless time (at least enough to fill a before and after gallery, one would assume) and likely has an opinion on how much stress the discomfort from that procedure can place on the body.

So between yourself and your surgeon, you should come to a consensus on the best way to manage pain, both before and after surgery. This is important not only for your comfort but also for your results—after all, pain can cause all kinds of issues that can interfere with excellent results. The more pain is managed, the more you can enjoy your results.