Choosing Local vs General Anesthesia for Plastic Surgery

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Did You Know That You Can Often Choose Between Local Vs General Anesthesia for Your Plastic Surgery? 

Many patients don’t realize that they actually have options when it comes to anesthesia. As a whole, the concept of intentionally depressing your sensory functions can seem a bit daunting. That’s why most of us leave the decisions regarding these somewhat intimidating processes to the medical professionals. However, there is a growing number of plastic surgery procedures that can be effectively and sometimes beneficially performed with local anesthesia. It might sound a little questionable at first, but when comparing local vs general anesthesia, many patients and surgeons alike are starting to see the strategic benefits to the former option. That is, these medical professionals are beginning to prefer a more minimal and less physically draining approach to anesthetic usage. 

local vs general anesthesia

What Types of Cosmetic Enhancement Procedures Require Anesthetics? 

The majority of surgical and non-surgical cosmetic procedures utilize at least some type of local anesthesia, typically in the form of lidocaine. Even facial injectables like Juvederm and Restylane are frequently mixed with lidocaine to minimize the discomfort felt at injection sites. For more intensive surgical treatments, a general anesthesia is traditionally used to ensure that the patient is entirely unconscious. There are also instances when lighter variations of general anesthesia can be administered to minimize consciousness to a controlled degree. This usage is commonly referred to as twilight anesthesia, as it places the patient in a relaxed and sleepy “twilight" state without completely knocking them out. 

For the most part, the use of local anesthesia during non-surgical treatments provides a minimal numbing effect that can help alleviate minor pain or discomfort. Patients can often opt-out of receiving injectables that utilize lidocaine with little overall change in the treatment results. The really important decisions for using local vs general anesthesia are reserved for the realm of surgical-based enhancements. If you are planning to undergo a plastic surgery procedure, it’s important to understand your anesthetic options to optimize your results while minimizing your discomfort and recovery time. 

A Closer Look at Twilight Anesthesia and Local vs General Anesthesia 

First, let’s take a closer look at the most common forms of local vs general anesthesia. In the world of local anesthesia, lidocaine reigns supreme. Lidocaine is a sodium channel blocker that numbs skin tissue in whatever area it is injected into. It effectively creates a temporary blockage of signals from your nerves, allowing for full sensory depression in the desired region. 

A Brief History of Lidocaine 

Lidocaine is the most recent medical development in a line of local anesthesia injectables that were originally spawned from cocaine. As modern formations of surgical and dental procedures were beginning to come to fruition throughout the 19th century, medical professionals struggled to find ways to efficiently minimize patient discomfort. Opium, alcohol, ether, chloroform, and nitrous oxide (laughing gas) were all experimented with as general anesthetics, however a suitable local anesthesia had yet to be discovered. Eventually, cocaine surfaced as a viable candidate for this localized pain relief. 

Unfortunately, cocaine’s effect on the circulatory system and its highly addictive nature made it very unideal for frequent usage. In the early 20th century, a less toxic synthesized version of cocaine was discovered and marketed as Novocaine. Today, most people assume that novocaine is still in widespread use at their average dentist’s office. What most fail to realize is that a less allergenic version called Lidocaine almost entirely replaced Novocaine in the 1960s. And now, Lidocaine is the most widely used local anesthetic in the realm of modern medicine. 

local vs general anesthesia

Local vs General Anesthesia: A Basic Overview of Effects and Uses  

General Anesthesia Overview: 

While both types of anesthesia are injected into the body, general anesthetics are typically done so intravenously or through an IV. Occasionally, a gaseous anesthetic is inhaled in order to achieve a lack of consciousness. The mixtures or blends of general anesthesia drugs are sometimes colloquially referred to as “cocktails” and can take on various forms depending on the desired effect and unique needs of each patient. Unless the intention is to reach a state of twilight anesthesia, most intravenous or gaseous anesthetic applications will render the patient completely unconscious and unable to feel. This is also known as a medically induced coma and the taxing effects it can have on the body are far from negligible. 

local vs general anesthesia

Effects of General Anesthesia:

It’s important to understand that "going under” for surgery using general anesthesia is not synonymous with falling asleep and waking up. The “anesthetic hangover” effects of being forcibly knocked unconscious through drug cocktails can sometimes take several days to fully wear off. And the recovery times for patients who have undergone local vs general anesthesia can be drastically different. 

Negative side effects of general anesthesia can range from nausea and vomiting to breathing disorders or issues with blood pressure. Even without these more drastic effects, coming back from a medically induced coma is not dissimilar to recovering from a nasty alcoholic hangover. Your entire body is forced to deal with delayed pain and discomfort and the withdrawal of serious drugs from your system. These various “hangover” symptoms can result in longer post-surgery recovery times and can even lead to minor illnesses like colds or flus due to depressed immune system functions. 

This isn’t to say that general anesthetics are inherently unhealthy or dangerous. The drugs used to fully anesthetize patients can be harsh on the body, however they are often necessary medical lifesavers that allow for serious surgical procedures to be performed without pain or strife. If your doctor strongly suggests or even requires that you use general anesthesia, you should probably head her or his advice. It’s not recommended to skip out on surgeries just because general anesthesia is a requirement. While “going under” can be intimidating, it is often the lesser of two evils to choose from. In fact, some people actually enjoy the entire process. It all depends on your unique constitution. 

Local Anesthesia Overview: 

Local anesthesia, namely lidocaine, is usually injected directly into the skin tissue surrounding the treatment area. It can also be used as a topical anesthetic depending on the circumstance. This is where the primary difference between local vs general anesthesia comes into play. For lidocaine, the only part of the body that experiences sensory depression is the actual targeted skin tissue, while the rest of the body and all cognitive and motor functions are unaffected. Ostensibly, patients who choose to undergo surgery with lidocaine will be able to carry out entire conversations during their procedure, while still feeling no pain or discomfort from the area being treated. This might seem even more frightening than general anesthesia at first, however the benefits are rather astounding. 

Lidocaine is often used in conjunction with other forms of anxiolytics or general anesthetics. This is especially the case when a type of twilight anesthesia is desired. During twilight anesthesia, aestheticians (doctors who specialize in anesthetics) will administer controlled amounts of their anesthetic cocktails in order to induce a light semi-conscious state in the patient. There are several stages or levels to twilight anesthesia, with the lowest consisting of a basic anxiolytic state that is typically paired with lidocaine or another topical anesthetic. During this stage, patients will be responsive and semi-alert, however their central nervous system will be mildly suppressed and they won’t be able to feel any pain. Twilight anesthesia allows for a more efficient awakening and recovery time for most patients. 

Effects and Benefits of Local Anesthesia, or Lidocaine:

Lidocaine was originally created as a less allergenic form of novocaine, although it is still possible for a minority of patients to experience allergic reactions. To be sure, you should always check with your primary care physician to determine various drug interactions or potential allergies. As a whole, lidocaine is a very safe and effective drug for numbing skin tissue and depressing nervous system responses within a given area. When administered properly, patients will be unable to feel anything in the treatment area and some major surgical procedures can be performed with a simple lidocaine injection. 

The benefits of using local vs general anesthesia are very promising. For one, surgeries performed with lidocaine take less overall time and are just as precise and controlled. And these speedier surgeries lay the groundwork for quicker recoveries with less undesirable side effects. Patient who undergo plastic surgery with local anesthesia are in and out of the office faster, often end up feeling better, and experience dramatically faster recovery times. This is because your body is able to focus on healing just the specific treatment areas rather than recuperating from a medically induced coma. Patients often feel better both physically and psychologically, without compromising their comfort in the least bit. 

local vs general anesthesia

What Types of Surgeries Can Be Performed with Local Anesthesia? 

We know what you’re thinking: “Lidocaine can only be used for minor procedures, right? There’s no way that a major surgery like a tummy tuck or a breast augmentation can be performed using only local anesthetic!” 

Well, actually, those very same major procedures are currently being undergone with standalone lidocaine injections and are seeing extremely high success rates. It’s entirely possible for you to receive a breast augmentation, tummy tuck, or even rhinoplasty without having to go under general anesthesia. No longer are the days where your fear of “going under” outweighs your desire to achieve your aesthetic goals. In other words, you can now have your cake and eat it too! 

Asking Your Doctor About Your Options

local vs general anesthesia

Still, we shouldn’t get too carried away here. Not all types of plastic surgery can be undergone without general anesthesia. And “going under” does still have its benefits for certain patients and types of procedures. It’s important to consult with a board certified plastic surgeon who can walk you through and thoroughly explain all of your anesthetic options. 

At CosmetiCare, we take pride in our continued efforts to understand each patient’s individual needs and desires. We start by consulting one-on-one with each patient and lay out all conceivable treatment options for achieving their unique aesthetic goals. We are currently seeing a high volume of patients who wish  to use local vs general anesthesia and we are more than willing to adjust our surgical plans to meet their desires. Click here to contact us or schedule a consultation to start discussing your ability to undergo plastic surgery with local anesthesia today. 

Call (949) 415-5965 to schedule a consultation today! 

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