Cosmetic Surgery: Promises and Pitfalls™

Anesthesia: Gain Without Pain!

OUR APPROACH

• Local anesthesia (see below) alone is used for minor or touch up procedures only
• Intravenous sedation (twilight sleep) with local anesthesia (see below) provided by a CRNA (Certified Registered Nurse Anesthetist) is our preference, when appropriate, because it:
  • Is safer than a general anesthetic
  • Minimizes post-operative recovery, as well as, nausea and vomiting Is less stressful on patient
  • Requires no breathing tube; therefore, no resulting sore throat
  • Reduces cost by using office facility
  • Eliminates need for overnight care
  • Twilight Sleep may be used for
    • Liposuction - for limited areas
    • Facial Surgery - including facelifts, eyelid lifts and nasal surgery
    • Breast Surgery - including augmentations, lifts and reductions
    • Abdominoplasty (Tummy Tuck) - usually modified abdominoplasties
• General anesthesia (see below) technique produces complete loss of consciousness and, therefore, anesthesia or the complete loss of the perception of pain.

Anesthetic agents are administered intravenously or by inhalation (gas) by an anesthesiologist or CRNA.

• Procedures requiring general anesthesia are done at an appropriate facility: a surgical hospital.
• Most procedures can be carried out in our office surgical facility, which is accredited for IV sedation or twilight sleep (AAAAFS). In fact, our extensive experience with local anesthesia and twilight sleep allow us to perform most of our surgery safely and effectively with twilight sleep.
• In any surgery, the choice of anesthesia ultimately rests with the surgeon; however, it is our belief that a well-informed patient can understand and participate in this important decision.
   

MEET OUR ANESTHETIST

Mahlon Forman, CRNA, has been administering anesthesia for the surgeons of North Dallas Plastic Surgery Associates since 1996. Prior to that time her experience focused on anesthesia for trauma and for cosmetic surgery in New York City and Fort Worth. She has been practicing since June of 1980 when she qualified on the national board exams and continues to be re-certified every two years by the National Board for Recertification of Nurse Anesthetists. She is also certified by the American Heart Association in Advanced Cardiac Life Support.

Mahlon currently specializes in intravenous sedation with monitored care, which demands not only a knowledge of the science of anesthesia, but an aptitude for the art of anesthesia. Her philosophy stresses patient care, communication, and vigilance.
 

OVERVIEW: Types of Anesthesia

LOCAL

A local anesthetic agent (Novocain, Xylocaine, Marcaine, etc.) is introduced into the tissues (injected). This technique provides a profound numbness that allows surgery to be carried out with no discomfort in an awake patient.

INTRAVENOUS SEDATION: (Twilight Sleep)

In this technique, relaxing drugs are administered into a vein. The medications are used in appropriate doses to provide anxiety relief, amnesia for the surgery and a light sleep. However, patient’s normal reflexes are maintained during the entire anesthetic period; in other words, at all times, the patient is able to breath without assistance, has a normal gag reflex, which is protective should unexpected vomiting occur, etc.

• It is NOT intended to provide relief of surgical pain, which is the purpose of the local, dilute local infiltration or regional anesthetic that is used in conjunction with the IV sedation.
• If IV sedation produces complete loss of consciousness, then it is actually a general anesthetic (because this is the definition of general anesthesia). This situation is to be avoided.
• IV sedation is usually provided by an anesthesiologist or CRNA.
• Careful monitoring of the patient’s vital signs ensures patient safety.
• It requires only a limited recovery period.
• It usually is associate with less nausea and vomiting than general anesthesia.
• It avoids the added risk of a general anesthetic.

GENERAL ANESTHESIA

This anesthetic technique produces complete loss of consciousness and, therefore, complete loss of the perception of pain.

Anesthetic agents are administered intravenously or by inhalation (gas) by an anesthesiologist or CRNA.

• A breathing tube is placed in the windpipe to maintain a clear breathing passage (airway) and respirations are assisted by the anesthetist or anesthesiologist.
• A wide range of vital signs is monitored constantly utilizing electronic (often computerized) monitoring equipment.
• However, any general anesthetic carries certain risk, which includes blood clots (pulmonary emboli), post-operative breathing problems (pneumonia, etc.), as well as, activating preexisting health problems, including heart, lung, liver, etc.
• A recovery period in a specially equipped recovery area is required to ensure patient safety and varies from 30 minutes to several hours.
• Modern general anesthesia, used in suitable setting (hospital, surgicenter, accredited office facility, etc.) and administered by a qualified anesthesiologist or nurse anesthetist, is very safe.

 
Back to top

Our Dallas Plastic Surgeons' Bios  +  About Us  +  Cosmetic Surgery Procedures
Promises & Pitfalls  +  Am I A Candidate?  +  Before & After Photos  +  Skin Care
Patient Forms  +  Contact Us  +  Office Locations  +  What's New  +  Home  +  Sitemap

© Copyright 1999-2009 North Dallas Plastic Surgery. All rights reserved.