types-of-anaesthesia-used-in-plastic-surgery

Types of Anaesthesia Used in Plastic Surgery
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Anaesthesia is one of the parts of cosmetic surgery that worry about most and least. The honest position is that modern is one of the safest interventions in medicine, that the used at regulated UK clinics have a very strong safety record, and that the right for a given on factors the anaesthetist with you in detail at the pre-operative . This guide explains the main types of used in surgery, when each is appropriate, what the experience of each is actually like, and how Centre for Surgery’s — built around TIVA (total intravenous anaesthesia) for the majority of our work — from the older gas-based some still rely on.

The three main types of anaesthesia

use one of three broad approaches, in combination:
Local anaesthesia. A specific area of tissue is numbed by a local anaesthetic (lidocaine, bupivacaine, or a combination). The fully awake and aware. Suitable for small, procedures — minor mole excisions, small skin lesion removals, some intimate procedures, and ear .
Local with . Local anaesthetic is combined with sedative medication, which makes the patient drowsy or lightly asleep but not fully . The patient breathes for . Used for moderate — some cases, some procedures, work, and selected facial work.
anaesthesia. The is fully with no awareness of the . Within general anaesthesia there are two main used in surgery:

Why TIVA is the standard at Centre for Surgery

For the majority of our cosmetic surgery — facelift, rhinoplasty, blepharoplasty, breast surgery, abdominoplasty, body contouring — we use rather than gas-based anaesthesia. The are clinically meaningful:
For most patients, the practical of TIVA is: a smooth propofol induction in under a minute, the procedure itself with no awareness, and waking up alert and comfortable with nausea. who have had report TIVA as a better experience.

How the anaesthetic is chosen for your procedure

The plan is to the procedure, patient health, anticipated time, and individual . Common patterns:
Local alone for:
Local with sedation for:
TIVA anaesthesia for:
The anaesthetist will the planned with you at the pre-operative meeting and answer any specific to your situation.

Local anaesthesia in detail

Local injection takes effect within and full pain relief in the treated area for 2-12 hours depending on the agent used. Lidocaine acts with a 2-4 hour duration; bupivacaine takes longer to take effect but lasts 6-12 hours and is often used for post-operative pain relief in larger .
What the experience is like:
Local anaesthesia avoids the time and complexity of general and is the safest option where the procedure is small enough to . The is that it does not address anxiety, body movement, or larger areas where the volume of local would itself become a concern.

Local with sedation in detail

local anaesthetic with intravenous produces an that sits fully awake and fully . agents (typically midazolam, propofol, or a combination) are titrated to keep the drowsy and relaxed but breathing independently.
What the is like:
This is particularly useful for who are about being fully awake during a but for whom full anaesthesia would be unnecessarily heavy-handed.

General anaesthesia (TIVA) in detail

Full general anaesthesia produces complete unconsciousness, with the the patient’s and physiology the . With TIVA specifically, the entire anaesthetic is intravenously using running .
What the experience is like:

Safety of modern anaesthesia

The safety record of modern anaesthesia in healthy adults undergoing surgery is among the in . The risk of death attributable to in a adult is approximately 1 in 200, ,000 — substantially lower than the risk of dying in a road accident in any given year.
Several factors contribute to this safety record:

Common side effects and how they are managed

Even with the safest anaesthesia, some minor side are common:
Post-operative nausea and vomiting (PONV) — substantially reduced with TIVA compared with gas-based . at higher risk (motion history, previous PONV, female, non-smoker) are given prophylactic anti-emetic . Most patients have no nausea at all with modern protocols.
Sore throat — caused by airway device placement. Usually mild and within hours. More common with endotracheal tubes than with LMAs.
Drowsiness and disorientation on emergence — much with TIVA than with gas anaesthesia. Most are clear-headed within 1-2 hours.
Headache — usually related to fasting and dehydration rather than the anaesthetic itself. Resolves with .
Shivering — common in the immediate period as the body’s to normal. Managed with warming and resolves quickly.
Bruising or tenderness at the site — minor and .
Difficulty urinating — occasionally seen, particularly after longer procedures. Almost always self-resolving.

Rare but serious risks

The serious risks of general anaesthesia are rare but should be discussed at pre-operative assessment:

Pre-operative preparation for anaesthesia

What you can do to make your anaesthesia as safe and smooth as possible:
Honest assessment. Disclose all medications (including supplements, herbal remedies, recreational drugs, contraception, and GLP-1 Weight Loss Medication, navigate here, loss medications), all known allergies, all conditions however minor, and any previous anaesthetic complications.
Fasting. Follow the fasting instructions exactly. The usual guidance is no food for 6 hours before surgery and clear fluids only up to 2 hours before. on fasting is a real safety issue, not a formality.
Medication . Some medications should be continued (most cardiac medications, anti-epileptics, asthma inhalers); others should be stopped (anticoagulants, some diabetes medications, GLP-1 weight loss medications). You will be given written guidance.
Smoking and vaping . Stop completely for 4-6 weeks pre-operatively. See and .
moderation. Reduce alcohol intake in the weeks before . Abstain completely for 48 hours before.
health. Postpone surgery if you a cold, flu, or chest in the days before. See .
Hydration and nutrition. Aim for normal and in the days before; this reduces the risk of and dizziness .
Transport home. a responsible adult to collect you and stay with you for the first 24 hours after general anaesthesia.

The post-anaesthesia recovery

What to expect after general anaesthesia (TIVA):

FAQs

Is general safe? In healthy adults having surgery, very safe. The risk of serious anaesthetic complication is low and substantially lower than the risk of many activities.
What is TIVA and is it better than gas anaesthesia? TIVA is total anaesthesia, delivered entirely via continuous IV of . It produces less post-operative nausea, smoother emergence, and better physiological than anaesthesia. It is our standard approach for most surgery. See .
Will I wake up during my ? under modern general anaesthesia is extremely rare. Depth-of-anaesthesia monitoring during your procedure makes it rarer still.
Can I choose local rather than general anaesthesia? For some procedures, yes — discuss at assessment. For that need full general anaesthesia, local would not be appropriate.
How long does the take to wear off? The acute clear within 1-2 hours of TIVA general . Full elimination from the body takes up to a week, though most effects resolve within hours.
Will I feel sick after ? Much less likely with TIVA than with older anaesthetic techniques. further reduces the risk. Most patients have no significant nausea.
What if I have had a bad reaction to anaesthesia before? Disclose this at pre-operative assessment. The anaesthetic plan can be to avoid the agents and add specific protective measures.

Booking a consultation

If you are considering cosmetic surgery and want to the anaesthetic for your specific procedure, this can be at the consultation and explored further at the pre-operative meeting. Call or use the to a consultation at our .
Centre for Surgery · · GMC specialist-registered surgeons · · · ·
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Centre for is a CQC-regulated private on London’s Baker Street, delivering plastic and cosmetic surgery through specialist surgeons. Our spans facial including and , , for men, and body contouring procedures such as and . safety, and results sit at the heart of everything we do.
Centre for Surgery is a CQC-regulated private hospital on London’s iconic , offering and surgery led by consultant surgeons.

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