This 32-year-old female patient had a modified abdominal skin resection, high definition liposuction, and a bilateral breast lift with implant augmentation – front view
This 32-year-old female patient had a modified abdominal skin resection, high definition liposuction, and a bilateral breast lift with implant augmentation – front view
This 32-year-old female patient had a modified abdominal skin resection, high definition liposuction, and a bilateral breast lift with implant augmentation – left view
This 32-year-old female patient had a modified abdominal skin resection, high definition liposuction, and a bilateral breast lift with implant augmentation – left view
General Anesthesia and Local Anesthesia
Advances and innovations in medicine and specifically surgery have enabled surgeons to address desired cosmetic improvements in a less invasive fashion. Specifically, avoidance of general anesthesia has become a priority for many clients. The drive for avoiding general anesthesia are multi-fold. Many patients desire to be in control at all times and are adamant regarding not being put to sleep for surgery. These patients rather undergo their cosmetic procedure with local anesthetic which numbs the area of treatment. Although not supported scientifically, some patients feel that general anesthesia is more dangerous than local anesthesia. Another population that have a higher risk to general anesthesia are clients that have pulmonary disease. A final patient population that prefer to avoid general anesthesia are the elderly.
Tummy Tuck with Local Anesthesia
One surgery in particular, where less invasive anesthesia is desired involves an abdominoplasty or tummy tuck. Awake abdominoplasty or tummy tuck can be performed using local anesthetic solution. Local anesthetic solution, termed tumescent solution, is a diluted solution that is used to strategically numb the pain nerves located in the skin and soft tissues as well as the underlying muscles. Tumescent solution is created using a solution of saline, in which lidocaine and epinephrine have been added as the main anesthetic solution. Tumescent solution is also used to constrict blood vessels. When the tumescent solution is infiltrated strategically, it can help clients avoid general anesthesia.
How is an Awake Tummy Tuck Performed?
To do awake tummy tuck, the patient’s abdominal region is infiltrated with the tumescent fluid. The skin and soft tissue are injected with an 18 gauge using a 20cc syringe. The muscle fascia is injected using specially used cannulas that are able to effectively numb up the pain nerves within the muscle fibers. In addition to local anesthetic solution, oral medications that provide minimal to moderate sedation are provided to patients. Both oral medications and skin and soft tissue infiltration are administered at least one hour prior to surgery to allow for appropriate induction of comfort prior to proceeding.
Focal and targeted liposuction is performed first. This maneuver results in partial fat reduction of the abdominal wall, limited to the areas not dissected surgically. This step allows for shaping of the abdomen to a more aesthetically pleasing contour. Using a more concentrated lidocaine solution, the preoperative marked incision lines are re-infiltrated so creation of incision lines will be pain free. As the dissection proceeds, dictated by the surgical design, additional layers are infiltrated under direct vision. Once the muscle lining, or fascia, is reached, anatomical knowledge and surgeon skills are used to block specific nerves innervating the muscle fascia using specialized cannulas.
Both attention to details in tumescent infiltration and patience make this procedure extremely comfortable for the patient. This is best characterized by the fact that patients will typically nap throughout their surgery. Although they are napping, they are aware of their surroundings and always willing to help with repositioning of their body when asked to.
Using awake tummy tuck techniques, all components of a tummy tuck, traditionally performed under general anesthesia, can be done with local anesthesia only. Even muscle plication or tightening, which is a very important and critical step of the procedure, that is considered to be most painful, are completed without the need for general anesthesia!
The benefits of doing tummy tuck under awake conditions are several. First, there is decreased bleeding since the blood vessels are maximally constricted following administration of epinephrine in tumescent solution. This in turn also makes dissection of the surgical areas easier for your surgeon. Also being able to follow the surgeon’s orders is invaluable, as moving the body and reposition oneself is achieved with ease and facilitates surgical maneuvers. Finally, awake tummy tuck is more affordable than conventional tummy tucks since it avoids anesthesia related costs.
The awake tummy tuck performed at Surgisculpt provides faster recovery as patients can leave the operating room on their own since they are not groggy. Additionally, awake tummy tuck patients universally have observed a quicker recovery and return to their daily activities likely because they have avoided general anesthesia side effects in the immediate postoperative period.