Tummy Tuck With Anesthesia
Anesthetic options include local anesthesia with oral sedation, conscious sedation, and general anesthesia. Mini-abdominoplasty can most always be performed under conscious sedation straight local anesthesia on an outpatient basis.
Dr. Michael Diaz and his experienced staff work with men and women throughout Biloxi, MS, including Mobile, Ocean Springs, Gulfport and the surrounding communities, to help them reshape and enhance their appearance whether through plastic surgery that results in more noticeable transformations or medical spa treatments that are non-invasive and simply enhance features on the face or slightly contour the body. read on to learn more on general anesthesia for tummy tuck and local anesthesia tummy tuck.
Tummy Tuck With Anesthesia
Abdominoplasty, or a tummy tuck as it is commonly referred to, is an operation that is designed to reshape the abdomen. Often, through weight gain and loss, pregnancies, and aging, the skin stretches beyond its elastic limit or ability to return to normal shape. Muscles also get pulled apart but never go back to original position. An abdominoplasty removes excess skin and fat while underlying muscles are tightened.
The actual placement of incisions and design of the abdominal incision varies depending on the excess of the skin and the underlying tissues, the condition of the overlying skin, and prior scars.
For those women whose sagging skin is mainly in the lower abdomen, the mini-abdominoplasty is an option, however, the muscles do not get addressed with this procedure and is not as extensive as a full abdominoplasty due to a smaller incision that is easily hidden under a two piece bathing suit. This procedure offers a more rapid recovery, is done on an outpatient basis, and is often performed under straight local anesthesia.
Who is a Candidate for abdominoplasty?
- Individuals with realistic expectations
- Physically healthy individuals at a stable weight
- Individuals with loose or sagging abdominal wall skin.
- Individuals with abnormal relaxation of the anterior (front) abdominal wall muscles due to weight gain or loss, pregnancies, or prior surgery.
Intended Results of Abdominoplasty
- A smoother flatter abdomen.
Procedure Description for Abdominoplasty
- Anesthetic options include local anesthesia with oral sedation, conscious sedation, and general anesthesia.
- Incisions
- Mini-abdominoplasty can most always be performed under conscious sedation straight local anesthesia on an outpatient basis.
- Standard abdominoplasty tightens all of the abdominal wall skin and abdominal muscles using a standard incision.
- Mini-abdominoplasty tightens the lower abdominal wall skin only leaving a shorter scar where possible.
- Small suction drains may be inserted with both procedures.
Recuperation and Healing
- Discomfort is usually controlled with oral medications or nasal spray.
- Recovery may be at home with a responsible adult caregiver, at a supervised recovery facility, or at the hospital with an overnight stay.
- If placed, drains are removed in 2-7 days.
- Most surgeons use sutures which are absorbable and do not need to be removed.
- A compression garment with dressings over the incision sites is used.
- Light activity may be resumed in 7-21 days. Sports will probably not be comfortable for about 6 weeks.
- An abdominal binder (compression garment) is usually worn for 4-6 weeks.
Local Anesthesia Tummy Tuck
The procedure can be performed under conscious sedation or deeper sedation with an anesthesiologist. In either case the safety of the procedure is enhanced. The patient is not paralyzed, and the risk of blood clots is greatly reduced, if not entirely eliminated. Additional advantages of this technique include:
- Lower incidence of nausea ( less anesthesia)
- A more comfortable recovery ( less thermal injury due to less use of cautery), a pain free experience for the first several hours which aids in recovery, and much less pain from muscle placation due to some techniques to minimize grabbing actual muscle as part of the fascial placation (bringing the muscles together.
It surprises many patients who are considering a tummy tuck at my Chicago practice when I explain that I prefer to perform the procedure using local anesthesia with sedation, rather than general anesthesia. Their quizzical looks are understandable because the innovative technique isn’t used by many plastic surgeons.
It is, however, perfectly safe and actually reduces the risk of side effects and complications
Abdominoplasty, or a tummy tuck as it is commonly referred to, is an operation that is designed to reshape the abdomen. Often, through weight gain and loss, pregnancies, and aging, the skin stretches beyond its elastic limit or ability to return to normal shape. Muscles also get pulled apart but never go back to original position. An abdominoplasty removes excess skin and fat while underlying muscles are tightened.
The actual placement of incisions and design of the abdominal incision varies depending on the excess of the skin and the underlying tissues, the condition of the overlying skin, and prior scars.
For those women whose sagging skin is mainly in the lower abdomen, the mini-abdominoplasty is an option, however, the muscles do not get addressed with this procedure and is not as extensive as a full abdominoplasty due to a smaller incision that is easily hidden under a two piece bathing suit. This procedure offers a more rapid recovery, is done on an outpatient basis, and is often performed under straight local anesthesia.
general anesthesia for tummy tuck
If you are considering a tummy tuck surgery and consult with more than one surgeon, you will likely get differing opinions about what type of anesthesia should be used. Do you need to have a general anesthetic and should the procedure be completed in the hospital setting? Or, is it better to use a deep sedation or even a conscious sedation anesthesia? Do you need an anesthesiologist or are certified nurse anesthetists (cRNAs) safe? The answers to these questions are not always clear and certainly can be debated. Here are my thoughts.
Anesthesiologist or nurse anesthetist?
If you talk to a surgeon who routinely uses an anesthesiologist for his/her procedures, you might be told that only an anesthesiologist has the training and knowledge to keep you safe during a tummy tuck. After all, do you really want to take your chances on having a complication by using an anesthesia provider who has less than the maximum amount of schooling and training? You might also be told that there just isn’t any reason to “scrimp” on your safety by trying to save a few dollars by using a nurse anesthetist.
Such statements seem convincing at first, but do they have merit? I can tell you that these statements were given to me as “selling points” by an anesthesiologist group that wanted me to use their services for my surgeries. They told me that even though they charged more for their services, I would more than make up for the extra costs by being able to “sell” the idea that I was providing a safer and more complete service. I could even charge my patients more for the surgeries because I would be easily able to convince them that they were getting a better product.
As a board certified surgeon, I certainly do not want to offer anything less than the best service possible to my patients and I certainly do not want to do anything that would compromise their safety. So I did some research to find the facts. And the facts are that there aren’t many clear facts. In all of my research, I have been unable to find a convincing study that proves that anesthesiologists are safer or provide better anesthesia than cRNAs for outpatient plastic surgery procedures including tummy tucks. Nor could I find studies that prove that cRNAs are better or safer.
There are two facts of which I am certain. One is that there are really good anesthesiologists and there are really good cRNAs. And two is that there are also really marginal anesthesiologists and equally marginal cRNAs. There are anesthesiologists that work almost exclusively in the hospital system and almost always use a general anesthetic. I would not feel very uncomfortable with such a person providing a deep anesthesia for a tummy tuck procedure because they just don’t do it all the time. There are cRNAs that spend almost all of their time providing deep sedation anesthesia in the outpatient setting that I would feel very uncomfortable giving general anesthesia for an open heart surgery because they just don’t do it all of the time. I would never want to minimize the importance of schooling and training, but like many things, schooling and training become less important the farther one gets into their career. At some point in time, it is the daily routine and knowledge gained from hands on experience that really matter most.
So anesthesiologist or cRNA? The answer could be either. I would choose the one that is the best at what they do. And the one that is the safest and most conscientious. I would choose the one that is the most caring and detail-oriented. And the fact is that such a person could either be an anesthesiologist or a cRNA. If you ask me, I would choose either of my two nurse anesthetists because I know their skill set, their attention to detail, their insistence on safety and protocol, and their track record of over 9 years of zero anesthesia complications while working in my operating room.