Local Anestesia

[zacksully]

Hey Everyone,

I am debating to get surgery for a stage 2 gynecomastia.  I was not aware that this surgery doesn't require more than local Anesthesia. Can anyone tell me what I will feel and if the Dr's give you any relaxer first? Do they give you a needle to your chest and wait until you don't feel anything? Does it feel like someone is slipping their fingers inside your chest?

Thanks everyone!

[Dr. Elliot Jacobs]

Local anesthesia numbs some types of pain receptors -- but not others.  Liposuction is a necessary part of the procedure in virtually all of my patients -- and local anesthesia doesn't deal adequately with the pushing and pulling of liposuction.  It could be very very painful.

That is why most gyne surgeons opt for surgery done under "twilight sleep" administered by an anesthesiologist (my choice) or general anesthesia.  

Local anesthesia is only useful for the smallest of gyne cases.

Dr JAcobs

[zacksully]

Thank you so much Dr.Jacobs.  I ended up calling them to ask and they put you under.  I was nervous it was local and that I would feel some pain. 

Do you find there is a higher risk of not waking up from general?

[Dr. Elliot Jacobs]

You would run a higher risk of being struck by lightning.

Dr Jacobs

[Dr. Schuster]

I agree with Dr. Jacobs. The majority of cases can be done under a twilight anesthetic (you also receive a lot of local anesthetic to reduce post op pain). It is perfectly safe in well trained hands.

[DrPensler]

Last week I reviewed an article for our major journal regarding the classification of gynecomastia. To make a long story short there is no accepted classification system for gynecomastia ! I  really do not have any idea what you mean by stage 2 gynecomastia.

It is possible to perform the surgery under local and I have a subset of patients who are in the military who prefer this.The overwhelming majority of my patients prefer sedation during surgery .Every patient I operate on receives local anesthetics to reduce postoperative pain.

As far as the specifics each patient is different. I just finished a patient with very slight gynecomastia on one side and significant gynecomastia on the other. The small side certainly could have been handled exclusively with local anesthesia but the large side benefited from sedation and so the patient had sedation for the entire procedure.

I cannot stress this strongly enough, the critical element for success is the experience and expertise of the surgeon. As surgeons we all do what has worked best for us however there is a tremendous difference in the likely hood of a successful outcome if the surgeon is drawing on his/her experience of thousands of cases correcting a specific problem as opposed to tens of cases.

[Dr. Cruise]

I routinely perform Type 1, 2 and even 3 gynecomastia under local anesthesia with great success. The patient experience greatly depends on the skill and experience of the surgeon. I always offer other anesthesia options (twilight, general) if the patient prefers something other than local. 
Dr. Cruise / Cruise Plastic Surgery