Local or general anaesthetic?

[Cellar_Door]

What did you choose? What is recommended?

I have never been under a general anaesthetic (totally put to sleep), and to be honest, it intimidates me a bit! But I think that is the option I would go for, if I was given it.

[Dider11]

go with the general man you'll be glad you did. They put you out and then you wake up and its all over

[Cellar_Door]

go with the general man you'll be glad you did. They put you out and then you wake up and its all over

Have you gone through it yourself? Can you describe it - is it like all the movies, where they make you count down from ten...and you're out?

[mattmando]

mine was just some guy giving me an injection ...and in like 15 seconds i was out...next time i woke up in the recovery room

[Dider11]

I had a nurse come into my room, give me the IV and then I moved to a stretcher. About 60 sec later I started feeling very spacey ( It didn't help that I didnt have my glasses on either) but we went down the hall to the op room, about 90 sec later they gave me a mask with oxygen and i was O-U-T. I woke up feeling like I had just slept for a week straight, but everything was done.

[Cellar_Door]

I had a nurse come into my room, give me the IV and then I moved to a stretcher. About 60 sec later I started feeling very spacey ( It didn't help that I didnt have my glasses on either) but we went down the hall to the op room, about 90 sec later they gave me a mask with oxygen and i was O-U-T. I woke up feeling like I had just slept for a week straight, but everything was done.

Lol, nice description

[DrBermant]

What did you choose? What is recommended?

I have never been under a general anaesthetic (totally put to sleep), and to be honest, it intimidates me a bit! But I think that is the option I would go for, if I was given it.

Plastic Surgery Anesthesia has evolved over the years.

For almost all gynecomastia surgery, local anesthesia with sedation provides a safer much more comfortable method. Patients receive medications from my Anesthetist in their vein and gently drift off to sleep.  At the end of the surgery they awake comfortable, with no nausea, and refreshed.

I prefer local anesthesia alone for long nipple reduction gynecomastia. When 2 stages are needed, as with this problem of enlarged nipples of gland and nipple tissue, I perform the first stage with local sedation, and the second with local alone.  For my upper body lift surgery, when I have to operate all around the chest - front / back, I need Light General Anesthesia.  This is still my Tumescent Technique, but adds the safety of airway protection while the patient is in the prone position.

I perform many revision gynecomastia surgery on patients first done elsewhere.  Many have told me how unpleasant their first doctor's experiences were under local anesthesia alone or General Anesthesia for liposuction and gynecomastia surgery.

You can find an extensive individual patients' experience with comfort and my Tumescent Technique Anesthesia for gynecomastia here.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia

[Cellar_Door]

Excellent and extremely helpful, thank you very much.

[Dr. Elliot Jacobs]

I perform the majority of my gyne surgery in my office operating room (accredited by the Joint Commission) on an out-patient, ambulatory basis -- rather than in a hospital. This works best for my patients -- no impersonal hospital personnel, no additional and unexpected hospital fees, etc, etc.  In order to accomplish this, we need anesthesia which  allows for a quick recovery.  For the vast majority of cases, IV (Intra-Venous sedation) is ideal.  However, just like surgery, it is an "art" form.  Some surgeons administer the medications themselves; others (myself included) have a separate anesthesia doctor.  In its best form, IV sedation (sometimes called "twilight sleep" or "conscious sedation") provides a smooth gentle sleep in which the patient feels absolutely nothing and is totally unaware of the passage of time.  It's as if you drift off to sleep and awaken 2 minutes later -- and the operation has been completed!  Once the patient is asleep, I will administer injections of local anesthetic -- but these injections are not felt by the patient.  To contrast, general anesthesia requires a tube to be placed in your windpipe and a machine to breathe for you.  You have to be more deeply anesthestized so as not to fight the tube -- thus more drugs and a slower wake-up and recovery.

I am proud to have worked with my anesthesiologist for over 15 years.  We work as a team -- effortlessly and smoothly.  His induction of IV anesthesia is gentle and the patient is carried through the surgery at a nice level -- not too "deep" and not too "light." He is totally unaware of the passage of time and obviously there is no pain at all! And then, when the last stitch is going in, the patient awakens gently, with no nausea, hangover or grogginess.  He opens his eyes and talks to us. And within 15 minutes, he can be moved to the recovery room.  Believe me, there is a true art to assessing each patient's needs and providing just the right amount of medication to keep him at the right level.  Together, we have used this technique on men from 135 pounds to over 400 pounds!

I, for one, believe that a good anesthesiologist providing IV sedation is the ideal method for gyne surgery.

Dr Jacobs

[Cellar_Door]

Interesting. I had never thought of it as requiring an exact, varying amount depending on the patient's physiology. The more posts I read from you guys the more I appreciate how much art is involved - after all, it comes down to aesthetics, and you change lives for the better, in immense ways.
It sounds like you have an excellent system in place.