Anesthesia options?

[get_it_off]

Hello,

I just went in for a consultation at a doctor in Dallas and he answered all my questions and they are looking into if my insurance covers the procedure, which I am not very hopeful. When I asked them about the fees they said you have two options which I was waiting for them to say either lipo or excision and to my surprise the doctor said he really recommend excision but I had the option of doing a local anesthesia in his office for total of $3,500 or do it the usual way at the hospital for $5,050. I had prepared for everything other than this question.

Anyone has a suggestion to go one way or the other with this? I assume the only difference is that you will be in more pain if you do local but the price difference might be worth it?

Thanks,
Tom

[samuel2040]

Hi;

I had a VASER ultrasonic lipo job done which got gland and fat, and I was put out (general anesthetic) for it.

Just my opinion here, but there's no way I'd want to be awake for 2-3 hours worth of surgery.

sam

[somedude]

General anes. is a the best way to go in my opinion.
But if you cant afford it, then local is fine too.

With a local, there is a chance you will feel mild pain during the procedure, not where they are working on you but the surrounding area, and you will be "awake" during the surgery, but generally they give you a mild sedative to calm you down.

If you can afford it, go with the general

Also, I live in Dallas, may I ask what Dr.  you chose?

[DrBermant]

Hello,

I just went in for a consultation at a doctor in Dallas and he answered all my questions and they are looking into if my insurance covers the procedure, which I am not very hopeful. When I asked them about the fees they said you have two options which I was waiting for them to say either lipo or excision and to my surprise the doctor said he really recommend excision but I had the option of doing a local anesthesia in his office for total of $3,500 or do it the usual way at the hospital for $5,050. I had prepared for everything other than this question.

Anyone has a suggestion to go one way or the other with this? I assume the only difference is that you will be in more pain if you do local but the price difference might be worth it?

Thanks,
Tom

I have not needed general anesthesia for my male chest sculpture for many years.  For my patients needing skin alone nipple reduction, I offer local anesthesia alone option.  With tumescent techniques, I have evolved a better system under local with heavy sedation.  Without the sedation, there are just too many possible problems.

Some surgeons use general with tumescent techniques. Some use general alone.  I found that general anesthesia can leave patients with a higher chance of nausea and discomfort after surgery.

Each surgeon has his / her preferences about anesthesia.  I typically use local with heavy sedation.  That is not general anesthesia, but the patient is not awake.  We use medications injected into an IV for this sedation.  That is how we help keep our patients comfortable for most types of gynecomastia chest sculpture.  Sedation itself is an art.  I will use local anesthesia alone when performing actual nipple reduction surgery.

You can look at other posts here in this forum where anesthesia and sedation are discussed:

I prefer to perform tumescent anesthesia with sedation over general anesthesia or local anesthesia alone for most types of male chest sculpture. We take the comfort of our patients very seriously. You can find a number of posts here in this forum where patients describe their anesthesia experiences under this local anesthesia with sedation:

http://www.gynecomastia.org/cgi-bin/gyne_yabb/YaBB.cgi?board=1;action=display;num=1021397758;start=0#0

http://www.gynecomastia.org/cgi-bin/gyne_yabb/YaBB.cgi?board=1;action=display;num=1030314533;start=0#0

http://www.gynecomastia.org/cgi-bin/gyne_yabb/YaBB.cgi?board=1;action=display;num=1037669367;start=4#4

http://www.gynecomastia.org/cgi-bin/gyne_yabb/YaBB.cgi?board=14;action=display;num=1052569996;start=0#0

http://www.gynecomastia.org/cgi-bin/gyne_yabb/YaBB.cgi?board=14;action=display;num=1062552462;start=0#0

http://www.gynecomastia.org/cgi-bin/gyne_yabb/YaBB.cgi?board=14;action=display;num=1065016337;start=4#4

http://www.gynecomastia.org/cgi-bin/gyne_yabb/YaBB.cgi?board=14;action=display;num=1073182463;start=4#4

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[get_it_off]

Wow... thank you very much for the very detailed responses. I guess it seems to be more of personal choice rather than anything medical. I remembered when I had my wisdom teeth pulled they didnt give me the gas while I didnt feel much pain but I defiantly felt all the pressure and I know how uncomfortable that was. So I will probably go with local.

As for the doctor, I went to my general physician to get a check up and I talked to her about my gyno and she recommended a plastic surgeon in Dallas by the name of Frederick Duffy ( http://www.duffyplasticsurgery.com/ ) Although it seems Dr. Duffy is not a specialist in gynecomastia but from what he told me and I saw he has done plenty of this type of surgery. Actually he said he has done 3 in the past 6 months and also he said that the techniques he will be using are what he uses with a lot of his other patients that he does many per week. I didnt know of anyone else around the area so it was either between him and Dr. Hamas and I had heard mixed things about him so I am going to take a risk on Dr. Duffy.

Thanks for all the help,
Tom

[get_it_off]

I know what you mean. That is one of other major concerns but he was highly recommended by my family doctor and he has a lot of experience with breast reconstruction in general and but not gynecomastia in specific. He assured me that the techniques he uses he has done many times and can do in his sleep so I think I am going to take the risk because any other local plastic surgeon I pick will be out of the yellow pages and wont be much different than this.

Any suggestions?

[turfpro]

Mine was done in the doctors office, I beleive local with heavy sedation?  Either way I was out, except when I woke up for maybe 10 seconds.
I felt him working on me and then opened my eyes and saw a few people, asked if I was suppose to be awake. and then I shut my eyes and was out again. Didnt feel much pain, and I didnt panic. Which supprised me because I was scared to death before I went in.
Then the next 3-4 days after I was a little dizzy, and had to go home from work, The Nurse said some people can have effects from the anesthesia for days after, but she was supprised and I almost went to the hostpital but it went away.