Excision while awake-Which doctors??

[alwayson]

Which doctors do excision while you are awake?

Or which doctors offer the option of being awake during excision?

[Atfiv]

I believe no one does it when you're awake, however I don't know.  

[headheldhigh01]

i've seen maybe one case mentioned here that was local only, but i think i could live without the memory of pulling sensations and cutting sounds.  

if it's general anesthesia you're worried about, people also do a less radical equivalent, local with sedation, it puts you out more like they sometimes do for wisdom teeth so you still don't experience it.    

[DrBermant]

Which doctors do excision while you are awake?

Or which doctors offer the option of being awake during excision?

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

[ifgyne2]

Hello--Most of the time, I perform gyne surgery under intravenous sedation, which is administered by a separate, board certified anesthesiologist.  However, in RARE circumstances, when there is a very limited amount of tissue directly under the areola or extending outward for under an inch, I can perform the surgery under local anesthesia and the patient will be awake.  There is initial discomfort when the injections are done, then everything becomes numb. During the surgery, you will have no pain but may have a sensation of pressure, pulling, or pushing.  All stitching is done with dissolving sutures under the skin.  The nice thing about this is that after the dressing is applied, you get up with no anesthetic hangover and, after appropriate postoperative instructions, you are free to go home.

Elliot Jacobs, MD
New York City

[JTZ]

I had both my excisions done under local anesthetic.

The two worst parts are:

#1. The needle injection into the nips.  

#2. Feeling the surgeon manipulate the tissue underneath your nip. Basically, it's him moving his finger around under the nip in a circular motion. It doesn't hurt of course, but you know exactly what he is doing. It's a very strange feeling indeed.

[haletownhill]

My doc did some glandular excision and skin removal for me under local.  He had previously done my lipo under general however.  

It was really not even as bad as a dentist appointment.  I would say it was the equivalent, only you don't have to have your mouth open the whole time.  

My doctor is Dr. Jeffrey Kenkel in Dallas.