Surgery

[shetal]

1. What type of anesthesia is best? Do I have a choice?
2. Can I have my surgery under local only?
3. What does an IV feel like?
4. What does anesthesia feel like?
5. Do I have to be catheterized??
6. I am having my surgery performed in the Surgery Center. What accreditations do I look for?
7. Can I have other procedures performed with my breast augmentation?
8. How long does surgery last for?
9. What if I wake up DURING surgery? What if I don't wake up at all?
10. Will doctors other than my surgeon perform any part of the operation? Will students be present to watch?

[shetal]

11. What will it feel like when I wake up? Will I be groggy? Will know what's going on? Will I be scared?
12. How long do I have to be there before I am able to go home?
13. What do I bring to the hospital/surgery center or keep in the car for the ride home?
14. Will I get sick on the way home?

[bullman]

1. What type of anesthesia is best? Do I have a choice?

You will more than likely find out that you don't have a choice, but rather will be subject to what your surgeon prefers.

It has been said that General Sedation is best for surgeries that last longer than 3 hours, typical breast augmentation-only cases last much shorter than 3 hours. General sedation is easier on the surgeon but harder on the patient.

I personally prefer Light IV Sedation with an oral valium and local, of course. But this isn't necessarily what you are going to get. Just be sure if you go under General and deep forms of sedation that you will have a certified anesthesiologist.

[bullman]

2. Can I have my surgery under local only?

Patients have undergone breast augmentation procedures (usually subglandular-only) under local anesthesia only. Local anesthesia (usually Lidocaine) is the pain reliever most often given by your dentist. These injections will be placed within the breasts and breast area. You will find that having your surgery performed under local only in a surgery center is less expensive due to the lack of sedation and anesthesiologist.

However, having surgery under at least conscious sedation is recommended.

[bullman]

3. What does an IV feel like?

If you had been given an oral sedative or valium prior you should be very relaxed and honestly the patient is less likely to experience needless anxiety beforehand. Regardless if you have IV or gas the surgical team will more than likely insert an IV into your arm or hand like we talked about earlier. Remember this is for a saline bag, anesthetic medications and possibly antibiotics. The saline will keep you hydrated and act as a carrier liquid and the IV in general, serves as a vascular doorway.

If you haven't been given a sedative, it may be more stressful for some patients. Having an IV inserted feels a bit like blood being drawn, but for a shorter period of time. It is the initial placement of the needle that may sting a bit. After the needle is injected into the vein it is pulled out and a little plastic tube is left in your vein. This is called a catheter, which is taped to your skin so it is not knocked out accidentally.

Regarding the placement of the catheter, this truly depends upon your veins. Personally I like an IV in the crook of my elbow rather than my hand. The hand is bonier and seems to bruise more and may be slightly more uncomfortable afterwards. However, if your veins are not very prominent you may not have a choice at all and wherever they can insert the catheter, that will be your IV connection. You are then brought to the operating room if you aren't on the table yet. You will not be given your anesthetic of choice until you are on the operating room table. Although some surgeons provide a sedative for relaxation purposes.

[bullman]

4. What does anesthesia feel like?

If you have chosen an IV Liquid Sedative, they will insert a hypodermic into your tube that you are attached to or they attach the bag of it with a drip system to add a few drops every few seconds and when they release the stopper. The anesthesia makes its way to your veins and the effects of the anesthesia are felt soon after, a few seconds in fact. It feels like heat going into you veins for some people, then it feels as though it is spreading up your arm, then it seems to jump from your shoulder to a metallic-like taste under your tongue and then you are blissfully anesthetized.

If you have chosen Gaseous-state anesthesia (Twilight, Gaseous General) General anesthesia only entails breathing through a mask. However this depends upon what type. The newer intubation, Laryngeal Mask Airway (LMA) is a lot like the standard intubation for General but there is a shorter tube and a little balloon the size of your two thumbs facing one another, holds your tongue out of the way so it does not obstruct your breathing. With the standard intubation you have a tube inserted down your throat but you will not remember it going in. You may wake up with a sore or raw throat though. Your throat and voice may be scratchy after your surgery due to the intubation or the dryness of the cylindered gases. There is no moisture in these cylinders (tanks). Yet another good reason to have a saline drip.

Also be advised that if you have bronchospasm, asthma or other disorders such as this, intubation is contraindicated.

Twilight or Laughing Gas (basically a weak form of General) can be given via a mask with no intubation whatsoever.

Regardless of the type of gaseous-state anesthesia, you are then instructed to count down from 100, and see how far you can make it - usually 96 to 97. After the gas hits the aveoli in your lungs, your blood is saturated by the anesthesia gases where they are carried to your central nervous system (CNS) where you are then blissfully anesthetized.

[bullman]

5. Do I have to be catheterized??

This is dependent upon how long your surgery will be and if your surgeon makes a habit of it for shorter surgeries. This also depends upon if you have a weak bladder. Don't worry it is usually done after you are anesthetized.

[bullman]

6. I am having my surgery performed in the Surgery Center. What accreditations do I look for?

If your surgery is to be performed at an on-site Surgery Center make sure they are accredited! Ambulatory Accreditation associations and organizations ensure that Surgery Centers are well equipped and staffed, sterile, competent and safe. Requirements specifically may include presence of life-saving equipment, autoclaves, generators, back up generators, sterility, air filters, even proper fire exits and easy access to emergency vehicles. These are two of the most common accreditation associations are:
The American Association for Accreditation For Ambulatory Surgery Facilities
AAAHC - Accreditation Association of Ambulatory Health Care

[bullman]

7. Can I have other procedures performed with my breast augmentation?

If you so wish it, yes. Discuss this with your surgeon. Combining procedures is very common, it cuts down on costs, surgical downtime in the long run and even saves you down time for healing.

[bullman]

8. How long does surgery last for?

This depends upon the technique, TUBA can take as little as 35 minutes and a breast augmentation with full lift may take 2 to 3 hours. This depends also upon your surgeon's skill. If you choose to have additional procedures this will add to your time as well.