Ask Dr. Man- Sedations

Dear Dr. Man, I’m having plastic surgery in one month. Originally I was supposed to get a few minor procedures; however, I’ve decided to also get a nose job and breast implants. For my original surgery, my doctor said he would be using twilight sedation. Now that I’m having additional procedures, he said I need to be put under general anesthesia. Can you please explain the difference between the two types of sedation? I’m quite confused. Thanks.

Many cosmetic procedures are performed under twilight sedation. Twilight anesthesia is local anesthesia with the addition of a sedative, such as Valium, given intravenously to relax you. This type of anesthesia is generally chosen for procedures lasting greater than an hour or for a few minor procedures that are being done at the same time in different body areas. It is also used when areas being treated cannot be well anesthetized using local anesthesia. Intravenous sedatives are generally a good addition to the local anesthesia injections given by the plastic surgeon. The combination helps make patients feel comfortable during the procedure.

With twilight sedation, you will be sedated to the point of being asleep, but you will not be unconscious or intubated. Twilight sedation does not provide pain relief to the area being operated on; so local or regional anesthetics may be used as well. Twilight sedation generally involves a shorter recovery and causes less, if any, nausea or vomiting.
In some cases, if the doctor finds that twilight anesthesia does not allow the surgical procedure to be carried out safely and comfortably, the doctor may switch to a general anesthetic.

A general anesthetic provides complete loss of pain sensation and loss of consciousness. It is often used for longer surgical procedures where a substantial amount of tissue manipulation is required. It is also used if multiple smaller procedures are being performed in different areas of the body.

General anesthesia is administered by injection, gas or a combination of both. This causes you to fall into a deep sleep. Your doctor may also use other medications for pain relief and muscle relaxation. Advances in anesthesia have made general anesthesia safer than ever.

No matter which type of anesthesia your doctor uses, be sure to have someone available to pick you up following your surgery, as you should not operate a vehicle. You’ll want to rest after the surgery to let the anesthesia wear off and to let your body heal from the surgery.

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Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.