Sherry in Fort Lauderdale says:  I went to three consultations for rhinoplasty. Two were for general anesthesia, or rather two surgeons recommended general anesthesia, one recommended sedation, and she said I’m very confused.

Dr. Salzhauer: It is a good question. General anesthesia versus sedation. I do 95 percent of my procedures under general anesthesia, and I’ll tell you why.  First of all the risk of general anesthesia today is very, very small. Something on the order of 1 in 400,000, or 1 in 450,000 people have a death related to a complication from anesthesia, if you’re young and healthy. To put those risks in perspective, the odds of dying in a motor vehicle crash are something along the lines of 1 in 50,000 or something like that. You’re far more likely, God forbid, to die in an accident than to die on the table if you’re young and healthy from general anesthesia. The benefits of general anesthesia are: you’re completely asleep; you don’t feel any of the pain, and you don’t move when you’re on the table. So if I’m delicately reshaping your nose, and it’s done through a combination of breaking the bones, reshaping the cartilage, and so forth, and I’m trying to do as best an aesthetic job as possible, I want you as still as possible while I’m doing this work. I don’t want you sedated and like thrashing about from left to right, because that’s typically what happens when patients are sedated. Because the anesthesiologist, when you’re sedated, is sort of walking a fine line between having you asleep and having you awake enough to breathe on your own. Now the danger of sedation is that if the anesthesiologist crosses that line, and you stop breathing in your own, then he needs to reverse the medications he gave you, or actually begin general anesthesia, and intubate you in a much more frantic emergency type situation. So when you’re under general anesthesia, everything is controlled, your air way is protected, I think it’s a safer, better way to do 95 percent of the procedures that I do. A lot of people get talked into having procedures under sedation because they think it’s safer, or they think it’s less dangerous, etc. In my personal opinion, I think general anesthesia is the way to go for most of these major procedures that plastic surgeons do. Certainly for breast augmentation, certainly for rhinoplasties and face lifts. There are other surgeons that would disagree vehemently, this is just one surgeon’s opinion, but I am board certified by the American Board of Plastic Surgery, and we do have a busy practice in Bal Harbor. We operate 5 days a week, so I’m fairly familiar with these issues. I think the way de do it is a safe and controlled way.  We just can’t. We do use — and especially for upper eye lids — we do under sedation, no problem. It’s a very quick procedure, relatively low risk, and essentially error free type procedure, upper eye lid. So I would do those under sedation. And I frequently do. But all other major procedures I do under general anesthesia.

This entry was posted on Sunday, April 29th, 2007 at 11:00 am and is filed under Anesthesia Fear, Sedation, Upper Eye Lid. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.