Author Topic: Revision Gynecomastia Forum - Anaesthesia  (Read 4033 times)

Offline Joe Haley

  • Novice Member
  • *
  • Posts: 22
    • View Profile
Revision Gynecomastia Forum - Anaesthesia
« on: July 26, 2011, 02:32:42 AM »
I've been doing a lot of research on gyno, and was wondering whether there are any views on the use of local anaesthesia versus general.  From what I've read so far, the cost and risk of a local is lower, as well as the recovery time.  I haven't seen much discussion on this though.  Any thoughts?
« Last Edit: July 26, 2011, 12:30:23 PM by DrBermant »

Offline DrBermant

  • Plastic Surgeon - Site Owner
  • Administrator
  • Mentor Member
  • *****
  • Posts: 1166
    • View Profile
    • Bermant Plastic Surgery
Revision Gynecomastia Forum - Re: Anaesthesia
« Reply #1 on: July 26, 2011, 12:23:50 PM »
I've been doing a lot of research on gyno, and was wondering whether there are any views on the use of local anaesthesia versus general.  From what I've read so far, the cost and risk of a local is lower, as well as the recovery time.  I haven't seen much discussion on this though.  Any thoughts?

Cost is not the only factor. Safety and comfort are much more critical in my opinion.

Local anesthesia alone is not enough to maximize comfort for good chest contouring. Plastic Surgery Anesthesia is an art form.  Sedation manages the patients conscious level.  Local and Tumescent Anesthesia manage the numbness and comfort.  For almost all of my gynecomastia surgery, local anesthesia with heavy sedation provides a safer much more comfortable method.  The patient starts with medication from an IV given by my Anesthetist.  He is an artist who blends various medications that gently drift each patients off to sleep.  We have been working as a team for many years.  By the end of the operation the patient awakes, comfortable, with no nausea, and unaware of the time that has transpired.  My local anesthesia and tumescence is given after the patient is asleep. 

I prefer local anesthesia alone for long nipple reduction gynecomastia. For almost all other gynecomastia surgery, local anesthesia with sedation provides a safer much more comfortable method.  When 2 stages are needed, as with this problem of enlarged nipples of gland and nipple tissue, I perform the first stage with local sedation, and the second with local alone.  For my upper body lift surgery, when I have to operate all around the chest - front / back, I need Light General Anesthesia.  This is still my Tumescent Technique, but adds the safety of airway protection while the patient is in the prone position.

I have performed many revision gynecomastia surgery on patients first done elsewhere.  Many have told me how unpleasant their first doctor's experiences were under local anesthesia alone or General Anesthesia for liposuction and gynecomastia surgery. Since you posted this in this section about  Revision Gynecomastia, local alone is rarely sufficient for this more complex and difficult sculpture. Some minor scar revisions can be done under local, but this has been quite rare in my practice

You can find an extensive individual patients' experience with comfort and my Tumescent Technique Anesthesia for gynecomastia here.

If you prefer direct links to each of those discussions:


Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia
Michael Bermant, MD
Retired Plastic Surgeon
Surgical Sculptor, Artist, Creative Thinker, Problem Solver
Plastic Surgery
Follow DrBermant on Twitter
Like us on Facebook:
Encyclopedia News
Forum Updates

 

 
anything