Types of Anaesthesia Used in Plastic Surgery

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Anaesthesia is one of the parts of cosmetic surgery that patients worry about most and least. The honest is that modern is one of the safest interventions in medicine, that the used at UK clinics have a very strong safety record, and that the right for a given procedure depends on factors the assesses with you in detail at the . This guide the main types of used in cosmetic surgery, when each is appropriate, what the of each is like, and how Centre for Surgery’s — built around TIVA (total intravenous anaesthesia) for the majority of our work — differs from the older techniques some still rely on.

The three main types of anaesthesia

Cosmetic procedures use one of three broad approaches, sometimes in combination:

Local . A specific area of tissue is numbed by a local anaesthetic (lidocaine, bupivacaine, or a combination). The patient remains fully awake and aware. Suitable for small, — minor mole excisions, small skin lesion removals, some intimate procedures, and ear .

Local with sedation. Local anaesthetic is combined with intravenous sedative medication, which makes the patient drowsy or asleep but not fully . The for themselves throughout. Used for moderate — some cases, some procedures, smaller revision work, and selected facial work.

. The patient is rendered fully unconscious with no of the . Within general there are two main subtypes used in surgery:

Why TIVA is the standard at Centre for Surgery

For the majority of our surgery — facelift, rhinoplasty, blepharoplasty, breast surgery, abdominoplasty, body — we use rather than gas-based general . The advantages are clinically meaningful:

For most patients, the practical experience of TIVA is: a smooth induction in under a minute, the procedure itself with no awareness, and waking up alert and comfortable with nausea. who have had previous gas-based report TIVA as a markedly better experience.

How the anaesthetic is chosen for your procedure

The plan is tailored to the procedure, patient health, anticipated time, and individual preferences. Common patterns:

Local anaesthesia alone for:

Local with sedation for:

TIVA anaesthesia for:

The anaesthetist will the approach with you at the meeting and answer any specific to your .

Local anaesthesia in detail

Local anaesthetic injection takes effect within and provides full pain relief in the treated area for 2-12 hours depending on the agent used. Lidocaine acts with a 2-4 hour duration; bupivacaine takes longer to take effect but lasts 6-12 hours and is often used for post-operative pain relief in larger procedures.

What the experience is like:

Local avoids the time and complexity of general and is the safest option where the is small enough to tolerate. The is that it does not anxiety, body movement, or larger areas where the volume of local would itself become a concern.

Local with sedation in detail

Combining local anaesthetic with intravenous sedation produces an experience that sits between fully awake and fully anaesthetised. agents (typically midazolam, propofol, or a combination) are to keep the patient drowsy and but independently.

What the is like:

This approach is useful for patients who are anxious about being fully awake during a procedure but for whom full general anaesthesia would be unnecessarily .

General anaesthesia (TIVA) in detail

Full general produces complete unconsciousness, with the managing the patient’s breathing and throughout the procedure. With TIVA specifically, the entire is delivered using continuously running .

What the is like:

Safety of modern anaesthesia

The safety record of modern anaesthesia in adults elective is among the strongest in medicine. The risk of death directly attributable to in a adult is approximately 1 in 200, ,000 — lower than the risk of dying in a road traffic in any given year.

Several factors contribute to this safety record:

Common side effects and how they are managed

Even with the safest anaesthesia, some minor side effects are common:

Post-operative nausea and (PONV) — substantially with TIVA compared with gas-based . Patients at higher risk (motion sickness history, previous PONV, female, non-smoker) are given prophylactic medication. Most have no nausea at all with modern protocols.

Sore throat — caused by airway device placement. Usually mild and resolves within hours. More common with endotracheal tubes than with LMAs.

Drowsiness and disorientation on emergence — much with TIVA than with gas anaesthesia. Most are clear-headed within 1-2 hours.

Headache — usually related to fasting and rather than the anaesthetic itself. Resolves with hydration.

Shivering — common in the immediate period as the body’s temperature to normal. Managed with blankets and quickly.

Bruising or tenderness at the cannulation site — minor and .

urinating — occasionally seen, Polynucleotide Hair Rejuvenation particularly after longer procedures. Almost always self-resolving.

Rare but serious risks

The serious risks of general are rare but should be discussed at pre-operative assessment:

Pre-operative preparation for anaesthesia

What you can do to make your as safe and smooth as possible:

Honest pre-operative . Disclose all (including supplements, herbal remedies, recreational drugs, hormonal contraception, and GLP-1 weight loss medications), all known allergies, all medical conditions however minor, and any previous complications.

Fasting. Follow the fasting instructions exactly. The usual guidance is no food for 6 hours before surgery and clear fluids only up to 2 hours before. Cheating on fasting is a real safety issue, not a formality.

management. Some medications should be (most medications, anti-epileptics, asthma inhalers); others should be (anticoagulants, some diabetes medications, GLP-1 weight loss medications). You will be given written guidance.

and vaping cessation. Stop completely for 4-6 weeks pre-operatively. See and .

moderation. Reduce alcohol intake in the weeks before . Abstain completely for 48 hours before.

Respiratory health. if you a cold, flu, or chest infection in the days before. See .

Hydration and nutrition. Aim for normal and nutrition in the days before; this reduces the risk of and dizziness post-operatively.

Transport home. Arrange a responsible adult to you and stay with you for the first 24 hours after general anaesthesia.

The post-anaesthesia recovery

What to expect after general (TIVA):

FAQs

Is general anaesthesia safe? In adults having surgery, very safe. The risk of serious anaesthetic complication is low and substantially lower than the risk of many activities.

What is TIVA and is it better than gas anaesthesia? TIVA is total anaesthesia, entirely via continuous IV infusion of propofol. It produces less post-operative nausea, emergence, and better stability than anaesthesia. It is our for most cosmetic surgery. See .

Will I wake up during my surgery? Awareness under modern general is extremely rare. Depth-of-anaesthesia monitoring during your procedure makes it rarer still.

Can I choose local rather than general anaesthesia? For some procedures, yes — discuss preferences at pre-operative assessment. For procedures that genuinely need full general anaesthesia, local would not be appropriate.

How long does the take to wear off? The acute clear within 1-2 hours of TIVA general anaesthesia. Full elimination from the body takes up to a week, though most subjective effects resolve within hours.

Will I feel sick after ? Much less likely with TIVA than with older anaesthetic techniques. Anti-emetic prophylaxis further reduces the risk. Most patients have no significant nausea.

What if I have had a bad reaction to anaesthesia before? Disclose this at pre-operative . The anaesthetic plan can be adjusted to avoid the agents involved and add specific protective measures.

Booking a consultation

If you are considering surgery and want to discuss the approach for your procedure, this can be covered at the and explored further at the anaesthetic meeting. Call or use the to arrange a consultation at our .

Centre for Surgery · CQC-regulated · GMC surgeons · · · ·

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