American Society of Plastic Surgeons
For Medical Professionals
5 years ago

Anesthesia Concerns

I have a family history of bad reactions (including at least one death) to general anesthetic. I've read about anesthetics which don't trigger these reactions. I was wondering how commonly used and safe they are, as well as the possibility of only having local anesthetic and light sedation. Thank you!

Procedure: Breast Augmentation
Location: Duluth, MN

Replies 5

Lawrence Glassman
ASPS Surgeon

You may be referring to Malignant Hyperthermia which is a rare condition in which susceptible individuals will suffer muscle rigidity and high fevers triggered by certain anesthetic agents. This can be hereditary. There are special drugs that can treat this reaction should it occur(although, success is not 100%).

The key is to be aware of the possibility and minimize the exposure to triggering agents such as inhalation anesthetic agents and paralyzing agents like succinylcholine.

Breast Augmentation can be done under local anesthesia with sedation. Achieving effective local anesthesia is easier if the implant can be put on top of the muscle. General anesthesia can also be done avoiding the triggering drugs. Regardless, in patients with a personal or family history of Malignant Hyperthermia, I perform their operations in a hospital with all staff involved aware of this potential reaction. Special preparation of the anesthesia machine further decreases the risk.

Mario Carranza-Garcia
ASPS Int. Surgeon

besides of the doctor glassman say we can do it with anesthesia epidural

Nelson Castillo

Although not common there are serious complications that can arise from general anesthesia but with knowledge ahead of time, this risk can be mitigated. For most patients general anesthesia is preferred but there are alternate options

Jon Ver Halen

Hello and thank you for your excellent question. There are a group of genetic conditions that can contribute to an adverse reaction to general anesthesia. For these patients, alternatives include using medications that do not trigger this adverse response, or performing procedures under local anesthesia or mild sedation. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. Good luck!

Paul Parker
ASPS Surgeon
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Not all the procedures we do require an anesthesiologist. For those that do (ie, general anesthesia or monitored sedation), we arrange an anesthesia consultation to meet with our anesthesiologist be sure we proceed with safety.


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