General anesthesia vs local

Historically the development of anesthesia for surgery was a monumental event.

Theories of disease have been part of mankind dating back to ancient times. That is ancient Egyptians, Middle Easterners, Europeans had ideas of how disease developed. Two major developments with respect to treating disease and assisting man in his quest for health and longevity were the ability to prevent infection and the ability to perform surgical procedures safely as a result of general anesthesia techniques. This process has been relied upon throughout the ages to serve mankind. 

Cosmetic surgery  is the ability to utilize creative , anatomic principles in order to enhance appearance and in doing so improve quality of life. Not all people believe that cosmetic surgery offers any significant benefit. However those of us in the Cosmetic and Aesthetic surgery profession are committed to providing surgical services in an appropriate and safe manner. 

Major procedures of the face ,the nose, the breasts , abdomen, arms and legs in my opinion are most safely performed under general anesthesia. 

The first principle of all surgery especially cosmetic surgery is safety and comfort of the patient. If the patient is comfortable and pain free then and only then can the surgeon perform his or her tasks most satisfactorily. If the patient is uncomfortable and experiencing pain and the only tool the surgeon has to relieve this pain is to administer additional local anesthesia then not only is the procedure compromised but the patient’s safety as well. 

Local anesthesia for liposuction became popular in the early 80’s because certain specialties are inclined to perform cosmetic procedures but did not have a facility to deliver the service. In this country in order for an individual to operate they must be credentialed to perform that procedure at the surgical center or hospital. As a way around this some healthcare providers began performing certain procedures primarily Liposuction, under local anesthesia  in their office.  I have had patients who have been dissatisfied with liposuction under local . Usually these patients relate not only major discomfort during the procedure but often should have had an abdominoplasty or tummy tuck and not the liposuction. That is to say-promoting liposuction under local-is a marketing ploy used to sell a liposuction under local.  It is my opinion that this is inappropriate when in fact the patient needed major body contouring under General anesthesia.

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