At first it may sound like a good idea: you remain awake during cosmetic surgery, you can communicate with your surgeon and, in a way, participate in the procedure. You avoid the effects—and the cost—of general anesthesia. Sounds appealing, right?
In fact, more and more doctors are becoming alarmed at the growing trend of what’s called “Awake cosmetic surgery.” In an article last month on MSNBC, the head of the American Board of Plastic Surgery (ABPS)—the organization behind the “board certification” that means at least two years of specific plastic surgery training—expressed his concern. Dr. Michael F. McGuire warned that Awake cosmetic surgery is part of what he called a growing problem of “amateurism” in the field.
Practitioners would have you believe that Awake cosmetic surgery is designed to benefit the patient. Indeed, general anesthesia, the method used by most plastic surgeons for most procedures, has its drawbacks. It poses certain risks, such as the risk of blood clots (stemming from patient immobility) and post-op nausea. Recovering from the effects of general anesthesia takes longer than recovering from lighter sedation, and it costs more.
But according to the MSNBC article, and to many board certified plastic surgeons, the risks of the Awake procedures are potentially even more serious. For instance, McGuire noted that the amount of lidocaine, a local anesthetic, required for Awake breast augmentation, can reach toxic levels. And, since the drug is absorbed slowly by fat cells, these levels can be highest after the patient is sent home.
Some Awake surgeons even offer tummy tuck surgery without general anesthesia. McGuire had this to say, “it’s inconceivable that anyone would do such a major procedure under anything less than a light general anesthesia.” He explained that abdominal surgery is some of the most invasive of all cosmetic surgery options and poses several risks.
One other criticism of Awake cosmetic surgery is that patients can experience a great deal of discomfort.