THE ADVANTAGES OF AWAKE PLASTIC SURGERY WITH LOCAL ANESTHESIA
Mytien Goldberg, MD, FACS • November 19, 2023
THE ADVANTAGES OF AWAKE PLASTIC SURGERY WITH LOCAL ANESTHESIA
Mytien Goldberg, MD, FACS • November 19, 2023
Plastic surgery has come a long way in recent years, evolving from its traditional roots of general anesthesia procedures to a more patient-centric approach – awake plastic surgery with local anesthesia. This innovative technique offers numerous benefits for both patients and surgeons alike, revolutionizing the field and enhancing the overall surgical experience. Explore the advantages of wide awake procedures with local anesthesia and how it has transformed the landscape of cosmetic and reconstructive procedures.
- Enhanced Safety Profile: One of the primary advantages of wide awake plastic surgery with local anesthesia is the significantly reduced risk associated with general anesthesia. General anesthesia carries inherent risks, especially for individuals with certain medical conditions. Awake surgery eliminates the need for the patient to be completely sedated, minimizing the potential for complications related to anesthesia, such as adverse reactions or respiratory issues.
- Minimized Downtime: Patients who undergo awake plastic surgery often experience reduced downtime compared to those who opt for general anesthesia. Without the grogginess and lingering effects of sedation, individuals can typically return to their normal activities sooner, leading to a quicker recovery period.
- Real-Time Patient Feedback: With patients awake and alert during the procedure, surgeons can benefit from real-time feedback. Patients can communicate their comfort levels, allowing the surgeon to make immediate adjustments if needed. This interactive approach enhances the precision and accuracy of the surgery, leading to more satisfactory outcomes.
- Cost-Efficiency: Awake plastic surgery tends to be more cost-effective compared to procedures performed under general anesthesia. The absence of an anesthesiologist and the reduced need for specialized equipment contribute to lower overall costs, making these procedures more accessible to a wider range of patients.
- Reduced Postoperative Nausea and Vomiting (PONV): Postoperative nausea and vomiting are common side effects associated with general anesthesia. Awake plastic surgery eliminates this concern, providing patients with a more comfortable and nausea-free recovery experience.
- Minimal Time Commitment: Awake procedures often have a shorter duration compared to surgeries performed under general anesthesia. The elimination of induction and emergence times, as well as the streamlined preparation process, means that patients spend less time in the operating room.
- Environmentally Friendly: The use of local anesthesia reduces the need for some of the environmentally harmful waste associated with general anesthesia procedures, contributing to a greener approach to plastic surgery.
- Wide Range of Procedures: Awake plastic surgery is versatile and can be applied to a wide array of procedures, from minimally invasive treatments like lip fillers and Botox injections to more complex surgeries such as breast augmentations and liposuction.
- This adaptability makes it a viable option for many patients seeking various cosmetic or reconstructive enhancements.
The advent of wide awake plastic surgery with local anesthesia has ushered in a new era of safety, efficiency, and patient-centered care in the field of cosmetic and reconstructive procedures. By reducing risks, shortening recovery times, and enabling real-time communication between patients and surgeons, this technique offers a range of benefits that have transformed the way surgeries are performed. As the medical community continues to embrace innovative approaches, awake plastic surgery stands as a testament to the remarkable strides being made in enhancing patient outcomes and experiences.
This month’s spotlight is on a 20-year-old woman who sought improvement for breast asymmetry and excess size . Her left breast was one cup size larger than her right, leading to discomfort and dissatisfaction with her appearance. She desired smaller, lifted, and more symmetrical breasts while maintaining a natural shape and youthful cleavage . The Procedure Dr. Goldberg performed the Goldberg’s Superior-Medial Pedicle Breast Reduction , a specialized technique that: - Removes excess breast tissue from the side and underside - Preserves fullness in the upper and inner breast for a natural look - Enhances cleavage while minimizing visible scarring Before & After Results (4 Months Post-Surgery) - Balanced & lifted breasts with improved symmetry - Smaller, youthful nipples for a rejuvenated appearance - Natural, long-lasting results with hidden scars This patient is thrilled with her transformation , enjoying newfound confidence and comfort. If you're considering a breast reduction and lift , schedule a consultation with Dr. Goldberg today! #GoldbergTechnique #BreastReduction #BreastLift #BeforeAndAfter #BreastAsymmetry #PlasticSurgeryResults
Are you considering breast implant removal options but still want natural breast enhancement after implants? Do you wonder what your breasts will look like without implants? If so, you're not alone—and there are solutions to help you achieve a beautiful, natural shape. Embracing Your Body at Every Stage As we enter our 50s and 60s, we become more in tune with our bodies, appreciating the journeys they’ve carried us through—whether it’s childbirth, breastfeeding, or simply the ups and downs of life. Over time, some women find that breast implants no longer feel right. They may seem like a foreign material that no longer aligns with their bodies, prompting the decision to remove them and seek a more natural alternative. However, many women feel uncertain about breast explant surgery and how their breasts will look post-explant. Will they be saggy? Will they still have cleavage? These concerns are valid because, at any stage of life, we want to feel confident, empowered, and beautiful in our own skin. The good news? There are several breast implant removal options that allow women to maintain fullness and a natural shape using their own tissue. Your Options for Breast Implant Removal with Natural Fullness Option 1: Breast Implant Removal with Local Breast Tissue Rearrangement If you have a good amount of breast tissue with some skin laxity, this technique could be ideal for achieving natural breast enhancement after implants . The procedure involves removing the implants through a small incision in the breast fold. Dr. Goldberg then uses the lower breast tissue to enhance fullness and create natural cleavage. This method offers a soft, natural result without the need for artificial implants. Option 2: Breast Implant Removal with Lateral Chest Fat Transfer For women who do not have enough breast tissue for the first option, this approach utilizes excess fat from the sides of the chest to restore fullness after breast explant surgery with flap transfer (living fat tissue) . Many women in their 50s and 60s have loose tissue on the lateral side of the breasts. This excess fatty tissue is repositioned into the breast to restore volume and projection. The benefit of this technique is that the tissue is a living tissue which is different than fat transfer . It is simply a superior technique. The result? A fuller, natural-looking breast while simultaneously sculpting the sides for a sleeker contour—truly a win-win! Option 3: Breast Implant Removal with Abdominal Tissue Transfer (DIEP Flap Reconstruction) This is the ultimate solution for women seeking a full-body transformation while achieving breast reconstruction after implant removal . Dr. Goldberg removes excess lower abdominal tissue and repurposes it as living tissue to reconstruct the breasts. This technique provides long-lasting fullness while also improving abdominal contour—similar to a tummy tuck, but with the added benefit of breast reconstruction. It’s a fantastic option for women experiencing issues like Breast Implant Illness (BII), recurring capsular contracture, or those desiring a "natural" mommy makeover. Your Journey to Natural Confidence If you're ready to say goodbye to implants and hello to natural breast enhancement after implants , you're not limited to just one approach. With modern techniques like breast explant surgery with microsurgical flap transfer , you can achieve a youthful, confident look that aligns with your body’s natural beauty. Dr. Goldberg specializes in breast reconstruction after implant removal and natural enhancement techniques, helping women regain confidence and comfort in their bodies. 🔹 Ready to explore your options? Schedule a consultation today to discuss the best breast implant removal options for you!
What is a lumbar artery perforator flap in breast reconstruction?
What is a lumbar artery perforator flap in breast reconstruction?
What is a lumbar artery perforator flap in breast reconstruction?
What is the recovery from a LAP flap look like?
6 Minute Read: I received radiation treatment as part of my breast cancer treatment. What is the best breast reconstruction option for me: implant or autologous tissue breast reconstruction? If you have received radiation as part of your breast cancer treatment, I hope this blog is informative for choosing the best option for your breast reconstruction. After mastectomy, the goal of breast reconstruction is to recreate an aesthetic breast mound plus or minus the nipple and to establish symmetry with the remaining breast.
A breast lift is a surgical procedure that raises the breasts and restores their firmness and youthful appearance. It can be done with or without breast implants. As a woman ages, her breasts may sag due to a natural loss of skin elasticity, pregnancy, breast feeding, weight changes, and gravity. Breast sagging is completely natural, but it’s also reversible with a breast lift. You might be asking, what is a breast lift and how does it differ from breast implants? Breast implants make the breasts bigger and, by default, they can fill up any excess skin to cause the breasts to lift. A breast lift is a procedure that has the specific goal of raising the breasts, usually using the existing tissue. Implants are not necessary for a breast lift, though some women may choose to get them. A breast lift without implants is for women who are comfortable with the size of their breasts or women who would like a small reduction in their cup size. This procedure is also called mastopexy. During surgery, the doctor removes excess skin and tightens the surrounding tissue to reshape and support the new breast contour. The volume of the breast that fills a bra is left in tact, but their shape and position will be noticeably improved. A breast lift may be part of a ‘mommy makeover’ to reverse the affects of pregnancy and breastfeeding on a woman’s body. Since no implant is added during mastopexy, the results can be quite natural looking. Every woman is different. An individualized approach is taken for each patient to ultimately give her back youthful, firmer breasts.
Saline breast implant deflation occurs on average 4.3 to 6% at 10 years. A Study on silicone rupture rate (Inamed Silicone Breast Implant Core Study Results at 6 Years rupture rate published in Plastic & Reconstructive Surgery: December 2007 – Volume 120 – Issue ) was 3.5 percent overall at 6 year. Overall, the rupture rate of both silicone and saline implants are equivalent. The difference is detection of rupture. For saline implants, the rupture is detectable by the patient and physician almost immediately. However in case of silicone implants, the rupture is silent. It would require a radiographic study such as MRI or an ultrasound to detect silicone implant rupture. Retrospective study showed untreated silicone gel fill implants are harmless conditions (Plastic & Reconstructive Surgery: July 2004 – Volume 114 – Issue 1). Unlike a silicone implant, saline implant ruptures result in an immediate deflation of the implant and skin envelope of the breast. If the deflation goes untreated, the breast skin envelope would retract back while the other breast envelope continues to be expanded. Over time, you would have significant asymmetry in your breast that may require additional procedure to the unaffected breast such as a lift. Therefore, if you have breast implants and note any changes in your breast shape or size, you should consult your plastic surgeon soon for diagnosis and treatment. If it is a breast implant rupture, the two major breast implant manufacturers in the United States (Allergan and Mentor) provide a lifetime warranty for all of their implants. If an implant fails or ruptures during the first 10 years, both companies will provide a new implant and $1200 applicable toward operating room and anesthesia costs which can be upgraded to an extended plan providing up to $2400 for a small fee prior to surgery. All implants have a lifetime guarantee and will be replaced by the manufacturer if the problem is related to the implant.
In America and throughout the world, both men and women are expected to look healthy and young well into their 30’s, 40’s, 50’ and 60’s. While diet and exercise can play a large role in looking younger, the use of modern cosmetic surgery has become one of the most popular ways to beat back the clock. Getting surgical cosmetic procedures has become very commonplace, with an ever-growing percentage of the population opting in to get cosmetic surgery. Yet there is a large divide between women and men, and what procedures are most popular for each of the sexes. The American Society of Plastic Surgeons today released top line data from its 2011 plastic Surgery Statistics Report. The latest data shows breast augmentation is still the most common cosmetic surgery procedure for 2011. There were 307, 180 breast augmentation procedures performed in 2011, up 3.7% since 2010. Many of the common signs of aging that occur to a woman’s breasts as she gets older can be very devastating to her self esteem. Yet with today’s modern surgical options, there is a viable option for women to change the way they look. Second to breast augmentation, rhinoplasty is the most popular cosmetic procedure, with a total of 243,772 procedures being performed in 2011. The growing number of cosmetic procedures is an indication that even in this tough economic climate, more consumers are choosing cosmetic surgery as a way to look younger and feel better about themselves. We certainly see the same trend in our practice. More and more women are seeking improvements in their look. We support this trend as many of these procedures equate to improvements in their overall self-confidence and quality of life.
A new study published in the Archives of Facial Plastic Surgery in February 2012, looks at perceived age after facial plastic surgery. This novel study attempts to quantify the degree of perceived age change after facial plastic surgical procedures . A total of 60 patients were enrolled in the study and divided into 3 groups: Group 1 patients had only facelift and neck lift (total of 22 patients); Group 2 patients had facelift, neck lift, upper and lower eyelid surgery (total 19 patients); and Group 3 patients had facelift, neck lift, upper and lower eyelid surgery, and brow lift (total 21 patients). The investigators then asked a group of first year medical student to estimate the patient’s age based on the Before and After pictures of each patient. The researchers tried to standardize the photographs by asking participants to not wear makeup. The researchers found that on average, the raters estimated that the patients looked 1.7 years younger than their actual age before surgery, and 8.9 years younger afterward. On average, the estimated age dipped by 5.7 years in group 1 (patients with neck and face lift), and by 8.4 years in the third group (patients with neck, face lift, upper and lower eyelid and brow lift). Therefore, the author of the study concludes that facial rejuvenation surgeries demonstrate a significant and consistent reduction in perceived age. This effect is more substantial when the number of surgical procedures is increase. The desire to improve one’s physical presentation and to maintain a youthful appearance is intrinsic in our evolution. Physical appearance and how we are perceived by others have implications for social and psychological functioning, as well as our sense of well-being, self-esteem, and self-confidence. Before you seek to have plastic surgery procedures, do your homework and check that the doctor is board-certified in plastic surgery. There is a lot of white-coat deception. Virtually any kind of doctor legally claims to be a plastic surgeon without any formal training in plastic surgery. As a board certified plastic surgeon, I have seen increasing numbers of patients who present with complications and unsatisfactory outcomes after having procedures done by non board certified plastic surgeon.