Staying awake during breast implants

Although a majority of the women who undergo breast implanting remain under general anesthesia, nowadays, doctors are advocating the use of local anesthesia for surgeries like breast implantation. This makes the patient aware of what is happening and she can give her suggestions on the approach and her choices as well.

With the new implants put inside the patient, she can look at a mirror to give their opinions on the surgery done. Many doctors however, do not consider this as an option because there is always the risk of something or the other going wrong in the surgery. According to them, they cannot give their best without total control over the situation.

However, a group of doctors are touting the option of their patients being awake as the safer thing than general anesthesia. This ‘awake’ surgery is done in offices that may not be vetted for security by accrediting organizations. The main problem in this is that the doctors are doing the procedures to avoid the accreditation process.

Patients say that during the majority of the surgery they did not have much sense about what was going on and they remembered nothing.

The doctors who do awake tummy tuck and awake breast augmentation advertise their cases on YouTube.com and point out on their views on websites. The marketing for the ‘awake’ procedure has gained momentum during the last couple of years.

Dr. Anil K. Gandhi performs these awake surgeries and has taught many doctors as well in different seminars lasting for a mere two days. The majority of the students taught by him are those who have completed their residencies in gyn or ob or family medicine.

They take weekend courses so that they can learn the process of aesthetic surgery with the help of sedation and local anesthesia.

The traditionalists get outraged by this adoption of a shortcut since the certified surgeons had to spend another five or eight years to learn about operations, and then their skills are examined and that too after learning the medical school method.

According to a plastic surgeon, the concept of learning the surgeries in two days is bizarre, as it takes them around 6 years to train cosmetic surgeons in breast augmentation. According to them, it is extremely irresponsible for doctors to allow their patients to choose the size of implants.

Since looking at the fact that people are not allowed to drive after a few packs of beers, the concept of choosing something with the effect of narcotics is very much irresponsible.

Many surgeons have the opinion that such consultation can have disastrous results if too large implants are chosen by the patient as it can produce unsightly rippling. According to a breast augmentation surgeon the decisions should be taken ahead of time.

Many surgeons say that this promotion of sedation and local anesthesia is a gimmick playing down the risks. In case of a panic attack in the middle of surgery there is nothing that the doctor can do. The promoters of awake surgeries claim that the method provides fast recovery but there is no evidence to prove the truth of such a claim.

Aspiration can be one of the rare complications involved. Under sedation, aspiration may become a possibility. Overdose of tumescent anesthesia should be avoided it may lead to abnormal heartbeats and seizures.


For minimum sedation, a little amount of Ativan and 5-10 milligrams of Valium is the best.
Dr. Gandhi gives minimal sedation as the screaming of the patients alerts him that he may be going wrong. However, later he retracted his claim.

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