Your New Body Blog.com

Tuck ‘N’ Stitch

YourNewBodyBlog.com welcomes two board certified Beverly Hills surgeons, Dr. Stuart Linder and Dr. Robert Kotler.

As the “FaceDocBlogger,” Dr. Kotler’s practice is exclusively devoted to cosmetic plastic surgery of the face and neck. Dr. Linder, the “BodyDocBlogger” specializes in plastic surgery procedures of the body.

You’ll find Doctors Linder and Kotler exclusively on YourNewBodyBlog.com as the ultimate plastic surgery insiders who have unique views and, often, the untold story behind the story. They are also sharp on trends, news and practices in cosmetic plastic surgery.

This Week: Anesthesia — Not So Bad, After All!

If you read a lot of blogs or posts about cosmetic plastic surgery, you’ll find that many patients fear going under anesthesia. Decades ago, it was more difficult to recover from general anesthesia that put you completely to sleep while the doctor operated. Side effects used to include nausea, headache and a foggy mind lasting longer than a basic hangover. The risks were greater.

But even today, some misinformed people think they stand a good chance of never coming out of anesthesia. However, times have changed, according to Doctors Linder and Kotler, and anesthesia isn’t at all like it used to be. It’s better and safer.

An intubated patient receiving general anesthesia.
A tube is used to deliver the anesthetic directly to the lungs.
The patient’s face is surgically marked
in places where facial fat grafts will be placed.
(Photo, courtesy of Brent Moelleken, M.D.)

BodyDocBlogger (Dr. Linder): The world of anesthesia took a giant leap in 1985, Dr. Kotler. Know what happened?

FaceDocBlogger (Dr. Kotler): I know what you are getting at because I attended a medical convention that year and my eyes popped out at what I saw being demonstrated by the anesthesia equipment companies.

BodyDocBlogger: Right. A lot of technology born for the safety of space program astronauts was released to the civilian medical market. So we surgeons got compact, micro-circuitry monitors that show the most important vital sign readings that an anesthesiologist needs to best monitor the health of the patient undergoing surgery.

FaceDocBlogger: Those readings would be — in additional to pulse and blood pressure — the percentage of oxygen and carbon dioxide in the patient’s bloodstream which is important data that we always longed for in the past.

BodyDocBlogger: These nifty machines, not much larger than a desktop computer, were portable and thus could be used during surgery and then accompany the patient to the recovery room.

FaceDocBlogger: And what a boon it has been! General anesthesia is now very safe, with many plastic surgery patients staying under for as long as seven or eight hours, with very little risk. One form of lighter anesthesia — local anesthesia with intravenous sedation — allows the patient to be pain-free and remember nothing. Yet, they can sit up, answer questions and cooperate with the surgeon. It’s ideal for upper eyelids and brow lifting where the surgeon must be certain of brow position and symmetry.

BodyDocBlogger: I don’t have the luxury of I.V. sedation in body procedures. I often explain anesthesia to my patients as being very much like an airplane ride. The gentle take-off is when the anesthesia is smoothly introduced via an intubation tube, like in the above photo; the smooth flight is when I am doing the procedure and the gentle landing is equal to when the intubation tube is easily removed.

FaceDocBlogger: Don’t forget to mention the flight’s pilot, doctor. For our patients, at the controls is a board-certified doctor-anesthesiologist. An anesthesiologist is an internal medicine specialist who limits his practice to the operating room. Our patients are comforted knowing there are two MDs at their side.

BodyDocBlogger: I use an anesthesiologist because my patients must lie completely still, like statues, while I’m working. During a breast augmentation, for example, I’m only an inch above the lungs. While using a liposuction wand, I require complete stillness of the patient because a slight shift of body could cause the wand to poke into a bowel. My rule is: no general anesthesia, no surgery.

FaceDocBlogger: Also, realize that plastic surgeons are working on the skin and layers just beneath. These layers are very shallow. We don’t enter the major body cavities, such as the abdomen or chest, as a general surgeon does. So cosmetic plastic surgery patients need not be as deeply under anesthesia but just enough to not move and have no awareness. I myself was put under a general anesthesia about a year ago and woke with no after-effects or hang over. I felt great four hours later and went hiking the next morning.

BodyDocBlogger: Doctor, you’re saying the process is very safe and there’s nothing to fear?

FaceDocBlogger: Let’s put it this way: You are safer in an operating room of an accredited outpatient surgery center, in the hands of a doctor-anesthesiologist, than you are in your car — driving on a freeway — getting to that surgery center.

Have a question for FaceDocBlogger or BodyDocBlogger? Let us know and we’ll do our best to have it answered. Feel free to leave your comments below!