Dear Cara,

Join us at 6:00pm on Tuesday, February 3, 2009 at the acclaimed St. Barnabas Surgery Center in Livingston, New Jersey for Dr. Slupchynskyj's next talk in a series of free educational seminars on the latest advances in non-surgical and minimally invasive facial rejuvenation.  Call early to register as seating is limited - 212-628-6464 or 973-303-2715.  Refreshments and light snacks will be served.
 
This issue discusses why anesthesia continues to be at the forefront of patient concern when considering cosmetic surgery.  Is it the type of anesthesia which lends towards complications, the type of procedure performed, or both?  Dr. Slupchynskyj answers these questions and reports on what procedures can be safely performed without sedation.

THE FEAR FACTOR:  ANESTHESIA

 Of all the frightening words in cosmetic surgery, the most frightening is ANESTHESIA:
 
1.  Will I wake up?
2.  Will I feel anything?
3.  Will I have any pain after the surgery?
4.  Will I have an allergy to the medication?
5.  Do you work with a board certified anesthesiologist or anesthetist?
 
The fear and the questioning can go on and on. Sometimes fear of anesthesia is enough to keep one from consulting with a plastic surgeon. Data shows that deaths and complications related to cosmetic surgery are rare.   Unfortunately, high profile deaths or complications, such as that of Donda West, Kayne West's mother or Olivia Goldsmith, (author of "First Wives Club") at Manhattan Eye and Ear Infirmary, become widely publicized and in effect scare the public. Deaths due to cosmetic surgery are similar to airplane crashes; they are so dramatic, catch the eye of media and frighten the public, when in reality are not commonplace as are traffic fatalities.  Even though the general public is aware of this fact, they still get in their cars and drive without thinking of the consequences.
 
Most deaths in cosmetic surgery are associated with body procedures such as liposuctions, abdominoplasty and other long cosmetic body procedures.  Many of these deaths are the result of lidocaine toxicity (local anesthetic used for liposuction), massive shifts in body fluids which can cause a variety of heart malfunctions and negligence on the side of the surgeon or anesthesiologist during surgery to monitor vital signs of the patient.  In spite of the potential risks, the incidence of deaths and/or complications in cosmetic surgical procedures are remarkably low and even lower in procedures involving facial cosmetic procedures.  Facial cosmetic surgery procedures, which involve only the skin and tissues beneath the skin, are in stark contrast to that of open heart surgery, abdominal surgery or even brain surgery.
 
The evolution of facial cosmetic surgery over the last 20 years has made tremendous progress. The procedures are much less invasive due to new technologies and earlier intervention or prevention of facial aging.  Similarly, anesthesia techniques and drugs have made facial cosmetic surgery safer. In theory, all facial cosmetic surgery can be performed under local anesthesia by blocking nerves associated with sensation of the face.
 
 Local anesthesia:  without any sedation using an Injectable numbing agent such as lidocaine or novacaine.  This is a safe and viable option for upper and lower eyelid surgery, neck liposuction, neck lifting, lower face lift and minimally invasive face lifting.
 
General Anesthesia (never used in my practice):
Patient is unarousable, even with painful stimulus. Airway intubation is usually required as the patient may not be able to breath on his own.  Spontaneous breathing/ventilation is inadequate and machine ventilation may be required. Cardiovascular function may be impaired.
 
In many cases, including minimally invasive face lifting, all that is used is local anesthesia. However, patients can still hear and feel pulling sensations and in certain cases we employ ear plugs or iPODS to quell any sound discomforts.  If a patient is particularly anxious or for cases that are long, i.e., two or more hours, it is wise to have some sort of gentle sedation which can include oral valium and Percocet.  All of my surgical cases are performed under local anesthesia or twilight sedation.  With these super safe alternatives to traditional general anesthesia, there is no need to put off feeling better about yourself.

Sincerely,
The Aesthetic Institute                        New Jersey Location: 

44 E. 65th Street   1A                          769 Northfield Avenue

NY, NY  10021                                     West Orange, NJ  07052

212.628.6464                                      973.303.2715