This Article Has Been Medically Reviewed By

Dr. Jennifer Emmett, M.D.

Home Breast Augmentation Anesthesia Options for Breast Augmentation

January 27, 2022

Any surgical procedure can be nerve-wracking for a patient, whether it’s a minor surgery or more involved such as breast augmentation.

Plastic surgeons typically rely on two options for anesthetizing their patients — general anesthesia, or a combination of IV sedation “twilight” and a local anesthetic.

At Emmett Plastic Surgery, we prefer twilight anesthesia with a local anesthetic. We use it for all of our operating room procedures. 

Twilight anesthesia has numerous benefits to help our patients reduce their anxiety, lower their blood pressure. We want to make the surgery go by quickly without having any memories created during the surgery.

If you’re curious about your breast augmentation anesthesia options, continue reading about general anesthesia and twilight anesthesia, and their applications.

Anesthesia — General or Twilight + Local Anesthesia?

The two most common types of anesthesia used for breast augmentation and enhancement procedures are either general anesthesia or a combination of an IV sedation paired with a local anesthetic. It places a patient in a twilight state.

Both of these options place patients into a comfortable, pain-free state. The surgeon is able perform breast enhancement without causing any physical or mental trauma. 

Once the surgery is completed, anesthesia will wear off, and the patient will regain their senses. You’ll then begin the recovery process.

However, each of these breast augmentation anesthesia options creates a different surgery experience that you should be aware of.

Let’s examine the differences between these two anesthesia types.

General Anesthesia

General anesthesia is the most commonly used type of anesthesia used by plastic surgeons.

Medications are injected via an IV sedation that quickly places the patient in a pain-free, unconscious state.

Because general anesthesia essentially temporarily paralyzes a patient from moving or feeling pain, a breathing tube will need to be placed in the trachea. The patient will need to breathe on a ventilator throughout the procedure.

While general anesthesia is a popular option by many plastic surgeons, there are many undesirable side effects, which can include:

  • Vomiting and nausea upon waking up
  • A lasting, drug-like hangover feeling that lasts several days after the procedure
  • Sore throat from breathing tube
  • Once general anesthesia wears off, pain from surgery is felt immediately because these areas haven’t been numbed locally

For these reasons, Emmett Plastic Surgery does not use general anesthesia for any of our procedures. 

“Twilight” Sedation (IV Sedation + Local Anesthesia)

Twilight sedation is a combination of IV sedation plus local anesthesia. This puts patients into a relaxed, pain-free, yet still conscious state.

There are numerous advantages over using twilight sedation over general anesthesia:

  • A patient can breathe on their own, without a breathing tube
  • Dramatically reduced hangover or nausea after the procedure
  • Patients have less pain immediately after surgery because of numbing local lidocaine injections near their breasts
  • Patients are awake, but not fully conscious, so they don’t feel pain or remember the procedure at all
  • It is safer and has less chance of overdosing

At Emmett Plastic Surgery, every procedure performed in our sterile operating rooms uses IV “twilight” sedation. We continually monitor our patient’s health throughout the procedure.

What Is “Awake Breast Augmentation”?

Awake breast augmentation means just what it sounds like — the patient is awake during their procedure and can talk to their surgeon if they need to.

At Emmett Plastic Surgery, all of our breast enhancement procedures are “Awake Breast Augmentations.”

We inject intravenous sedation that puts our patients into a relaxed, groggy, and semi-conscious state. Then we inject a lidocaine numbing solution into the breast area.

Don’t be concerned about being partially awake during the procedure, patients are heavily medicated and have no awareness of what’s happening. Patients will be medicated enough so they don’t feel pain, but can still breathe on their own. 

Awake Breast Augmentation – Big Questions

Twilight sedation is designed to specifically reduce anxiety and put you into a relaxed state where you’re not aware of your surroundings. 

When your surgery is over, you’ll have no recollection at all during your time in the operating room, and can begin recovery right away compared to general anesthesia, which has a lingering, hangover effect that takes days to get rid of.

Let’s answer some of the bigger questions you may have associated with awake breast augmentation:

Will I Be Completely Asleep?

Patients who receive a combination of IV sedation and local anesthesia will not be fully asleep but will be in a “twilight” stage, which is somewhere between being conscious and unconscious. 

Twilight sedation is preferred at Emmett Plastic Surgery because it gives us greater control over the amount of medication our patients receive and can reduce nasty side effects associated with general anesthesia (nausea, vomiting, pain from incision sites).

Most patients under twilight sedation will feel very drowsy, and will not remember their surgery.

Will I Feel Pain During the Procedure?

Twilight anesthesia in itself does not block pain but relaxes the patient and puts them into a hypnotic state where their brain is unable to form new memories. This is why patients don’t remember their surgery.

However, IV sedation must be paired with local anesthesia to actually numb the nerves of the surgical site.

With these two combined medications, the IV sedation and the lidocaine anesthesia, the patient will not feel any pain at all during the procedure. Nor will they feel any anxiety or mental discomfort during the procedure either, which is a common concern for patients undergoing an “awake breast augmentation.”

How Long Does It Take to Wake Up After Twilight Anesthesia?

Twilight anesthesia has a much shorter recovery period after a surgical procedure than general anesthesia, and because patients are in a semi-conscious state, they’re not actually waking up, but regaining their awareness and ability to form memories. 

Whereas general anesthesia can take a full day, up to a week to fully wear off, twilight anesthesia takes a few hours to wear off, so patients can recover more quickly and feel less groggy or foggy-brained.

Schedule Your Consultation at Emmett Plastic Surgery

Dr. Jennifer Emmett, M.D. is a highly skilled and experienced plastic surgeon serving the greater Denver and Centennial areas of Colorado.

Unlike most plastic surgeons who use general anesthesia, Dr. Emmett only uses a combination of IV sedation and local anesthesia for her operation room procedures, as they are proven to be safer options, and have fewer side effects for her breast augmentation patients.

She and her staff specialize in numerous plastic surgery procedures, including breast augmentation, breast implants, breast lifts, breast reduction, liposuction, facelifts, Botox, body contouring, and more.

Have you been considering breast augmentation but weren’t sure where to start? 

Contact us today to schedule your initial consultation with Dr. Emmett, and she will meet with you one-on-one to discuss your motivations for receiving breast augmentation surgery.