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Dr. Jennifer Emmett, M.D.

Home General IV Sedation Vs. General Anesthesia: What’s the Difference?

March 13, 2022

Plastic surgeons rely on different anesthetic techniques to help ease their patients’ anxieties and nerves before and during operations.

Some minor procedures, such as a facelift, only require a numbing medication such as a lidocaine injection and can be performed in the surgeon’s office, similar to a dental procedure.

But for more major surgeries, such as breast enhancement procedures, tummy tucks, and rhinoplasty, stronger anesthesia is required.

Most plastic surgeons rely on general anesthesia to sedate their patients into a completely unconscious, deep sedation. While others prefer moderate sedation that puts patients into a groggy, dream-like unconscious state.

In this article, we’ll compare IV sedation vs general anesthesia, and explain why our office never uses general anesthesia for our operating room procedures. 

Continue reading to learn more about general anesthesia, twilight sedation and why we prefer it at Emmett Plastic Surgery.

What is the Difference Between Twilight IV Sedation Vs General Anesthesia?

Today’s plastic surgeons rely on two main forms of sedation for placing patients into a pain-free state — general anesthesia or twilight intravenous sedation with a lidocaine injection.

Each one of these anesthesia types has its own applications and uses depending on the type of surgical procedure.

For instance, most plastic surgeons will choose to place their patients under general anesthesia for operating room procedures for more in-depth surgeries such as breast augmentation, breast lifts, and breast reductions.

General anesthesia is an intravenous medication that places patients into an unconscious, pain-free state so they cannot remember anything. However, general anesthesia essentially temporarily paralyzes a patient, so a breathing tube must be inserted to assist with breathing. 

With twilight IV sedation, patients are also given medication intravenously, however, this drug is a hypnotic that doesn’t cause full body paralysis like general anesthesia. Instead, they remain totally unconscious and go into a relaxed, trance-like state where they cannot form new memories.

Because sedation doesn’t numb anything, it must be paired with a lidocaine injection to numb the incision site. With it, the patient can breathe on their own without a tube.

For smaller operations, like facelifts, an operating room isn’t necessary and the procedure can be performed in the surgeon’s office using a numbing agent such as a lidocaine injection, similar to what dentists use to numb a patient’s gums and for other dental procedures.

Anesthesia vs Sedation: Is Twilight IV Sedation Safer than General Anesthesia?

At Emmett Plastic Surgery, we believe twilight IV sedation is a safer and better option and use this method for all of our major surgeries, including breast augmentation, breast reduction, breast lifts, and tummy tucks. 

We do not use general anesthesia in our office at all.

A few reasons why twilight IV sedation is preferred include:

  • Patients under general anesthesia must use a breathing tube and ventilator to breathe during the procedure, as they cannot breathe on their own
  • Sedation does not require a breathing tube, patients can breathe on their own
  • General anesthesia typically makes people vomit upon waking up, due to air bubbles from the breathing tube and nausea from the medicine
  • Sedation does not cause vomiting
  • General anesthesia leaves a lingering, hungover feeling for days
  • Sedation doesn’t have a drug hangover
  • Pain from incision sites is felt immediately after general anesthesia wears off
  • Sedation uses lidocaine to numb incision sites, so they’re still numb when the patient regains their senses
  • General anesthesia can be dangerous for older adults with unknown coronary artery disease
  • Sedation is safer for older adults, which is why it’s typically used in colonoscopies

Are You Completely Awake with IV Sedation During an Awake Breast Augmentation? 

At Emmett Plastic Surgery, because we use twilight sedation during our breast implant surgeries, this counts as an “awake breast augmentation” procedure. 

The term “awake” itself is a misnomer. The patient is totally unconscious, while the patient’s brainstem is awake enough to breathe on its own. This is why we prefer IV sedation over general anesthesia because the patient can still breathe on their own without a breathing tube.

This sedation is specifically created to eliminate anxiety and place patients into a completely relaxed and unconscious state where they cannot form new memories.

When the procedure is over, you’ll have no recollection at all of what happened, and can recover quickly, without the nasty hangover feeling for days.

What Does Twilight IV Sedation Feel Like?

Twilight sedation helps patients stay relaxed and puts them into an unconscious state.

It’s designed to calm the nerves of patients. This medication also creates temporary amnesia in the patient so they won’t remember their surgery at all.

While twilight anesthesia can reduce physical feelings, it must be paired with a local numbing agent such as lidocaine to reduce pain from incisions. When sedation and lidocaine injections are used today, they create a great alternative to other intravenous medications.

Anecdotally, many patients who reported extreme anxiety prior to surgery felt that melt away as soon as they were sedated.

Once your procedure has finished, it can take about an hour for the effects of the sedation to wear off after your surgery, much quicker than general anesthesia. 

Another benefit of twilight anesthesia is that it won’t cause nausea or vomiting post-operation, unlike general anesthesia, which is the last thing you’d want if you just underwent a tummy tuck or received breast implants.

Schedule Your Consultation at Emmett Plastic Surgery

Dr. Jennifer Emmett, M.D., is a double-board certified plastic surgeon serving the Denver and Centennial areas of Colorado.

She and her team excel in breast augmentation, breast lifts, breast reduction, facelifts, tummy tucks, Botox, body contouring, liposuction, and more.

Have you been considering breast augmentation or another plastic surgery procedure?

Contact us today to schedule your initial consultation with Dr. Emmett.