Patients interested in undergoing plastic surgery are mostly interested in the risks entailed by the procedure they are about to have and sometimes don’t even ask about the risks associated with general anesthesia. There are also patients who are surprised to find out they will undergo general anesthesia all the while believing local anesthesia should be enough for their surgery. When it comes to plastic surgery, we often have to choose between local and general anesthesia. Some people fear general anesthesia not because they had it before and experienced complications, but because of the common myths associated with it. While some procedures can be performed with just the help of local anesthesia, complex or lengthier surgeries require general anesthesia, mostly for the comfort of the patient. In this article, we will discuss general anesthesia and its risks. What is anesthesia and why is it needed in plastic surgery? To put it simply, anesthesia would be synonymous with “no pain,” and this is an important detail to consider in the context of plastic surgery. Even if most of these procedures are performed for solely aesthetic purposes, they are surgeries that involve the incision of the tissues and a certain level of pain and bleeding. It hurts if you cut your finger with a knife, even it is very small. The same applies with any type of incision on the skin or tissues. Anesthesia is a precision act performed only by the anesthetist and only after the patient has undergone a thorough medical examination. The patient should understand what anesthesia is, why it is needed, and what side effects can be encountered afterwards. Many patients ask why they need general anesthesia when their friend had the same procedure with only local anesthesia. The type of anesthesia for a certain patient is decided by the plastic surgeon together with the anesthetist and explained to the patient. It is true that when it comes to plastic surgery, the patient’s desires and expectations play an important role in choosing the medical approach and even the materials used (e.g. implants), but for anesthesia, you should leave this to the plastic surgeon and the anesthetist as they will make the decision to reduce the risks as much as possible. Generally speaking, the patient can have a local/regional anesthesia which involves the administration of the anesthetic substance directly on the nerves and the patient is conscious during the procedure. General anesthesia involves the anesthetic substances to be delivered via the bloodstream, which means the patient will be deep asleep and unconscious during the duration of the surgery. Keep in mind that each type of anesthesia is associated with specific risks that should be evaluated for each patient. Often, the patient becomes worried about general anesthesia due to numerous urban myths such as general anesthesia will “take ten years off your lifespan.” This is just false. General anesthesia doesn’t reduce lifespan; it only induces deep sleep and an unconscious state during the period that the patient is under it. It is often recommended for the patient not to be under general anesthesia for more than five to six hours at a time as this can increase the risks and potential complications. How to prepare for general anesthesia Before surgery, the patient will need to have a meeting with the anesthetist. During this time, the doctor will evaluate the health condition of the patient and perform the pre-anesthetic consultation. This meeting with the anesthetist has many roles, but probably the most important one is to prepare the patient both from a physical and emotional point of view. Make sure to mention to the anesthetist if you had any general anesthesia performed before and if you experienced any side effects, as well as potential allergies you might have. There is some important information that the patient needs to exchange with the anesthetist during the consultation, such as: 1. Medical history This information is important because it will give the anesthetist an idea about any chronic diseases so the patient can be safe at all times. Each type of chronic affliction will require a specific anesthetic approach. The consultation with the anesthetist has the purpose to bring to light information about any condition that the patient might have and the current medication prescribed, if any. For example, if the patient is on treatment for arterial hypertension, he can continue to take the treatment including on the date of the surgery. But if the patient is on anticoagulants, they need to be stopped a few days before the procedure to reduce the risk of excessive bleeding. These instructions will be made by the anesthetist only after the consultation with the patient and is an important part of preparing for plastic surgery. 2. Surgical history This refers to the other times the patient has taken anesthesia. If the patient had general anesthesia before and no complications or side effects occurred, chances are the results will be the same. At the same time, potential problems experienced in a previous surgery will give an indication to the anesthetist about the most suitable anesthetic plan for the patient. 3. Allergies This is a very important aspect that the anesthetist must be aware of, even if it is something that doesn’t seem related to the surgical field such as an allergy to pollen. This will indicate what substances are suitable to be used in your particular case. Risks associated with general anesthesia During the meeting with the anesthetist, the risks will be identified and explained to the patient. The risks associated with anesthesia are gastric aspiration, perioperative ischemia, thromboembolic risk, and bleeding. Preparation must be done in such a manner that these risks are reduced to a minimum. Unlike anesthetic substances used in the past, modern general anesthesia techniques aim for a fast metabolization and elimination of the anesthetic substances from the body. This is the reason why the risks have been drastically minimized over the years. It is also important to mention that general anesthesia itself can’t lead to the death of the patient. Some unpleasant side effects such as headache, nausea, dizziness or vomiting can often be experienced by patients undergoing plastic surgery with general anesthesia, but these are not risks on their own and don’t put the patient’s life in danger. Proper hydration before and after surgery are essential to minimize these side effects. Conclusion Used to reduce pain and discomfort during plastic surgery, general anesthesia involves certain risks, just like any other medical procedures. If the patient already has a chronic condition, it is important to consider these risks and be aware of potential consequences of undergoing plastic surgery with general anesthesia. It is also important to mention that unlike scheduled procedures, such as plastic surgery, interventions performed on an emergency basis have a higher risk of developing complications. Modern techniques, as well as the anesthetic substances used nowadays, make anesthesia a safe medical act that is both easily supported by the patient and comfortable. The patient will be required to have a meeting with the anesthetist a few days before surgery and discuss the details about medical history and potential allergies. The risks associated with general anesthesia are gastric aspiration, thromboembolic risks, and others that are common to all procedures where general anesthesia is used. It is essential for the patient to follow the doctor’s recommendation for pre-operative preparations to minimize the risks of the plastic surgery. If you have a chronic health condition, you should understand that it might lead to increased risks for you. Make sure to mention this to the plastic surgeon even from the first meeting.