Awake Plastic Surgery: Pros and Cons

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by Morgan Fogarty
Bio | Email | Follow: @MorganFogarty

CHARLOTTE, N.C. - Two years ago, 36-year-old Lisa Benton had breast augmentation surgery. The south Charlotte mom of two is considering other procedures, also, but has no plans to try out "awake" surgery. "There is no way I'd want to have plastic surgery awake,” she says.

 

Other women are interested in the technique. Instead of using general anesthesia for surgeries like breast augmentation, liposuction and abdominoplasty (tummy tucks), doctors use large doses of local anesthesia. They say it offers the patient more control, even lets them provide input on shape or size, and saves them money, too. "If you do surgery under local anesthesia, you don't have to employ an anesthesiologist so there's one fee you wouldn't have to pay if you were the patient,” says Dr. Marco Pelosi III. Pelosi is an OB/GYN in New Jersey. He also performs cosmetic surgery and does 4 to 5 awake lipo procedures a week.

He uses the awake technique for other surgeries, too, like breast revisions and tummy tucks that only involve skin tightening, not muscle. Pelosi says more and more women are requesting the technique but that it requires the right candidate. He says, "People who are poor candidates for this type of surgery are people who have a low pain threshold or are extremely anxious about procedures or they may have a medical condition."

"Safety should be first and patient comfort should be second. And if being awake doesn't provide safety or comfort for a patient, you're at a loss,” says Dr. Stephan Finical of Charlotte Plastic Surgery. Finical is certified by the American Board of Plastic Surgery. He says awake"surgery is driven by doctors who don't have legitimate certifications in the field of plastic surgery, not by patient empowerment. "In truth, anybody who's somewhat sedated is not in any position to make judgments,” says Finical.

Finical says large doses of local anesthesia can be toxic and warns women about the lower costs, too. "It may be cheaper, but the cost is on the other side. The cost is on your results and the cost is on the future surgeries, possible pain, problems, health issues that money can't buy,” he says.

Benton can't imagine being awake during her surgery. And as for the lower price tag? She says: you get what you pay for. "I think its just people trying to bargain shop for a procedure they should not bargain shop for,” says Benton.

We heard from a woman who prefers to be awake during her lipo. She's had it done three times and is considering a fourth go-round. She says if she panics during the procedure, her doctor calms her down with breathing exercises.

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