March 27, 2023

There’s a lot of misconceptions about being awake during surgery. For years, awake surgery has been stereotyped as the kind of procedure that only “snake oil salesman” and fly-by-night surgeons would perform. Yet, when you go to the dentist you probably don’t think twice about being awake while they remove teeth from your bones or drill into your tooth. If being awake during routine dental procedures like root canals can be easy and painless then why can’t being awake during plastic surgery be the same?

Rather than asking yourself “Can you be awake during plastic surgery?” your first question is probably more like, “Who would want to be awake during plastic surgery?” Well, as it turns out, you might want to stay awake during plastic surgery if you are interested in quicker recovery time, less side effects, reduced cost, and more agency as a patient.

In this article, we will dispel any preconceived notions you may have about awake cosmetic surgery as being painful or gruesome, as this is simply not the case. At most, what some patients experience is a degree of anxiety which can easily be treated with medication. Awake cosmetic surgery is every bit as painless as being put under for cosmetic surgery with general anesthesia and it means you won’t have to deal with the side effects that might come after waking up. If, however, you don’t have any preconceived notions at all about being awake during cosmetic surgery because you just now found out about its possibility, then this article will show why it’s a great option to consider.

Do I Have To Be Under Anesthesia For Plastic Surgery?

If you want to know about the pros and cons of awake plastic surgery the first thing you need to understand is that there are three primary levels of anesthesia that are administered to patients during surgical procedures. The lowest level is local anesthesia which is essentially numbing medicine applied to the specific area of the body where the procedure will occur, leaving the patient totally numb but wide awake for the duration of the procedure. Oral sedation with medications can also be administered to help ease anxiety without making you fall asleep.  Next, you have IV sedation where a sedative is administered into the bloodstream through an IV, putting the patient to sleep and commonly known as “twilight anesthesia.”  Lastly, you have general anesthesia at the highest level which takes away your reflexes and paralyzes your body. General anesthesia is administered in hospitals or ambulatory surgery centers (ASCs) where you would have a breathing tube placed and an anesthesiologist present to monitor your breathing, heart rate, and blood pressure.

You do not have to be under general anesthesia for plastic surgery. While general anesthesia is widely considered to be safe, there will always be some amount of risk involved when a patient is put under. Additionally, you may want to avoid general anesthesia if you have:

  • sleep apnea
  • diabetes
  • obesity
  • seizures
  • heart, lung, liver, or kidney disease
  • excessive alcohol or drug use
  • adverse reactions to anesthesia in the past

Even if you are not affected by any of those conditions you might experience some unpleasant side effects beyond the typical grogginess and disorientation as you wake up from general anesthesia, resulting from the combination of drugs that were administered to put you under. These post-anesthesia side effects may include:

  • dizziness
  • shivering
  • muscle aches
  • dry mouth or sore throat
  • blurred vision
  • nausea and vomiting

On the other hand, awake plastic surgery procedures require less drugs because patients do not need to be put to sleep. This greatly reduces your chance of experiencing those unpleasant side effects, particularly nausea and vomiting.

Can You Be Awake During Plastic Surgery?

Sometimes when we ask patients if they would like to consider being awake for their procedure the reaction we usually get is total surprise: “You can be awake during plastic surgery?” After their awake procedure, patients often tell us things like, “I never would’ve gotten this work done if I had to go under anesthesia.” 

So can you be awake during plastic surgery? It all comes down to choosing the right anesthesia for the right patient. Most patients can be awake during plastic surgery. However, if you’re the sort of person who is afraid of needles then awake surgery is probably not a good option for you. Additionally, if you suffer from severe anxiety then you should probably stick with general anesthesia. Even though local anesthesia will numb the pain from surgery, if you are conscious you will still feel your body being moved around by a surgeon or occasional pulls and tugs. If you’re an anxious person then this body movement alone is probably going to cause you a certain level of discomfort.

The most important thing is to find an empathetic surgeon who understands your needs as a patient. One who is willing to go through the procedure with you slowly, ensuring that you are properly numbed, medicated, and comfortable. If you’ve got an attentive and patient surgeon, then there’s no reason you won’t be comfortable during awake plastic surgery. Now that we’ve discussed why you might want to avoid going under general anesthesia for plastic surgery, as well as the kind of people who should avoid being awake during a cosmetic procedure, let’s get into the reasons why awake plastic surgery is a great option for most patients.

Is It Cheaper To Do Plastic Surgery Awake?

Not only is it cheaper to do plastic surgery awake, the difference in cost is significant. This is because general anesthesia requires administering several medications in tandem, more medical equipment, and a lot more after the procedure to ensure that any risks to the patient’s safety are minimized. Put simply, general anesthesia is not a simple process, nor is it cheap. Its additional resources and complexity add up to additional costs for you. Whether you prefer general anesthesia or not, we offer friendly payment plans through PatientFi that can help you get the elective procedures that you feel are right for you without worrying about the cost upfront.

What Does Awake Breast Augmentation Surgery Cost?

The cost of any plastic surgery procedure can vary considerably from one clinic to the next. Breast augmentation is certainly no outlier in this regard. Like many plastic surgeries, it can range from a few thousand dollars to north of ten thousand dollars depending on the region you live in, the qualifications of your plastic surgeon, and how complex your procedure might be. But what does awake breast augmentation surgery cost in comparison to a breast augmentation procedure performed under general anesthesia? We can tell you one thing for certain: awake breast augmentation surgery costs significantly less than going under. Awake breast augmentation can save patients thousands of dollars.

That cheaper price tag begs another important question: are there awake breast augmentation risks you should consider?   Although there will always be some amount of risk involved in any surgical procedure, the risks of going under with general anesthesia can be higher than an awake breast augmentation.  Awake surgery can lead to shorter recovery times, reduced side effects like nausea and vomiting, and, most importantly, these benefits do not increase the risks of complications.

Is It Faster To Do Plastic Surgery Awake?

Ensuring you are properly numbed for your procedure is a slower process with local anesthetics than with general anesthesia. But while surgical time is reduced when you go under anesthesia, awake plastic surgery can save you time as soon as your surgery is done. Let’s walk you through what general anesthesia aftercare looks like if you prefer to be put under: For roughly one to two hours after your surgery you will be under observation to help manage your pain, provide light snacks and juice, and ensure that you are safely bouncing back to normal consciousness. When everything looks good, you will be cleared to leave the hospital or ambulatory surgery center (ASC). At this point you are free to go home. However, you will need to follow post-operative instructions and activity restrictions.

On the other hand, the efficient use of local anesthesia in awake plastic surgery trims over an hour off your time in the clinic post-procedure since you will not need to go through the general anesthesia recovery routine.  So, is it faster to do plastic surgery awake? Yes, when it comes to the recovery period it is significantly faster.  However, this increase in speed is usually offset by the longer times it takes to wait for numbing medicine to kick in since we can’t start any procedure until the patient is completely comfortable.

What Kind Of Plastic Surgery Procedures Can I Be Awake For?

You won’t want to be awake for more aggressive procedures or a lengthy procedure which combines two like a “mommy makeover” (a tummy tuck and breast lift). Those procedures take about five hours even under general anesthesia. Being awake can make that operating time even longer. After a couple hours most patients get tired of staying put and being asked how they’re doing. Can you still get other procedures like liposuction while awake? How about an awake mini tummy tuck? Yes, there are still many plastic surgery procedures that you can be awake for. Here are a few of the most popular procedures Dr. Elston performs:

  • Awake Mini Tummy Tuck
  • Awake Breast Lift
  • Awake Breast Augmentation
  • Awake Liposuction
  • Awake Brazilian Butt Lift

Awake breast lifts are a great opportunity for patients to verify that their breasts look symmetrical in real time by sitting up and looking at themselves in the mirror. Dr. Elston views this as something of an insurance policy, ensuring that he and the patient are on the same page. 

If you are interested in a more subtle increase in breast volume or cleavage lines take a look at our low monthly payment plans for natural breast augmentation via fat transfer. This fat transfer could be linked with an awake liposuction procedure, which happens to be our most common here at Elston Clinic. This can be an elegant option by using something natural for natural breast or buttock augmentation in accordance with the patient’s wishes.

What If I Prefer To Be Under Anesthesia During Plastic Surgery?

Even though there are many benefits to awake plastic surgery, many patients might still feel uncomfortable with the idea of being awake during these kinds of procedures. And that’s okay. Patients have the option of awake surgery, but it's not the only thing that we offer. When it comes to having a procedure under general anesthesia, you can rest easy knowing that Dr. Elston is a board certified Plastic Surgeon and has privileges to operate in accredited surgery centers or hospitals. Wherever you decide to go, it’s important to ask the surgeon you’re considering where they are allowed to take patients as some doctors may be operating outside the scope of their training. In other words, some doctors may not be forthcoming about whether they are legally allowed to operate in hospitals or ambulatory surgery centers (ASCs).  This is one reason awake surgery has gotten a bad wrap over the years.

If you would like to find out more about awake plastic surgery or any of the other procedures we offer, please give us a call at 253-525-4100 or feel free to request a consultation through our website. We will get you scheduled for a 15-minute virtual consultation with Dr. Elston that is absolutely free. At this point, you will be under no obligation whatsoever to move further in the process. We’d rather give you the chance to get to know us before you make a decision one way or the other. And as a low-volume, patient-centric clinic, we’d love the chance to get to know you too.