When discussing the option of awake plastic surgery, many patients express curiosity about how it differs from traditional approaches, and whether it might be the right fit for them. In my practice, I always want my patients to feel well-informed about the benefits, risks, and key considerations before undergoing any procedure.

What is Awake Plastic Surgery?

Awake plastic surgery refers to procedures performed under local anesthesia or mild sedation, where the patient remains conscious but relaxed. While you may not feel any pain during the surgery, aside from the initial nerve block injection, you are alert and able to communicate with your surgical team. This method contrasts with traditional plastic surgery, which is typically performed under general anesthesia, where patients are completely unconscious and unaware of the surgery taking place.

Awake surgery has grown in popularity over recent years because of its potential advantages in terms of safety, recovery time, and cost. However, just because it works for some patients doesn’t mean it’s suitable for everyone. My goal is to provide you with all the information necessary so you can make an informed decision if your plastic surgeon presents awake surgery as an option.

Why Consider Awake Plastic Surgery?

There are several reasons why someone might opt for awake plastic surgery over general anesthesia. Here are some of the most compelling benefits:

1. 1. Reduced Risk of Complications: General anesthesia, while very safe for most patients, does carry some risks, especially for those with underlying health conditions like heart disease or respiratory issues. Local anesthesia significantly reduces these risks, making it an excellent option for patients who may not be ideal candidates for general anesthesia.
   2. Quicker Recovery: Because you’re not being put to sleep with general anesthesia, your body doesn’t have to deal with the after-effects of strong anesthetic drugs. This often means you may experience a quicker recovery. There’s no grogginess or confusion after surgery, and you can usually return home faster than you would after a procedure performed under general anesthesia.
   3. Cost Savings: General anesthesia typically requires the services of an anesthesiologist, which can add to the cost of your surgery. On the other hand, local anesthesia is much less resource-intensive and can reduce the overall cost of the procedure.
   4. More Involvement in the Procedure: Some patients appreciate being more involved in their surgery. Awake plastic surgery allows for real-time communication with the surgical team. For example, if you’re undergoing a cosmetic procedure, your feedback during the operation can help guide the surgeon to ensure the final result meets your expectations. Of course, I always guide this process carefully to make sure everything remains safe and efficient.
   5. Shorter Time at the Surgical Facility: Since the preparation for general anesthesia takes longer and requires a longer post-surgery recovery, procedures done under local anesthesia can generally be completed more quickly. That doesn’t mean we rush through the surgery, but it does mean your overall experience may be more streamlined.
   6. Lower Facility Fees: In-office procedures typically cost less than those performed at an accredited surgical facility, like our Northern Arizona SurgiCenter in Flagstaff, due to lower overhead costs for anesthesia, nursing staff, and operating room costs.

Is Awake Plastic Surgery Right for You?

Not all patients are ideal candidates for awake plastic surgery. The decision often depends on your medical history, the type of procedure you’re considering, and how comfortable you are with the idea of being awake during surgery. Here are some factors to consider:

1. Your Health: If you’re generally healthy and have no significant underlying conditions, you’re more likely to be a good candidate for awake surgery. However, if you have certain medical conditions, like heart or lung issues, local anesthesia may be safer for you than general anesthesia.
2. The Type of Procedure: Some surgeries are better suited for awake procedures than others. Minor cosmetic procedures like liposuction, upper eyelid surgery (blepharoplasty), scar revision surgeries, or hand surgeries are often performed under local anesthesia. However, more extensive surgeries, such as tummy tucks or breast augmentations, are typically not appropriate for awake surgery due to the complexity and duration of the procedure.
3. Your Anxiety Levels: Being awake during surgery can be unnerving for some patients. If you tend to experience high levels of anxiety, it’s important to weigh whether staying awake might make the process more stressful. We may offer mild sedation to keep patients comfortable, but you’ll still need to be aware of what’s happening to some degree. If the thought of being awake during surgery makes you too anxious, general anesthesia might be a better fit.
4. Your Tolerance for Discomfort: While you won’t feel pain during an awake surgery, you may feel pressure or movement. Some patients find this sensation disconcerting, while others don’t mind it. If you’re okay with the idea of feeling some degree of sensation during surgery, then awake surgery could be a good option for you.

The Awake Surgery Experience: What to Expect

One of the most common questions patients ask me is, “What will it actually feel like to be awake during surgery?” Let me walk you through the process step by step:

• Preoperative Preparation: Just like with any surgery, we’ll begin by reviewing your medical history and discussing your expectations. On the day of the procedure, we’ll use local anesthetics to numb the area being operated on, ensuring you won’t feel pain during the surgery. In some cases, we may also administer mild sedatives to help you relax.
• During the Procedure: You will be awake, but the local anesthesia will block pain signals from reaching your brain. You may feel some pressure or pulling, but you won’t experience any sharp pain. I’ll explain what’s happening during the procedure and check in with you regularly to ensure you’re comfortable.
• Postoperative Recovery: Since you haven’t been under general anesthesia, your recovery will likely be quicker. You won’t experience the grogginess or nausea that sometimes accompanies waking up from general anesthesia. After the procedure, I’ll provide you with post-operative care instructions, and you’ll likely be able to go home shortly after.

Awake Surgery vs. General Anesthesia: Which Is Better?

One of the most significant considerations when deciding between awake surgery and general anesthesia is the type of procedure. While awake surgery has many benefits, it’s not suitable for every type of operation. More complex and intensive surgeries typically require general anesthesia for patient safety and comfort.

Here’s a breakdown of how the two options compare:

1. Safety: Both awake surgery and general anesthesia are safe when performed by a qualified surgeon and anesthesia team. However, awake surgery generally has fewer risks for patients who might experience complications from general anesthesia.
2. Comfort: General anesthesia provides complete unconsciousness, so patients don’t feel any discomfort during surgery. Awake surgery involves more sensation—though you won’t feel pain, you might feel pressure or movement. I always prioritize patient comfort and will use techniques like sedation to minimize any discomfort during awake procedures.
3. Recovery Time: With awake surgery, recovery is often quicker because your body doesn’t have to recover from the effects of general anesthesia. You’ll be more alert immediately after surgery and can usually go home sooner. General anesthesia may require a longer post-operative recovery period due to the need for monitoring as you wake up.
4. Cost: Awake surgery is typically less expensive because it doesn’t require the services of an anesthesiologist or the equipment necessary for general anesthesia. This can make it a more affordable option for many patients.
5. Procedure Suitability: Some surgeries are better suited to general anesthesia. If a procedure is particularly invasive or will take several hours, general anesthesia may be necessary for your comfort and safety. Awake surgery works well for smaller, less complex procedures that can be completed relatively quickly.

Choosing the Right Surgeon for Awake Plastic Surgery

If you’re considering awake plastic surgery, one of the most critical factors in your decision should be the experience and qualifications of your surgeon. Awake surgery requires a skilled and experienced plastic surgeon who is comfortable managing both the surgical and anesthetic aspects of the procedure.

When selecting a surgeon, here are some things to look for:

1. Board Certification: Make sure your surgeon is board-certified in plastic surgery. This certification indicates that the surgeon has completed rigorous training and meets the highest standards of the field.
2. Experience with Awake Surgery: Not all surgeons perform awake surgery regularly. Ask your surgeon how many awake procedures they’ve done and whether they feel confident performing the specific surgery you’re considering while you’re awake.
3. Patient Reviews and Testimonials: Look for reviews from other patients who have undergone awake surgery with the same surgeon. This can give you insight into their comfort level, the quality of care they received, and their overall satisfaction with the results.
4. Consultation Questions: During your consultation, don’t be afraid to ask questions. You should feel comfortable with your surgeon and trust their recommendations. Some important questions to ask include:
   • Am I a good candidate for awake surgery?
   • How many awake procedures have you performed?
   • What can I expect during and after the surgery?
   • What are the risks associated with awake surgery?

Final Thoughts

Awake plastic surgery offers many benefits, from a quicker recovery to lower costs, but it’s not the right choice for everyone. As a surgeon, my primary concern is always your safety and comfort. If you’re considering this option, I encourage you to consult with a qualified, experienced plastic surgeon who can help you make the best decision for your unique situation.

Is awake plastic surgery right for you? Book a consultation to find out.

If you have any further questions, please do not hesitate to contact our office and schedule a consultation with one of our highly trained plastic surgeons. Your health and happiness are our top priorities at Plastic Surgeons of Northern Arizona, and we are here to support you every step of the way.