Gynecomastia Surgery & Anesthesia
If you read many plastic surgery bulletin boards or forums, you frequently see notes from plastic surgery patients who report going under general anesthesia can be dangerous, painful and debilitating.
Fortunately, times have changed — for the better!
In fact, the newest, most modern and patient-friendly general anesthesia is something that has recently been in celebrity news.
I’m talking about propofol, the substance that entertainer Michael Jackson referred to as “his milk” because of its milky white color. (Read more about Michael Jackson’s death and propofol.)
But Jackson’s untimely and unfortunate death does not mean propofol is dangerous. Quite the contrary – in the right hands and settings.
Propofol, known commercially as Diprivan, is a boon to cosmetic plastic surgery patients. It takes effect quickly yet allows the patient to wake quickly when halted – and with no after effects. The combination of propofol and other medications is known as “twilight sleep” (technically, conscious sedation.)
In the past, with general anesthesia, some would awake with a 24-hour headache or bouts of throwing up. Not so with “twilight sleep” anesthesia!
I now use propofol in every case except for soy allergies. That’s where the drug gets its white color – from its soy base.
Propofol is always administered by a board-certified M.D.-anesthesiologist in combination with other drugs which have different and additive effects during surgery.
The result is a cocktail of small doses of medications which keep patients sleeping quietly and gently, breathing on their own with a quick wakeup with no nasty after effects.
Formerly, general anesthesia – also safe in the right hands — knocked the patent out so the doctor had to insert a tube in the patient’s throat and attach it to a breathing machine. The anesthesiologist then used stronger drugs to maintain the sleep.
After surgery, some patients awoke slowly with a sore throat from the throat tube and had a drug-like hangover.
Some gynecomastia surgeons say they can use only a local anesthetic like lidocaine to numb the treatment area. But I’ve found locals are not comfortable to the patient. Local anesthesia can only be used to treat very small, localized problems.
As for Michael Jackson’s case: the maker of propofol warns that the substance is only for use in a facility where proper electronic monitoring, resuscitative and support drugs are on hand. It is routinely used only by trained practitioners in certified operating rooms.
My opinion?
Using propofol for better sleep at home – even in the presence of a doctor — is as wise as taking cancer chemotherapy drugs only because you like your head bald.
Look at some before and after gynecomastia surgery pictures.