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Anestheisa: Gas or IV?

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Anestheisa: Gas or IV?
« on: April 27, 2008, 10:46:51 PM »
i'm dead on about getting the surgery but i can't help but be nervous about the anesthesia. have most of you people with success stories had the anesthesia delivered through gas or the iv? i heard that with the iv, you're more prone to experience anesthesia awareness, and for a 3 hour procedure i would not wish this on my worst enemy.

Linkback: https://www.gynecomastia.org/smf/index.php?topic=13881.0

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Re: Anestheisa: Gas or IV?
« Reply #1 on: April 28, 2008, 11:00:25 AM »
I am just about two weeks post op and I DID have the IV.

I was too was very uneasy about the anesthesia.  I had general three times before all without a hitch.  This time it was "twilight anesthesia", even less risky, but for some reason I was very uncomfortable with the idea.

I recall laying down on the surgical table.  My arms were spread out wide.  The anesthesiologist said "I'm gonna insert the IV, may pinch a little", it did but I was still awake.  About 45 seconds later I recall saying "I am feeling something, is that the anesthesia?".  He replied "I gave you a little something to get started", and about 20 seconds later I was out.

Never felt anything during the procedure.  I woke up completely unaware of what I had been through the last two hours.

Two weeks later, thrilled I did it.

Normal to be nervous, just don't let it consume you, not worth it, no need.

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DrBermant

Re: Anestheisa: Gas or IV?
« Reply #2 on: April 28, 2008, 11:33:16 AM »
i'm dead on about getting the surgery but i can't help but be nervous about the anesthesia. have most of you people with success stories had the anesthesia delivered through gas or the iv? i heard that with the iv, you're more prone to experience anesthesia awareness, and for a 3 hour procedure i would not wish this on my worst enemy.

Anesthesia is rarely delivered by IV, sedation is.  The anesthesia during local with sedation comes from the injected medication.

I prefer local anesthesia alone for long nipple reduction gynecomastia. For almost all other gynecomastia surgery, local anesthesia with sedation provides a safer much more comfortable method.  When 2 stages are needed, as with this problem of enlarged nipples of gland and nipple tissue, I perform the first stage with local sedation, and the second with local alone.  For my upper body lift surgery, when I have to operate all around the chest - front / back, I need Light General Anesthesia.  This is still my Tumescent Technique, but adds the safety of airway protection while the patient is in the prone position.

You can find an extensive individual patients' experience with comfort and my Tumescent Technique Anesthesia for gynecomastia here.

If you prefer direct links to each of those discussions:


anesthesia and comfort in gynecomastia patient from California

anesthesia and comfort after revision gynecomastia surgery in patient from Hong Kong China

comfort and anesthesia in physician's son with gynecomastia

comfort and anesthesia in gynecomastia patient from Florida

comfort and anesthesia in gynecomastia patient from Illinois

comfort and anesthesia with gynecomastia patient from Texas

comfort after gynecomastia surgery with patient from Colorado

comparing comfort and anesthesia of my revision surgery with prior gynecomastia surgery in Florida

comfort and anesthesia in patient 4 hours from Richmond with gynecomastia

parent of teenage gynecomastia patient commenting about comfort after surgery

comfort after gynecomastia revision surgery on patient from the United Kingdom

comparing comfort of my revision surgery to prior gynecomastia surgery done in New York

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

Re: Anestheisa: Gas or IV?
« Reply #3 on: May 01, 2008, 04:35:57 AM »
i was really scared about the anesthetic as well...i got general anesthetic...they injected something in my arm...about 1-2 hours later i woke up without gyne, feeling a bit tingly in the feet but otherwise great. 

I was expecting a lousy headache, the type of which i always get from local anesthetic but this wasn't the case
Surgery done 18th March 2008

Re: Anestheisa: Gas or IV?
« Reply #4 on: July 04, 2008, 09:01:31 PM »
Well I didnt have my surgery yet but when I had my wisdom teeth removed they gave me the IV one...I just remember asking the nurse "So is that suppose to make me sleep" Boom woke up 30 minutes later looking around and feeling lost...they sat me up, gave me a ice patch...the room was spinning and I felt like I didnt sleep for a week but after 20 minutes or so I was ok...
Lose 10 (kg) by August... Achieved
Lose 5 (kg) by Mid-September.....Achieved
Gain 20 (lb) in Muscle by December.......Achieved, Gained 24lb in Muscle
Gynecomastia Consultation October 17, 08......Complete

Surgery Completed January 8th, 2009 with Dr. Elliot Jacobs in NYC!

Re: Anestheisa: Gas or IV?
« Reply #5 on: July 11, 2008, 07:10:52 AM »
I do 99% of my surgery under twilight sleep (IV) sedation, which is administered by a separate (and very expert) board-certified anesthesia physician.  His job is to keep you gently sleeping at a nice level and to keep you safe by monitoring all blood pressure, pulse, etc.  Then I can concentrate on my job: your surgery.  I supplement the sedation by administering local anesthesia but you do not feel the injections because you are sleeping.

I much prefer this type of anesthesia over general anesthesia -- you are speaking coherently and opening your eyes when the last suture is placed.  And within 15 minutes or so, you can be moved to recovery where there is virtually no headache, nausea or other side-effect of general anesthesia.

BTW, my anesthesiologist and I have been together for over 15 years -- so we work very well together!

Elliot Jacobs, MD, FACS
Dr. Jacobs 
Certified: American Board of Plastic Surgery
Fellow: American College of Surgeons
Practice sub-specialty in Gynecomastia Surgery
815 Park Avenue
New York, New York 10021
Telephone:  (212) 570-6080
Email:  dr.j@elliotjacobsmd.com
Website:  http://www.gynecomastiasurgery.com
Website:  http://www.gynecomastianewyork.com/revi

Re: Anestheisa: Gas or IV?
« Reply #6 on: July 11, 2008, 10:09:19 AM »
i was really scared about the anesthetic as well...i got general anesthetic...they injected something in my arm...about 1-2 hours later i woke up without gyne, feeling a bit tingly in the feet but otherwise great. 

I was expecting a lousy headache, the type of which i always get from local anesthetic but this wasn't the case

Same here. I woke up thinking "When are they gonna start". My surgery was a great experience

Re: Anestheisa: Gas or IV?
« Reply #7 on: July 16, 2008, 10:01:31 PM »
Just had my surgery today :D

I was sedated through IV, I barely felt the pinch... the anesthesiologist(sp?) told me, im gonna put something thats gonna feel like after you've had 2 shots of tequila lol...around 20 secs later I was out, didn't feel ANYTHING... I woke up an hour and 45 mins later and they were done, they just raised the table a little to put my compression vest, and here I am now hehe...

overall im quite happy right now, the experience wasn't as bad as I thought it would be, Doc said everything went perfect and tomorrow Ill remove my vest to replace the bandages and clean up a little bit, Im a little nervous to how i'm gonna look lol, hopefully the gyne will be gone!

But yeah, IV sedation was totally good... I did have the feeling that I wanted to vomit about an hour after the surgery, but I quickly drank some water and its all settled now.

Cheers!

Re: Anestheisa: Gas or IV?
« Reply #8 on: July 23, 2008, 04:24:56 PM »
i know exactly what your thinking and no don't be scared. I was thinking that too cuz Ive heard the horror stories from tv like that women and the eye removal surgery? I heard about that one too. First this is extremely extremely extremely extremely extremely rare and nearly impossible. so impossible its not even worth thinking about it. I know your concerns I was terrified too.

I saw the scale it says something like 291 pounds right before I went in. But I'm very tall about 6'4 so I don't really look that fat at all I am a big individual. People always underestimate my weight and they don't believe me when I tell them I'm like 300 pounds. I was scared to death of not being given enough sleepy stuff. My surgeon wasn't able to weigh me at his office but I gave him an estimation of 270, a white lie, but I wanted the surgery. The nurse weighed me literally 5 minutes before I went in and I was scared seeing how much heavier I actually was and prayed that they would double check my weight on my way in. I was extremely nervous over this.....

I think they added something into my IV, then I breathed from a mask and lights out time.

But everything worked out fine. My mom had a surgery a while back and said she was under the influence on anesthesia for like 2 days after but when I came too I was sober as a bird and to the suprise of the nurses I was able to get up and go to the bathroom without much assistance at all.

Coming out of the surgery I think I experienced a bit of bad pain tho. They asked me prior to identify it as either an ache pain or burning pain. It was burning and it hurt a lot so they gave me an oxycodon right away, waited 45 minutes I was still in pain so they called the doc on the cell to ask if was ok to put me on a dilauded. Afterwards I was fine. I got up and went to pee and I felt pretty damn good.

I want to stress it was not nearly as bad as it sounds. There was some pain I experienced but really really its not anywhere near as bad as one would imagine. It wasn't bad at all you don't have to be scared. I am certain you will not experience any form of awakening while under the knife. Usually the anesthesiologist is right there the whole time anyway. You will have lots of care.

Afterwards they will ask you to identify your pain on a scale of 1-10 they want you to be at least 3 or lower. So its important to speak up about discomfort. Once again the pain isnt really that bad. almost like a sunburn and some aches. If you have pain at all.

You will not be mistakingly awake during the surgery.