I am frightened of having an anaesthetic, how dangerous is it?
General anaesthesia is extremely safe for fit and healthy patients. You will be carefully assessed to ensure that you have no health problems that would increase your anaesthetic risk. Anaesthetists are doctors who have undergone specialist training in anaesthesia and are very experienced in anaesthesia for cosmetic surgery.
Why do I need to stop eating and drinking before the operation?
You are starved to reduce the risk of you being sick during the operation and then breathing it into your lungs. It is vital that your do not eat for 6 hours prior to surgery or drink for 4 hours. A small amount of water only can be drunk up to 2 hours pre-op to take tablets. Failure to do this may result in the operation being postponed or cancelled. This applies to general anaesthesia and sedation.
Can I have a local anaesthetic?
Some minor procedures can be done under local anaesthetic. This can be discussed with your Surgeon at your consultation.
I’d like to be asleep but not have a full general anaesthetic, what about sedation?
Sedation means different things to different people. Light sedation can make you more comfortable and reduce anxiety during surgery under local anaesthesia. You will be able to talk and obey instructions throughout the procedure but you will be sleepy. Often people have reduced memory of the surgery. Deep sedation when you are fully asleep is really anaesthesia and uses the same drugs. There is no evidence that it is safer or better. Your Anaesthetist will be happy to discuss your options by telephone before your admission.
Will I need lots of investigations?
Fit healthy people age below 60 usually do not require any tests. If you are over 60 or have other health problems, some simple tests will be required. Please bring copies of any letters and test results you have from your GP or Specialist so we can avoid repeating tests unnecessarily.
I am afraid of dying during the operation
Death under anaesthesia is very, very rare but this is a frequent fear. We all have risks in our daily lives which we accept and rarely think about eg car or air travel. Anaesthesia is extremely safe. During your anaesthetic your Anaesthetist is watching your heart beat, blood pressure, oxygen level and breathing all the time. He or she is with you and looking after you all the time.
Will I wake up during the operation?
The level of anaesthesia is constantly monitored when you are asleep and adjusted to ensure you are not receiving too much or too little. Awareness can occur but is very rare for this type of anaesthetic.
Will I have a pre-med?
No. Premeds are not normally used in modern anaesthetic practice which most people prefer. If you are especially nervous and want a premed please discuss this prior to admission.
I have had anaesthetics before but I feel particularly anxious about this one, can you help?
Having a cosmetic operation is not the same as having your appendix out! It is your choice and not necessary for your health. This makes most people much more worried about the anaesthetic. So really you are normal. We all understand how stressed you can feel and will do our best to support you. Your safety and well-being are very important to us and you can be assured of the highest level of care.
I am a needle phobic, will I have to have any injections?
No one likes needles! If you are afraid of pain you can have a local anaesthetic cream which makes it pain free. Please request this early as it takes about 45 minutes to be fully effective. Intravenous anaesthesia is safer and smoother so we do not recommend going to sleep with gas.
I have difficult veins
Your anaesthetist is very experienced, skilled and an expert in difficult veins.
I don’t like masks
You may be asked to breathe oxygen before you go to sleep but you do not have to have it by a facemask. Oxygen is very important and is given routinely when you wake up, again you do not have to have it by mask.
I smoke, is this a problem?
Smoking especially more than 5 cigarettes a day can increase the risk of anaesthetic complications. You will be advised to stop all smoking before your operation ideally for 6 weeks. This will reduce the risk of chest infection significantly. If this is not possible it is extremely important NOT to smoke for 24 hours pre admission or for 72 hours post-operatively.
I take regular medication prescribed by my doctor, should I continue taking it?
Please continue all regular medication as normal, this includes tablets and inhalers. The only exceptions are the antidepressants in the group called ‘monoamine oxidase inhibitors’. These are only rarely prescribed and you will have been given a card as you must avoid certain foods. Tablets can be taken with a small sip of water. It is important to have a full list of all medicines taken in the last 6 months.
What about non-prescription medications including herbal remedies and recreational drugs?
Please inform us of ALL medications. Some herbal remedies eg St Johns wort can interact with other drugs and should be stopped. Recreational substances can be extremely dangerous with anaesthetics especially cocaine which should not be taken within 7 days of your operation.
I have asthma, is this a risk?
If your asthma is well controlled this should not be a problem. Please continue your inhalers and check your peak flow. If you feel wheezy or have a cold your surgery may need to be postponed until you are well again.
I am overweight, is this dangerous?
Being moderately overweight is not a contraindication to anaesthesia. However if you have other problems like diabetes or high blood pressure this can increase overall risk. Ideally weight loss of a few kilos and some regular exercise eg walking, can help, but we recognise this may be unrealistic. Deep vein thrombosis is rare but you will probably require some extra peri-operative anti-thrombosis treatment. Cosmetic surgery is not like saving and so minimising risk is important.
I am diabetic, what should I do?
This will depend on whether you are managed with insulin, tablets and/or diet. The key is being well-controlled. This will be discussed pre-operative assessment and a management plan will be made.
Can I have my operation as a day-case?
Some procedures can be done as a day-case. You will need to have a responsible adult to take you home and look after you for 24 hours post discharge. You will need to stay a minimum of 4 hours post-operatively. If you live more than 60 minutes away by car, it is recommended to stay overnight.
Will I be sick?
We routinely give anti sickness medication to prevent nausea and vomiting. It is never 100% effective, so if you have suffered nausea and vomiting after anaesthetics please discuss it pre-operatively so any adjustments can be made.
Why am I asked if I have any caps, crowns, bridges, loose teeth or veneers?
Artificial teeth may not be as strong as natural teeth as so there is a small risk of dental damage. Your Anaesthetist needs to know where these teeth are in your mouth so they can be protected where possible.
Will the operation be painful?
Many cosmetic procedures are relatively pain free. You will receive pain killers while you are asleep as well as some local anaesthetic. Pain killers will be prescribed for you after your operation and to take home.
Are you experienced in this type of surgery?
Your Anaesthetist and Surgeon work together as a team often for many years! All the Anaesthetists are very experienced in this field. Your safety and well being is our priority.
When will I meet my Anaesthetist?
You will meet the Anaesthetist on the ward on the day of your operation. A full assessment will be made which will involve answering questions you have already been asked. Please bear with us. We want to get to know you and form a full picture of you and your needs. You will meet us again in the anaesthetic room and again when you have woken up. We are available for post-operative advice.
I would like to talk over the anaesthetic before I commit to the surgery or pre-admission. Is this possible?
We are always happy to do telephone consultations, please discuss this with your surgeon who will arrange it. Sometimes it may be necessary to make an outpatient appointment.
Do you have any other advice?
Please help us to help you! We need to be fully informed and request that you comply with any pre or post operative instructions. We aim to make your operation and recovery as safe as possible. If in the extremely unlikely event you are cancelled on the day of surgery, this will be for your safety. It is a team effort, between your Surgeon, Anaesthetist and you at the centre.
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Cosmetic Surgery Partners,
The London Welbeck Hospital,
27 Welbeck Street,
0207 486 6778