Houtan Chaboki, MD cautions that extensive surgeries should not be performed under only local anesthesia, and encourages plastic surgery patients to ask what type of anesthesia will be used during their procedure.
Washington, DC (February 2011) – Dr. Houtan Chaboki, a facelift surgeon near Maryland, expresses concern regarding the use of local anesthesia rather than general IV sedation during complex procedures. On the heels of recent reporting on the subject in the magazine SELF and other media outlets, Dr. Chaboki warns that “anesthesia awareness,” or being conscious during surgery, can be extremely dangerous and risky.
“Performing a complex procedure using only local anesthesia can pose many additional risks,” says Dr. Chaboki, a Washington, DC rhinoplasty specialist. “The large volume of anesthesia needed to numb the area can be toxic to the body, and there is a greater possibility of other risks.”
“Awake surgery” is the new term used to describe this conscious method of surgery, with some people choosing this approach for cosmetic procedures ranging from breast enhancement to Northern Virginia facelift. Typically, the patient is given oral sedation such as Valium and is then injected with numbing solution at the treatment site. Some doctors who advocate awake surgery argue that the dangers of this approach are less severe than the risks associated with general anesthesia. However, Dr. Chaboki disagrees – stating that general anesthesia or IV sedation provided by a board certified anesthesiologist is a safer approach. In addition, if not numbed properly, the patient may be able to feel pain during conscious surgery.
“There is the possibility of regaining sensation in the affected area during an extensive surgery,” Dr. Chaboki says. “That can easily turn into a very painful or even dangerous situation because there’s no anesthesiologist available to render the patient unconscious if he or she is in pain.”
One of the main reasons that “awake surgery” appeals to some patients is the issue of control. Many people simply have a fear of “going under” and certain doctors argue that allowing the patient to “have a say” on the operating table is liberating and empowering.
“A person who is under the influence of sedatives is in no position to make thoughtful decisions,” Dr. Chaboki says. “Their perceptions are distorted and they are not thinking clearly. Every decision about surgery should be discussed in detail between the patient and the surgeon prior to the operation.” In fact, Dr. Chaboki typically meets with his patients several times prior to surgery, ensuring a collaborative decision process regarding their cosmetic surgery treatment options.
The reduced cost of “awake surgery” is another draw for many people who want cosmetic surgery, but may not be able to afford it. Without an anesthesiologist, doctors are able to provide discounted rates on popular plastic surgery procedures such as liposuction, breast implants, and tummy tucks. But Dr. Chaboki warns that the lower initial costs may come with a higher price.
“Many of the doctors performing these procedures are not board-certified surgeons, and they may be touting ‘awake surgery’ as a way to disguise the fact that they have not gained privileges to operate in an accredited hospital,” Dr. Chaboki explains. “That’s why it is so important for people considering plastic surgery to research their doctors’ qualifications carefully.”
In addition to “awake” practitioners working outside their area of board certification, many of these doctors operate in facilities that are not accredited, with unsterile conditions and few safety standards. Dr. Chaboki performs his extensive facial cosmetic procedures that require anesthesia in facilities that are accredited by a major nonprofit organization that oversees safety and doctor training.