Breast augmentation is one of the most popular cosmetic surgery procedures performed in the United States. During this surgery, breast implants are placed to increase breast size or restore breast volume. As with any surgery, patients often wonder exactly what the experience will be like. One common question is: Will I be awake during breast implant surgery?
Quick Answer
In most cases, no, patients are not awake during breast implant surgery. The vast majority of breast augmentation procedures are performed under general anesthesia, meaning the patient is fully asleep and unconscious throughout the operation. Being put to sleep helps ensure patient comfort and safety.
Overview of Breast Augmentation Surgery
During breast augmentation, a board-certified plastic surgeon places breast implants either under or over the chest muscle. Incisions are made to insert the implants in one of four locations:
- Under the arm (transaxillary)
- Around the nipple (periareolar)
- In the breast crease (inframammary)
- In the navel (transumbilical)
The procedure usually takes 1-2 hours to complete. Patients are given anesthesia beforehand so they do not feel any pain or discomfort during the surgery.
Are Patients Awake During Surgery?
The vast majority of plastic surgeons use general anesthesia for breast augmentation procedures. Being “asleep” or unconscious is safer and more comfortable for patients.
With general anesthesia, patients are fully asleep throughout the surgery. A board-certified anesthesiologist carefully monitors the patient and adjusts the levels of anesthesia as needed. Common general anesthesia medications include:
- Propofol
- Sevoflurane
- Desflurane
- Isoflurane
General anesthesia produces a state of controlled unconsciousness. Patients have no awareness or memory of the surgery.
Other Types of Anesthesia
Less commonly, breast augmentations may be performed under IV sedation or local anesthesia with sedation:
- IV sedation – The patient is given sedative drugs through an IV line. This produces a semi-conscious state. The patient may be sleepy or “twilighted” but not fully unconscious.
- Local anesthesia with sedation – Local numbing medication is injected to block pain. Sedatives are also administered through an IV. The patient may drift into a light sleep but can still respond if stimulated.
With these lighter forms of anesthesia, the patient may have some awareness of the surgery but should not experience pain or discomfort.
Why Do Most Surgeons Use General Anesthesia?
There are several important reasons most plastic surgeons rely on general anesthesia for breast augmentation:
- Patient comfort – Being completely asleep provides the most pain-free experience and avoids intraoperative discomfort or awareness.
- Muscle relaxation – General anesthesia relaxes the chest muscles, allowing easier surgical access and implant placement.
- Motion prevention – Patients won’t move during the delicate surgery.
- Amnesia – Patients won’t have any memory of the procedure.
- Safety – The controlled unconscious state is optimal for monitoring vital signs under anesthesia care.
Are There Any Cases When a Patient May Be Awake?
The vast majority of plastic surgeons only perform breast augmentation under general anesthesia. However, there are rare exceptions when a patient may opt for a lighter sedation. Reasons include:
- Fear of general anesthesia
- Health conditions that increase anesthesia risks
- Extreme anxiety about being unconscious
- Personal preference
- Smaller procedure such as fat grafting augmentation
In these uncommon cases when general anesthesia isn’t used, the surgeon will take steps to maximize patient relaxation and comfort:
- Warm blankets and clothing to prevent sensations of coldness
- Soothing music played in the operating room
- Calming conversation and reassurance from the surgical team
- Anxiety-reducing medication in the IV line
- Additional local anesthetic injections if any pain is felt
With an experienced, compassionate surgical team, patients who opt to remain lightly sedated typically report minimal or no intraoperative awareness or discomfort.
Conclusion
The majority of patients undergo breast augmentation under general anesthesia and are asleep throughout the surgery. Being unconscious provides the most comfortable, controlled, and safest experience. In rare cases when a patient opts for IV sedation or local anesthesia with sedation, the surgeon takes extra precautions to ensure a relaxed, pain-free surgery with minimal awareness.
Frequently Asked Questions
Can I choose to be awake during breast augmentation surgery?
Most surgeons only perform breast augmentation under general anesthesia, but some may agree to use an alternative if requested by the patient. Reasons for wanting to remain awake are rare but can include anxiety about general anesthesia or certain medical conditions.
What kind of anesthesia is typically used for breast augmentation?
The overwhelming majority of plastic surgeons use general anesthesia for breast augmentation surgery. Being completely asleep provides the optimal experience for patient comfort, safety, and surgical access.
Will I feel any pain if I’m awake during the surgery?
You should not feel pain if you remain lightly sedated or under local anesthesia. The surgeon will take every precaution to maximize comfort. Extra numbing medication can be administered if any discomfort occurs.
How do I know if being awake is an option?
Discuss anesthesia choices with your plastic surgeon. Most prefer general anesthesia, but some may accommodate a request for light sedation or local anesthesia on a case-by-case basis after assessing your health and other factors.
What are the risks of being awake during breast augmentation?
Being awake carries rare risks like discomfort, anxiety, surgical awareness, or embarrassment. General anesthesia avoids these risks and provides superior pain control, amnesia, and safety monitoring.
The Breast Augmentation Procedure Step-by-Step
Wondering what happens during a typical breast augmentation surgery? Here is an overview of the step-by-step process:
- Anesthesia – The anesthesiologist administers general anesthesia through an IV to put you into a controlled sleep.
- Incision – The surgeon makes an incision in one of several possible locations like under the breast or around the areola.
- Creating a pocket – A pocket is created behind or in front of the muscle to fit the implant.
- Inserting the implant – The surgeon places the implant through the incision and positions it within the pocket.
- Closing the incisions – Dissolvable sutures are used to close the incisions.
- Bandages and compression garment – Soft bandages and a support garment are applied after surgery.
- Anesthesia reversal – You slowly wake up from anesthesia after the procedure in the recovery room.
The entire augmentation surgery typically takes 1-2 hours. You will be asleep for the entire process and will not have any awareness or memory of the procedure.
Choosing an Experienced, Board-Certified Surgeon
When considering breast augmentation, it is essential to do your research and pick a qualified plastic surgeon. Key factors to look for include:
- Board certification from the American Board of Plastic Surgery
- Extensive training and experience in breast surgery
- Operating privileges at an accredited surgical facility
- Aesthetic artistry and listening skills
- Excellent bedside manner and communications
- A focus on patient safety, care, and results
Be sure to ask any potential surgeon about the specifics of your procedure, including what type of anesthesia will be used. Reputable doctors welcome all questions and seek to ensure you are fully educated and comfortable with the process.
It’s also a good idea to look at before/after photos, read reviews from past patients, and make sure you feel confident with the surgeon before booking your procedure.
Preparing for Breast Augmentation Surgery
These tips can help you get ready for your upcoming breast augmentation:
- Follow pre-op instructions – This may involve discontinuing certain medications, fasting, arranging transportation, and more.
- Prepare your recovery area – Get plenty of rest, nutritious foods and cold packs. Have loose, comfortable clothing on hand.
- Make childcare arrangements – Plan for help with childcare duties as you won’t be able to lift children.
- Stop smoking – Smoking impairs healing. Quitting at least 6 weeks before surgery is recommended.
- Get pre-surgical labs done – Blood work, medical clearance, and other tests may be required beforehand.
Thoroughly following your surgeon’s preoperative instructions helps ensure you are prepared for surgery and have a smooth recovery afterwards.
Recovering After Breast Implant Surgery
Post-operative care is an important part of your breast augmentation journey. Here is what to expect during the recovery period:
- Discomfort and swelling – This is normal and temporary. Use ice packs and prescribed medication for relief.
- Wear a support bra – A post-surgical bra provides comfort and protection for several weeks.
- Avoid strenuous activity – Activities like exercise will be restricted for 4-6 weeks.
- Sleep on your back – Sleeping on your stomach or side can disturb the implants.
- Numbness – Temporary numbness in the breasts and nipples is common.
- Expect some scarring – Incision lines will fade over several months.
Be diligent about follow-up appointments to monitor your progress. Complete healing can take 6 months or more.
Results and Outlook After Breast Augmentation
The results following breast augmentation are very rewarding for most patients. You can expect:
- Increased breast size and enhanced curves
- Better proportion between the breasts and body
- Improved self-confidence
- Greater satisfaction with your appearance
- An uplifted, youthful breast contour
- More clothing choices and swimsuit options
With proper surgical technique and implant selection, results are meant to look and feel soft and natural. Implants are designed to last many years, but may need replacing at some point due to normal wear.
Be sure to communicate your cosmetic goals and expectations to your plastic surgeon. An experienced surgeon will help you choose ideal implant types and sizes to fulfill your vision.
The Takeaway
Breast augmentation is an extremely popular plastic surgery procedure that enhances the breasts through the placement of implants. The vast majority of breast augmentations are performed under general anesthesia, where the patient is completely asleep and unaware during the surgery.
Being fully unconscious provides the most comfortable, controlled experience. In rare cases when a patient prefers, the surgeon may agree to use an alternative like IV sedation or local anesthesia. However, general anesthesia remains the gold standard and allows both the patient and surgeon to focus solely on the procedure at hand without distraction or discomfort.
When considering breast augmentation, do your homework in selecting an experienced, board-certified plastic surgeon. Be sure to ask about the specifics of anesthesia and share any preferences or concerns. With an expert surgical team, you can feel at ease knowing your procedure will go smoothly and safely, whether you are asleep or sedated.
