By: Ruth Donnelly
Created on 08th October 2010
Invasive surgery tends to conjure up images of extended stays in hospital, away from family and familiar surroundings. But advances in anaesthetic technology mean you can now go under the knife and return home the same day. Cosmetic Surgery & Aesthetics Guide investigates...
If you’ve ever spent a night in hospital, it’s probably not something you’d want to do again in a hurry. And yet each year thousands of people put up with the discomfort of a night in unfamiliar surroundings for the sake of beauty.
Boob jobs, liposuction, facelifts... all these procedures have traditionally called for at least 24 hours’ hospitalisation. And it’s not just a question of comfort; a longer stay in hospital increases your risk of contracting infections such as MRSA or C. Difficile. So why do we need to stay in overnight when we’re not even ill?
Well, as it turns out, we don’t. Anel, a 27-year-old PA from London, had been hankering after a breast augmentation for years, but found the prospect of an overnight hospital stay off-putting. “I had Macrolane two years ago, but had never had a surgical procedure before, as I didn’t want to be in overnight.”
When Angelica Kavouni, the surgeon who had performed the Macrolane procedure, contacted Anel to let her know that Cadogan Clinic were offering breast augmentations as a day surgery procedure, she leapt at the chance to finally realise her dream. “It was great,” says Anel, “I was in a comfortable bed, they supplied the food that I wanted, rather than any old hospital food... the whole experience was very pleasant.”
Anel arrived at the clinic in the early morning, was operated on at midday and left the clinic at 5pm that same day. So why doesn’t every clinic offer this service?
Dr Alex Oliver, consultant anaesthetist at Cadogan Clinic, explains: “At Cadogan, we use an intravenous anaesthetic technique called TCI, or Target Controlled Infusion. I’ve been doing TCI anaesthesia for years, and it is a learning curve. I’m very lucky as I work in a trust where the equipment is freely available, but that’s not the case across the country. Some hospitals may only have two pumps for the whole department, which means you don’t get to practise at it.”
The founders of Cadogan Clinic, husband and wife team Bryan and Sue Mayou, made the decision very early on to only offer day case surgery at the clinic. “It’s just more efficient for everyone,” says Bryan. “For the patient and for the surgeon. You’re not ill after cosmetic surgery, so why should you stay in hospital? It also means that we can perform all the operations here, we don’t have to farm people out to another hospital, which most of the big clinic chains do.”
With more ‘old fashioned’ methods of general anaesthesia, usually administered as gases, patients had to stay in hospital after waking as they would be nauseated and drowsy for several hours post-surgery. With the TCI method, however, it is possible to calculate the exact dose of anaesthetic your body will need to produce an anaesthetic effect, a light sedation or a deep sleep.
At Cadogan, they take it one step further, monitoring you throughout the operation to ensure that you never dip into too deep, or too light, a sleep.
“What that means,” explains Dr Oliver, “is that the computer monitors the EEG patterns in your brain, like the ECG monitors you have for the heart. “And because we’ve got that depth of monitoring on board, we know when you’re asleep, we know when you’re going to be too asleep, and we know when you’re too awake, and we can adjust the dosage accordingly. We want it to be just right, so you can wake up instantly after surgery and go home soon after.” And how do the surgeons feel about performing these operations as day cases?
Mr Jian Farhadi, consultant breast surgeon at Cadogan Clinic, is very clear in his views: “Any procedure you can do as a day surgery case should be done that way, because the patient experience is better, you reduce the risk of hospital acquired infections and the patients want to go home, they don’t want to be feeling sick and staying in hospital.”
Whilst you can go home to your own bed after day surgery, you are not without the support of the surgical team, as Mr Farhadi explains: “You need to make sure the patient is wellinformed, and you need to discuss with them what they will be doing when they get home, to make sure that they have a contact number and that the surgeon is close by and available in the unlikely event that they are needed.”
The patient experience of same day surgery seems to be a very positive one, as summed up by Anel: “Nobody likes hospitals as a general rule, and I just thought I’d be so much more comfortable in my own bed. A hospital can be a very stressful environment, whereas being at home and having my family around me just made my recovery so much more pleasant.”
So if you’ve always dreamed of having surgery but couldn’t face the idea of a hospital stay, perhaps now there might be light at the end of the tunnel.
CS&AG
