To Sleep or Not to Sleep

By: Ruth Donnelly
Created on 24th November 2011

Mr Azhar Aslam is surgical director of Linia Cosmetic Surgery, which continues to be at the forefront of providing cosmetic surgery procedures under local anaesthetic, both with and without sedation. Here, he explains why he believes that local anaesthesia is preferable to general when it comes to cosmetic procedures

Most people link surgery with general anaesthesia, where patient is put to sleep, and an anaesthetist’s controls the airway to assist breathing through an airbag. Sometimes the body is paralysed partially or completely.

With the techniques employed at Linia, your body is neither paralysed, nor do you lose consciousness. Instead, pain is relieved completely and medications are given to relieve your anxiety. Several of our patients describe it as ‘gin and tonic’ effect. You are completely relaxed and breathing on your own.

General anaesthesia is commonly referred to as ‘being put to sleep’. Recent studies, however, suggest that the body is actually almost in a comatose state and that brain activity dips to a level on a par with brain stem death.

Although this sounds alarming, general anaesthesia continues to be a safe and necessary tool for major surgery. Whilst a patient is ‘under’, the body is closely monitored. The anaesthetic is a balance of muscle relaxants, sedatives, cardiovascular drugs, etc.

General anaesthesia is often appealing, as many patients suffer from anxiety related to a fear of pain and being aware of what is happening if their surgery is performed under local anaesthetic. However, it all comes at a cost.

There are troublesome side effects to general anaesthesia. These include: nausea, retching and vomiting, which often follow; grogginess; a state of emotional volatility; prolonged drowsiness in some cases and the intense feeling of pain that accompanies many operations as you recover.

More serious side effects can include chest infection and a risk of clotting in your veins that can break and block the blood vessels of your lungs. Sometimes the effects of anaesthesia can last for up to 72 hours, delaying recovery. Patients are mostly required to stay in hospital.

Additionally, the insertion of the anaesthetic tube down one’s throat can potentially damage teeth, tongue, the back of the throat and the upper airways. This can be a real stumbling block for a number of people seeking cosmetic surgery.

Of course not everyone can tolerate a general anaesthetic due to health reasons. Additionally the thought of being ‘asleep’ and having complete loss of control can also hold people back.

Now let’s look at local anaesthesia. People worry about feeling pain and being aware of what is going on, mainly due to being squeamish. For the most part, this is the fear of the unknown. At Linia, we employ techniques that relax you first and once the anaesthesia starts working you are not asleep but do not feel any pain whatsoever.

Those who are concerned about being aware of the surgery being carried out may be reassured to know that there is a screen and you cannot see the operation.

The major advantages are that once the operation is finished, you are up and about straightaway, and recover within minutes, rather than hours and days. None of the side effects of general anaesthesia are present.

Your body has suffered much less trauma because, instead of your whole body being anaesthetised, only the area of operation is affected. Consequently swelling is much less, and you recover more quickly.

For example, a patient who has breast enlargement under general anaesthesia can take two to three months to recover, but when the same operation is performed under local anaesthesia, in our experience, the breasts tend to settle in just two to three weeks.

You can go home and be in your bedroom within a few hours and ease back to your normal routine within 24 to 48 hours, albeit with some restrictions depending upon the operation. It is well established that people recover quicker at home where they feel more comfortable and relaxed.

From a surgical standpoint the main benefit is that in procedures such as facelifts or eyelid lifts, there is no anaesthetic tube giving distortion. The surgeon can work on the dynamic face and ask the patient to move their face or open and close their eyes so that he can check the nerves. This helps the surgeon to produce the best results. The pain relief lasts for 24 to 48 hours.

At Linia, we offer several operations with this method, including eyelid surgery, facelifts, breast-reshaping and enlargement, and liposculpture. Linia were the first to pioneer, what was referred to in the press as the ‘Lunchtime boob-job’ and to perform facelifts using local anaesthetic.

We have performed these procedures for ten years now and have been featured extensively on TV and in National Media. These can be viewed on our website, where you may also watch several operations under local anaesthetic.

“It has really changed my outlook on surgery. I was in the clinic for only three hours – the equivalent of a long lunch with a client. Just two weeks after... I felt completely back to normal and was doing the housework and the school run. My new breasts look fantastic...I feel so much more confident.” - Claire Harrison, as quoted in the Daily Mail

“When Mr Aslam had finished he let me look in a mirror while I was still in the operating theatre. I could see straight away what a brilliant job he had done. The other bonus was that it didn’t take much time to recover. Everyone has said how natural it looks.” - Frances Carter, as quoted in the Daily Mail, after facelift surgery

CS&AG