Breast Enhancement: The Twilight zone
Tuesday, March 13th, 2007
Until recently I thought the only way a person could undergo surgery for breast enlargement was by being knocked out cold through general anaesthetic - go to sleep for a couple of hours and wake up with breasts that you have always dreamed of, albeit a little swollen and bruised. To contemplate any alternative seems completely silly to me, as I am utterly squeamish and have the pain threshold of a five year old. However, in the last couple of years more people are turning to a different type of surgery known as twilight or conscious sedation whereby local anaesthetic is used for such procedures. So what is the difference between the two types?
General anaesthetic is where the patient is asleep for the length of the surgery procedure. A specialist anesthetist is present throughout, monitoring the patients breathing and controlling the amount of anaesthetic given.
Twilight sedation is whereby the patient is ‘awake’ throughout the procedure and a local anaesthetic is prescribed at the point of surgery. The patient can respond to the medics although they are often very drowsy and most people do not remember the events afterwards. (Much like the day after a heavy drinking session then?)
The first I learned about Twilight sedation was in an article in Grazia magazine in December 2005 when a girl named Kerry Williams was awake during her breast enlargement. The article showed photos of her awake, looking and smiling at the camera and talking to the nurses. However, after surgery she couldn’t actually remember anything about it.
Some people are opting for twilight sedation because the initial recovery time is quicker as it is the sedation drug that is used during surgery which makes the patient weak. There is no overnight stay in a hospital which is therefore cheaper to the patient because there is no cost of a hospital bed. Patients can be out of hospital the same day as their surgery. But is that a good thing? Having a breast enlargement in a hospital isn’t just about the surgery but also the after care. Unsurprisingly, after undergoing such surgery, a woman is going to feel rather bruised and battered, much like going through 10 rounds with Mike Tyson. In such circumstances I know I wouldn’t want to be chucked out within just a couple of hours. Immediately after a breast enlargement operation is when a patient is going to need most care and attention and it is the time when potentially some problems may occur. In hospital, the dedicated doctors and nurses can monitor your progress and if anything untoward should happen they can see to you immediately.
The general opinion from surgeons is that Twilight surgery for breast enlargements is not a better alternative to general anaesthetic. The few surgeons I spoke to thought it was a bad thing. If the patient is awake and talking they could flinch and with a sharp knife in even the steadiest of surgeon’s hands this is not a great idea.
The question is do you really want to be awake throughout a procedure? I know I wouldn’t want to be able to hear or see what the surgeon is doing to me. Watching such procedures on other people on the TV is enough to make my legs turn to jelly. The other thing to consider is what if the surgical team encounter a complication midway through surgery? This could be very frightening and although easily rectifiable I’d rather not know about any problems until after the event.
A lot of the big companies who offer breast enlargement will not perform twilight surgery. To me that speaks volumes.
