Many guys we talk with about man boobs in New York and online express confusion about anesthesia for gynecomastia surgery. It’s no wonder it can be hard to figure out what’s best when even doctors seem to disagree. You probably know that general anesthesia is used most often, but perhaps you don’t like the idea of “going under” and waking with a hangover. You might have heard that local anesthesia may be less expensive, but is not recommended by most board certified gynecomastia specialists.
Maybe you have also heard of another option some surgeons call MAC. But what is it? Is it a good choice for you?
MAC, or monitored anesthesia care, is one of several terms used in medicine to mean sedation administered through an IV. It’s also called twilight sedation, and in our practice, we often refer to it as MIS or monitored intravenous sedation. MAC/MIS offers key benefits for both the patient and the operating team, in large part due to that key term, “monitored.”
When we begin surgery for man boobs in New York, the IV sedation and monitoring are handled by a skilled M.D. anesthesiologist we’ve worked alongside for 25+ years. This means he works with us seamlessly, plus he’s a fully-licensed and qualified medical doctor as well as an anesthesiologist, ready to help in just about any turn of events. He begins by carefully giving small doses of a variety of medications that cause light, then deeper sleep. Our plastic surgeon can then inject local blocking medications such as Novocaine and lidocaine without the patient having to feel even a needle stick.
As surgery progresses, our M.D. anesthesiologist keeps careful watch over the patient’s sedation level, administering more or less medication through the IV as needed. This enables our plastic surgeon to concentrate fully on the procedure. Best of all, because the medications we use are short-acting, our patients can wake up right away—even as the final sutures are completed. They can talk to us and observe dressings being placed. Within about 15 minutes they can walk to the recovery room to relax, and within about 90 minutes they can be on their way home.
General anesthesia is a safe and effective way to keep patients fully asleep and still during many surgeries, particularly those of longer duration. It’s easier for the operating team because the patient is deeply asleep, and monitoring, while necessary, doesn’t require the same vigilance and precision as MAC/MIS. The simple reason we usually don’t often choose general anesthesia? It’s harder on the patient. Well-known side effects include nausea, vomiting, chills, headache, and others. It also takes guys much longer to wake up and shake the groggy feeling the medication leaves behind.
A leading reason some doctors and patients agree on local anesthesia is cost. Since the cosmetic surgeon administers the injections and the patient is fully awake during the operation, no anesthesiologist is needed. Some non-board certified surgeons will even perform man boob surgery as an in-office procedure (sometimes with scant emergency technology on hand).
There’s another potential problem with this approach, aside from the patient having to endure several injections and possible safety issues. It’s not unusual for an anesthetic such as Novocaine or lidocaine to spread unevenly throughout an area, and if the doctor should hit a painful spot, the patient will inevitably squirm. The cosmetic surgeon may then try to hurry surgery along, or he or she will pause the procedure to give additional injections. The latter prolongs operating time and may or may not work well. Either way, the chances of sub-optimal results are very real.
Of course, there’s an element of “going under” with MAC/MIS as well as with general anesthesia, and a few guys are afraid of this gentler form of sedation as well. We understand! We reassure them that every single one of our patients does wake up. Many tell us afterward that the “anesthesia was the best part of the entire experience.”
Along with a few other experienced gynecomastia surgeons, we firmly believe that closely monitored IV sedation plus local anesthetics—call it MAC, MIS or another name—is best for the majority of our New York man boob patients. Using this approach, we can achieve our goal: a quiet, peaceful, relaxed sleep experience which allows the surgery to be properly performed, and then a gentle awakening with no harsh side effects. As our surgeon says, “Isn’t that what anyone would want from an operation?”
If this sounds like what you want, contact us and let’s talk!
Reach out to Dr. Jacobs today to schedule your consultation!