Our patients are always interested in knowing what type of anesthesia will work best and most safely for them. We strive to inform our patients about the most common types of anesthesia used by Dr. Weber as well as the type of facility in which that anesthesia will be delivered. We want our patients to be well informed and comfortable about not only the procedures they plan to undergo but also the necessary anesthesia that will be involved. Our goal is to provide all of this information below to help you in your journey to find the right surgeon (and anesthesia) for you
Local Anesthesia: The vast majority of the procedures that Dr. Weber performs are completed under either local anesthesia or local anesthesia with oral sedation (pill medications) to relax patients during surgery. Local anesthesia involves the gentle injection of numbing medications to eliminate any discomfort during surgery. Dr. Weber often performs this type of anesthesia for mole removal, LASER resurfacing, upper eyelid surgery or ear pinning procedures. While less common, local anesthesia (by itself) can even be used for facelift and neck lift procedures and Dr. Weber performs facelifts under “local” many times each year due to patient requests.
Oral sedation: Oral sedation is used to supplement local anesthesia and involves giving patients several mildly sedating pill medications 45 minutes to 1 hour prior to surgery. These pills help reduce any anxiety that patients feel during surgery and also provide a significant amount of amnesia about the procedure experience. Even when patients feel awake and chat with Dr. Weber during surgery, they tend to have very little recollection of the procedure itself. Oral sedation is very safe and Dr. Weber has used this technique extensively for over ten years.
Intravenous (IV) sedation: IV sedation is the most challenging and, in Dr. Weber’s opinion, the most difficult type of anesthetic to safely administer. IV sedation requires exceptional patient monitoring and attention to levels of sedation. Dr. Weber performs surgery under IV sedation RARELY. These surgical procedures are performed at an accredited ambulatory surgery center and Dr. Weber requires that patients be constantly supervised by a board-certified Anesthesiologist during these procedures.
General anesthesia (GA): Although patients are often reluctant to “give up control” or “go completely to sleep” for surgery, general anesthesia is actually an incredibly safe way to perform surgery in properly selected patients. About 20%, or 1 in 5, of the surgeries performed by Dr. Weber are completed at a fully accredited ambulatory surgery center with GA delivered by or monitored by a board-certified Anesthesiologist.
In general, our patients tend to be younger and healthier than the typical surgery patient undergoing major general surgery due to a medical issue. The minor medical problems that some of our patients present with are typically well managed and well-controlled further lowering the risk of anesthesia. For most patients undergoing elective general anesthesia, the risk of driving to the surgery center in Denver I-25 traffic is much greater than the risk of the combined surgery and anesthesia that they are about to undergo. That’s right, driving to work every day or crossing the crosswalk for an afternoon meeting are, in most cases, more dangerous than the general anesthesia and surgery that you’re planning to undergo!
Other helpful non-anesthetic techniques:
We employ a handful of non-anesthetic techniques to ensure the comfort and safety of our patients. Dr. Weber is constantly on the lookout for new methods to ensure that his patients have a positive experience before, during and after surgery. A sample of some of the methods that we use include the following:
Topical numbing cream: Numbing cream is most often utilized during laser resurfacing and injectable filler treatments but can diminish the mild discomfort that patients feel during the injection of local anesthesia for minor surgical procedures.
Pronox: Pronox is a fascinating device that delivers a safe mixture of nitrous oxide and oxygen. This is a “light” version of the sedation provided during dental procedures at some dental offices. Our patients tell us that Pronox can “take the edge off” or eliminate their anxieties surrounding surgery without making them overly sleepy. Patients are safe to drive within 15 minutes of stopping the use of the Pronox device. We use Pronox most often with lip filler treatments, LASER resurfacing or for patients who are bothered by the mild sting of local anesthesia injection prior to surgery.
Vibratory stimulation: There is a lot of scientific studies that shows that our brains have difficulty perceiving pain and vibration simultaneously. We’ve adopted several different types of “distraction” tools that vibrate the skin during lip injections, Botox and numbing of certain parts of the face such as the nose. Our patients tell us that “distraction” eliminates anywhere from 50% to 99% of the discomfort that they have experienced in the past without this tool.
“Talkesthesia”: Performing in-office surgery does require Dr. Weber and our team to talk and check in with our patients to make sure that they are comfortable and not experiencing any issues that we can address. It is surprising how much this can positively affect a patient’s experience. Something as simple as repositioning the procedure room chair or raising a person’s back or knees can make the difference between a patient undergoing a surgical procedure and sleeping until the end of their chosen in-office surgery and having no recollection of the surgery itself.
Tumescent anesthesia: Tumescent anesthesia has been used for decades to ensure patient comfort and safety. Dr. Weber has not only used tumescent anesthesia extensively but he has lectured across the US and abroad about how this technique has transformed his practice. This technique is actually quite fascinating! Dr. Weber uses the typical components of numbing injections such as lidocaine and adrenaline (epinephrine). However, with tumescent anesthesia, the lidocaine is diluted 20-40 times more than what you’ve experienced at the Dentist or Dermatologist. The result is minimal to no STING with injection. With regard to adrenaline, we also use approximately 1/10 of the amount used during dental or dermatologic procedures which virtually eliminates the racing and pounding heartbeat that many of us have experienced during dental procedures or skin biopsies. The result of these changes in our approach to numbing is that our patients are MORE comfortable and their numbness lasts LONGER. Our patients also experience LESS bleeding and bruising as well as FASTER recovery from surgery due to LESS bruising and swelling. It sounds too good to be true but this is well documented in decades of scientific study.
Anesthesia safety methods
Patient safety is the number one concern for Dr. Weber. We take anesthesia safety very seriously no matter whether we are performing in office surgery with light oral sedation or general anesthesia at a fully accredited Ambulatory Surgery Center. General anesthesia is a very safe procedure when performed correctly and monitored closely. On rare occasions, patients have adverse reactions to the anesthesia, but safety procedures of the surgery center and the anesthesiology team allow them to address any issues rapidly and effectively.
The board-certified Anesthesiologists that Dr. Weber works with at the Ambulatory Surgery Center maintain the highest standards with patient health and safety. While Dr. Weber directs the surgical portion of your procedure, your Anesthesiologist is absolutely the “boss” when it comes to your anesthesia safety. The surgery center Anesthesiology staff are always present while our patients are under general anesthesia; we never leave them alone before, during, or after surgery. We also only perform procedures under deep levels of anesthesia at a fully accredited center that specializes in providing for anesthesia and surgery and has exceptional patient monitoring.
Standard anesthesia practices
There are several essential practices that we follow in accordance with medical standards as well as the Anesthesia Patient Safety Foundation. Some of these crucial safety practices that are followed during general anesthesia or IV sedation include:
- Pre-testing: We always take care to verify ahead of time that our patients have no history of reaction to the agents used in anesthesia, and we test beforehand as an added precaution.
- Constant monitoring: With an anesthesiologist supervising your anesthesia at all times, any indication of an adverse reaction is caught immediately before any issues can progress.
- Oxygenation: Our patients are provided supplemental oxygen following standard safety practices and to ensure they remain fully oxygenated throughout the procedure.
- Breathing: We always monitor the breath of our patients, so any breathing irregularities are detected and resolved at once.
- Circulation: Each patient is closely monitored with an EKG machine and blood pressure monitor to ensure their circulation and heart behavior remain standard and normal.
- Blood pressure: A drop or rise in blood pressure can indicate a reaction, so we carefully monitor the blood pressure of our patients at all times.
The reason why
General anesthesia does come with an element of risk, but it is very helpful for more invasive surgical procedures.
Our goal is to provide the most effective, safe, and helpful cosmetic procedures to our patients. To that end, anything that could create a safety risk is simply not tolerated. If you have any questions or concerns about the safety of any level of anesthesia, contact us today at (720) 738-4443, and we will be happy to help answer your questions and put your mind at ease. This discussion is also a standard part of the conversations that will take place between you and Dr. Weber prior to any procedures being performed for you.