Many patients wonder whether they should have their breast augmentation procedures performed under a Local or General Anaesthetic. Some Clinicians offer surgery under sedation with tumescent Local Anaesthesia of the breast, sighting this as a safer procedure with less need for General Anaesthetic agents.
The reality is that this procedure is less safe than performing breast augmentation under a General Anaesthetic and in fact there have been three cases in New South Wales recently that highlight the dangers of this technique with two of those cases suffering cardiac arrests and the third, seizures due to excessive use of Local Anaesthesia.
General Anaesthetics are safe, predictable, and are performed in Accredited Units such as hospitals and day surgeries rather than in doctor’s rooms and unaccredited procedure units where only Local Anaesthetic and sedation procedures can be offered. The decision to therefore have Local Anaesthetic with tumescent infiltration and sedation is largely made due to the fact that the operating clinician is not a surgeon and is not able to operate in an Accredited Facility. It does reduce the cost of providing the service and therefore these clinicians are often able to offer the surgery at a discounted rate compared to trained surgeons.
Patients considering breast augmentation surgery should look at the credentials of their operating doctor and ensure that they have proper training through the Royal Australian College of Surgeons. Other qualifications are often provided by organisations whose practitioners are not surgeons and who do not have surgical training that is recognised by the Australian Health Practitioners Regulation Authority (APHRA). Clinicians who do have surgical training will have the letters FRACS or FRCS behind their names to indicate that they have had surgical training. If they have training in Plastic Surgery then they are permitted to use the words Specialist Plastic Surgeon in their name, if they do not have this, then they may be Ear Nose and Throat Surgeons who have undertaken Fellowships in ‘Facial Plastic Surgery’ or they may be General Surgeons with further training in Oncological breast surgery (Oncoplastic Surgery). Plastic and Reconstructive Surgical training involves five years of specialist training with a significant component of that training in aesthetic breast and reconstructive surgery. Their names can be found on the website of the Australian Society of Plastic Surgeons. www.plasticsurgery.org.au