If someone were to ask what has been the greatest advance in plastic surgery in the last 200 years, what would be the answer? Some might suggest liposuction, others the invention of the medical laser, and others injectables like Juvederm and Botox. I would suggest something a bit different!

What do liposuction, laser treatments, and the use of injectables have in common? The answer is the use of anesthesia! Liposuction is done either under sedation, general, or local anesthesia and the solution that is injected into the area of proposed liposuction contains an anesthetic agent. Laser treatment is usually done after the application of a numbing cream or under local, sedation, or general anesthesia. Injectables either contain a local anesthetic agent or the procedure is done under anesthesia of some sort. Were it not for excellent anesthesia, far fewer folks would be willing to undergo a procedure for the sake of appearance!

When did anesthetics originate? They were known in ancient Greek and Roman times, frequently being herbal in origin. Alcoholic drinks were used as well. Nitrous oxide, also known as laughing gas, as well as ether came to the forefront in the mid 1800’s and began to be used to anesthetize patients who were going to have surgery. This type of anesthesia was known as inhalational anesthesia. The patient merely inhaled or breathed the anesthetic gas, fell asleep, and painless surgery was then performed. Since the mid 1800’s, many other agents have been invented, allowing safe and pleasant anesthesia.

The first local anesthetic widely used was cocaine. It was introduced in the mid 1800’s as well, and many others such as Xylocaine have followed.

Morphine, which is found in opium, was first isolated in the early 1800’s and became widely used once the hypodermic needle was introduced in the mid 1800’s. Many other intravenous anesthetic agents have been invented such as Propofol.

I use inhalational, intravenous, and local anesthetic agents in my practice. Sometimes the choice is made by the patient. For instance, a MACS-Lift can be done under local anesthesia, although some patients prefer sedation anesthesia which is done with intravenous Propofol and sometimes a bit of inhalational agent. At other times, the choice is mine, as in breast augmentation that requires the relaxation of the chest muscles by means of intravenous agents for insertion of an implant beneath the muscle.

Regardless of the technique of anesthesia used, it is done safely and pleasantly. The advance of anesthetic techniques over the past 200 years allows for this and certainly has played a major role in the increased popularity of plastic surgery.

Should you desire further information, please contact my Encino plastic surgery office by calling (818) 981-3333.