The procedures
Plastic surgery restores or changes the form and function of the body. It includes:
- Reconstructive surgery, such as breast reconstruction after cancer, skin cancer removal and repair, hand surgery, and the transfer of tissue from one part of the body to another (flap surgery), sometimes joining very small blood vessels under a microscope.
- Cosmetic surgery, which changes appearance for personal reasons rather than medical need.
Procedures range from short day operations to reconstructions that take many hours.
The role of your specialist anaesthetist
My role is to keep you safe and comfortable throughout, to provide conditions that suit the operation, and to plan for a smooth recovery with good pain relief and as little nausea as possible. For long reconstructive operations, I also manage blood pressure, fluids and temperature in ways that help the transferred tissue keep a healthy blood supply.
The decision to have any operation, including cosmetic surgery, is yours to make with your surgeon. My part is to assess whether the anaesthetic can be given safely, to explain the anaesthetic risks honestly, and to make sure the facility is appropriate for the procedure and for you.
Common anaesthetic approaches
- General anaesthesia is used for most longer or more extensive procedures.
- Local anaesthetic with or without sedation may suit smaller procedures, such as some skin and hand operations.
- Regional anaesthesia, including nerve blocks, can numb an arm or other area. A block may be used on its own, for example for some hand surgery, or with a general anaesthetic for pain relief afterwards. Blocks of the chest wall are sometimes used for breast surgery.
Not every technique suits every patient or operation. We will choose together, based on the procedure, your health and your preferences.
Preoperative assessment and preparation
I will review your general health, medications, allergies and previous anaesthetic experiences. Please tell me if you have had severe nausea or vomiting after a previous anaesthetic, or motion sickness, as this helps me plan prevention. Smoking and vaping reduce blood flow to healing tissue, and your surgeon may ask you to stop well before surgery. Some medications, including blood thinners, some supplements and GLP-1 and weight-loss medicines, need individual advice; please do not stop any medication unless you have been advised to. See Medications Before Anaesthesia.
Cosmetic procedures should take place in a hospital or accredited day surgery with appropriate anaesthetic facilities. You are welcome to ask where your procedure will be done and who will be giving your anaesthetic.
What happens during the procedure
Standard monitoring of your heart, blood pressure, oxygen and breathing is used throughout. For longer operations, extra attention is given to:
- Positioning: padding pressure points and supporting the arms, neck and back, with checks during the operation. Some procedures need you to be turned.
- Warming: warm air blankets and warmed fluids keep your body temperature normal, which helps wound healing and reduces bleeding and infection risk.
- Blood clot prevention: calf compression devices, and sometimes blood-thinning injections afterwards.
- Nausea prevention: a combination of anti-nausea medicines, and sometimes total intravenous anaesthesia (TIVA), for people at higher risk.
Recovery and postoperative considerations
After a short procedure, you may go home the same day with a responsible adult. After major reconstruction, you will stay in hospital, and after microsurgical flap surgery, nurses will check the transferred tissue regularly in the first days. A nerve block can keep the area numb for many hours; protect the numb limb and start your regular pain relief before the block wears off. See Recovery & Aftercare.
Relevant anaesthetic risks and precautions
Nausea and vomiting, sore throat, shivering and tiredness are common and usually short-lived. Long operations carry a higher risk of pressure injuries, blood clots and low body temperature, which is why the precautions above are taken. Nerve blocks occasionally cause temporary numbness or tingling that lasts longer than expected; permanent nerve injury is rare. Large-volume liposuction and combined cosmetic procedures carry additional risks that your surgeon and I will discuss with you. See Anaesthetic Safety & Risks.
Links to additional patient resources
- Preparing for Your Procedure
- Understanding Your Anaesthetic & Informed Consent
- Medications Before Anaesthesia
- Recovery & Aftercare
- Anaesthesia and cosmetic surgery, Australian and New Zealand College of Anaesthetists (ANZCA)