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Experience of Immediate Ambulation and Early Discharge After Tumescent Anesthesia and Propofol Infusion in Cosmetic Breast Augmentation

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  • Breast Surgery
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Abstract

Introduction

Current cosmetic breast augmentation relies on general anesthesia that normally requires 40 min to total recovery. With experience, the surgical procedure can be completed expediently in 20 min under tumescent anesthesia and propofol full sedation to achieve immediate postoperative ambulation and home discharge readiness, and thus improve patient satisfaction and reduce cost. We retrospectively examined the outcomes of the protocol.

Materials and Methods

Per protocol, 1200 female patients underwent simple cosmetic breast augmentation accomplished with tumescent anesthesia, immediate mobilization, and early home discharge readiness after surgery. The following records were analyzed: vital sign stability during mobilization in the first 30 cases (primary goal), duration of surgery and anesthesia, frequency of intraoperative opioid use, frequency of ambulation needing assistance, Verbal Analog Scores and incidences of pain, orthostatic intolerance events, incidences of postoperative nausea and vomiting or anti-emetic use, and complications at follow-up visits (secondary goal).

Results

Hemodynamics during immediate postoperative mobilization demonstrated no statistically significant fluctuations and/or orthostatic intolerance requiring interventions. The mean duration of surgery was 20.4 ± 4.1 min. The mean duration of anesthesia was 25.2 ± 6.8 min. All patients tolerated immediate postoperative ambulation well. Adverse postoperative events were scarce. Only 9.1% reported postoperative pain, and 5.7% reported postoperative nausea and vomiting. One percent had transit post-ambulation dizziness needing supine positioning for less than 3 min. The average time to meet home-readiness criteria was 4.7 min, and there was no incidence of hematoma, infection, or complaints at follow-ups.

Conclusions

For simple cosmetic breast augmentation, instead of general anesthesia and 40 min of recovery time, a tumescent anesthetic technique can be used for immediate postoperative ambulation and a 4.7-min home discharge readiness without a decrease in anesthesia quality and safety.

Level of Evidence IV

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Acknowledgements

The authors thank Angela Pang for her assistance with manuscript preparation and management.

Funding

No funds or benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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Authors and Affiliations

  1. Advanced Aesthetics Surgery Center, 7425 Conroy Rd., Orlando, FL, 32835, USA

    Weiwu Pang, John M. Chois & Diana Lambie

  2. Department of Anesthesiology, Wuri Lin Shin Hospital, No.168, Rong-he Rd. Wuri Dist., Taichung, 41454, Taiwan, ROC

    Weiwu Pang

  3. Department Head of Emergency and Critical Care Medicine, Lin Shin Hospital, No.36, Sec. 3, Hueijhong Rd. Nantun Dist, Taichung City, 40867, Taiwan, ROC

    Richard Ming-Hui Lin

  4. Department of Emergency and Critical Care Medicine, Wuri Lin Shin Hospital, No.168, Rong-he Rd. Wuri Dist., Taichung, 41454, Taiwan, ROC

    Zao-Ming Shih

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  1. Weiwu Pang
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  2. John M. Chois
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Correspondence to Zao-Ming Shih.

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Ethical Approval

All procedures performed in this study were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Pang, W., Chois, J.M., Lambie, D. et al. Experience of Immediate Ambulation and Early Discharge After Tumescent Anesthesia and Propofol Infusion in Cosmetic Breast Augmentation. Aesth Plast Surg 41, 1318–1324 (2017). https://doi.org/10.1007/s00266-017-0929-5

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