For patients with a fear of general anesthesia this is a significant upside, but “I don’t think the difference between general anesthesia and IV sedation has any real effect on risk,” says Dr. Teitelbaum. “When general anesthesia is done by an MD anesthesiologist, the risk is negligible, particularly compared to IV sedation.” Some argue that because the depth of IV sedation is variable, it can be just as strong as general, but without the added safety of a breathing tube. Nevertheless, “many patients will be pleased not to be going under general anesthesia,” Dr. Teitelbaum notes.
The entire Preservé process takes 30 to 40 minutes, which is similar to the time it takes to do a traditional breast augmentation (for this, surgeons quoted me a range of 25 to 90 minutes, start to finish). Dr. Pittman attributes any time savings with Preservé to the difference in anesthesia. “It takes virtually no time to initiate the sedation, and when the procedure is over, the patient is awake,” he says. With general anesthesia, “we’re putting the patient asleep, intubating them, waking them up, and then extubating them,” which can extend OR time.
When using sedation, patients tend to come around quickly. “By the time I’m done [with a Preservé surgery], the patient is fully awake and can walk herself back to the recovery area,” says Ran Stark, MD, a board-certified plastic surgeon in Bryn Mawr, Pennsylvania. Likewise, in Dr. Schwartz’s OR, “patients literally sit up at the end of the procedure and they’re like, ‘Wow, that was easy,’ as opposed to having all those [general anesthesia] drugs in their system and needing to stay in the recovery room for a long time.” The next day when he sees them back, he says, “most haven’t taken any pain medication and they tell me they’re pain-free.”
5. Patients can be looking at an overall easier recovery.
If surgeons aren’t cutting breast tissue, “there’s a lot less swelling and pain, and the downtime is better because of it,” Dr. Gould says. Most people can manage any discomfort with Tylenol. Those with office jobs are usually back within a day or two (and able to drive the day after surgery). “As early as two weeks, my patients are working out and doing a lot of things that they’d have to wait six weeks for with my traditional augmentation,” adds Dr. Gould. At this point, every surgeon has slightly different recovery guidelines for Preservé . Dr. Pittman asks patients to do “basically nothing” for the first few days. “At 72 hours, I let them go back to their normal life activity,” he says. “They can do Peloton at one week and their regular exercise routine at two weeks.”
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