Do They Have to Put a Tube Down Your Throat when You Are Having a Breast Lift and a Tummy Tuck?

            Combination
abdominoplasty and breast lift surgery requires general anesthesia in the vast
majority of cases. During these procedures anesthetic agents and oxygen can be
administered by either an endotracheal tube or an LMA (Laryngeal Mask Airway).
An LMA doesn’t require placement of the tube within the throat, but this
procedure does have significant limitations. This procedure shouldn’t be used
in patients who are obese, have neck problems, airway problems, gastric reflux,
or will be re-positioned during their surgical procedure.

            If
you’re concerned about the use of an endotracheal tube during your surgical
procedure, it’s important to discuss the issue with your plastic surgeon and
anesthesiologist. They should be able to formulate a plan that addresses your
concerns and alleviates your anxiety. 

Thank you for your question.

The short answer is no. You do not have to an endotracheal tube put down your throat to have a breast lift and tummy tuck.  There are many kinds of anesthesia and many times, an LMA (laryngeal mask airway) is sufficient.

To be sure, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.  I hope this helps.

Many (most) of our breast lift and tummy tuck ("mommy makeover") patients do not have an endotracheal tube. For non-obese patients with good neck mobility, no gastric reflux, no airway concerns, and no need to roll or reposition the patient during surgery (say, for liposuction of the hips or thighs), our CRNAs (certified registered nurse anesthetists) are very comfortable and experienced in use of laryngeal mask anesthesia (LMA). LMAs do not go through the vocal cords into the trachea, and still provide excellent airway access, control, and safety. But, not for everyone! Re-read the partial list above.

This is a question best asked of your plastic surgeon first, and then your anesthesia provider. Safety is the primary concern, not a minor sore throat (if even that) from an endotracheal tube. I always allow my anesthesia provider to make that assessment and "call." But you WILL require a general anesthetic to perform these surgeries properly. TIVA is my best recommendation for the least post-op nausea and vomiting risk, and the smoothest and most comfortable wake-up. Click on the web reference link below for more information about this and please don't worry about the choice of airway mangement devices. Best wishes! Dr. Tholen

Anesthesia for a mommy makeover (breast lift with/without implants and a tummy tuck) is most commonly done with general anesthesia.  This is the type where a tube is put down your throat, but this is the safest.  More importantly, the surgery may take 4-6 hours and any type of anesthesia other than general may put you at risk for aspiration.  In my extensive experience of performing mommy makeovers, I always use general anesthesia and my patients have done great afterward.  I also only work with board certified anesthesiologists for this type of surgery.  Therefore, I would highly recommend that you get general anesthesia for your mommy makeover. 

In my practice I require general anesthesia for a tummy tuck and breast lift. There are several reasons: The first is that I do liposuctions of the back and flanks on the vast majority of tummy tuck patients. This is in a face down position.  When you have general anesthesia in a prone position a ET tube is the safest manner. The second is that this surgery will take several hours. The longer the surgery the slightly higher the aspirations risk. Third when plicating the rectus muscle I prefer my patients to be completely relaxed. Therefore I use the ET with all my tummy tuck and breast lift patients. Some doctors might not, but most probable do.

 

Good luck and thank you for your question.

 

Sincerely,

 

Anire Okpaku MD FACS

 

There are different options for anesthesia for your mommy makeover.   One option is tradition general anesthesia that involves a temporary breathing tube.  Another option may be general anesthesia with a mask (LMA).   A third option is TIVA (total iv anesthesia) that does not require the breathing tube.    So yes, there are alternatives for you.   In addition, you MUST have your procedure performed in a fully accredited surgery center or hospital facility to ensure proper patient safety standards have been met.  Make sure your facility is accredited by AAAASF or AAAHC or JCAHO.   Please talk to your board certified plastic surgeon to see what he/she recommends for you.

Dr. Basu

Houston, TX

You may find that there are a variety of different ways of managing the airway during mommy makeover surgery. What technique a particular anesthesia provider will use will depend on his/her experience, training, and judgment. In my opinion, the use of the endotracheal tube ( tube through the trachea) provides for the most stable/secure method of protecting an airway (for example preventing aspiration related issues) during a relatively longer surgical procedure.

Keep in mind, that the presence of the endotracheal tube ( besides the occasional sore throat) is not a part of the operation that you will be aware of or remember.

Best wishes.

 

Dear Suzie Q,

 

A Mommy Makeover consisting of a tummy tuck and breast lift can be performed under either general anesthesia (completely asleep, with a breathing tube or mask inserted) or twilight sleep (local anesthesia with IV sedation).

 

The choice of anesthesia depends on a number of factors including the patient, the surgeon, the anesthesiologist, and the amount of work that needs to be done. Many surgeons would recommend general anesthesia for a longer procedure such as a Mommy Makeover because it will ensure that you are comfortable throughout surgery and that your airway is controlled. Twilight sleep may also be an acceptable alternative. I would discuss these options with your surgeon and anesthesiologist.

 

More importantly, I would strongly recommend that you consider a few additional points:

 

1. Choose a Board Certified Plastic Surgeon

2. Choose a facility that is certified to meet high standards for patient safety and care, ie. an accredited Hospital, or a Surgery Center that is accredited by AAAASF, AAAHC, JCAHO, and/or Medicare.

3. Choose a surgeon that works with a Board Certified Anesthesiologist.

4. Be wary of any surgeon that offers to perform a major procedure such as a Mommy Makeover in his or her office under straight local anesthesia. 

 

Warmest wishes,

Larry Fan, MD

 

 

 

 

 

 

The decision to use endotrachial tube or LMA during general anesthesia should be left to the anesthesiologist. Patient safety is priority and having contro of the airway is very important. Discuss your concerns with the anesthesiologist.

Most plastic surgeons perform these surgeries under general anesthesia, and this requires control of your airway so that you are guaranteed to be getting the oxygen you need.  This can be done either with an endotracheal tube (a tube passing down into the trachea) or an LMA (which just sits in the back of the throat).  Different anesthesiologists have different preferences depending on the length of the surgery, and whether you need muscle relaxation in order to repair a diastasis recti (separation between the rectus muscles and fascial stretching from pregnancy).  Either way, you will be asleep when this is done and will not be aware of having a tube "down your throat", and either one is removed before you are awake.