One of the main concerns that patients have when undergoing any type of plastic surgery or invasive aesthetic procedure, is “Will it hurt?”. Answering this question accurately will involve a discussion of a patient’s pain tolerance, and the type of anesthesia offered at a practice. Everybody has probably heard all kinds of stories about anesthesia, both good and bad. The bottom line is, anesthesia has come a very long way, with leaps and bounds made in the last 10 years. At the Maas ClinicTM, your safety and comfort during your procedure is a big priority for us. We have lots of options available that are suitable to different procedures, and different patients, so even patients who are extremely sensitive to pain or who are averse to needles will be able to enjoy various treatments without discomfort.

Types of Anesthesia Available

Relaxation Medication

Some patients have a great deal of anxiety about needles, but still wish to enjoy the benefits of injectable treatments like Botox or facial fillers, which by and large do not require any anesthetic use at all. For these patients, we often pre-treat them with an oral medication that has relaxing effects, like a Valium, an Ativan, or something in that class of drugs. If absolutely necessary, we can also use Benzodiazepines as a pain medicine.

Oral Anesthesia or Inhalation Anesthesia

Old-fashioned laughing gas has been upgraded for this century. We are proud to offer our patients the Pro-Box nitrous oxide system, which is delivered with 50% oxygen. As patients breathe the gas in and out gently, the formula delivers both analgesic (pain relieving) and relaxation effects. Patients can breathe this in and out throughout their entire procedure for no discomfort during otherwise potentially painful treatments like Ultherapy.

For patients with needle anxiety but require local anesthesia for their procedure, you will be able to breathe this formula until the local anesthetic or blocks have been delivered.

Topical Anesthetics

For patients undergoing office-based procedures, we have a combination of effective topical anesthetics that are custom-mixed for us in a formulary. They are applied under Dr. Maas’ direction to the skin’s surface, and left on for 30 to 60 minutes. This provides near-complete anesthesia so even the ‘pinch’ you would otherwise feel from small needles is blocked. This is suitable for patients concerned about the pain they may experience from treatments like injectables, microneedling, and certain laser-based treatments.

Local Anesthesia

Carefully delivered with extremely fine needles, local anesthetic helps to completely numb an area so patients feel no discomfort at all.

Local Anesthesia With Sedation

One step up from local anesthesia, this is for procedures that are somewhat more involved, including hair transplants and laser skin resurfacing treatments. This short acting yet effective combination allows patients to relax and feel very comfortable, and often not remember the procedure itself. It is important to note that if sedation is used, you will need a ride home as you will not be able to drive or operate heavy machinery.

We offer two options for sedation. The first involves oral medication. After first performing a thorough medical history check to ensure you do not have allergies, you may be prescribed this medication which will kick into effect within 30 to 60 minutes. If this option is used, you will need to arrive earlier so we can administer it to you.

Another option that works more quickly, but will require a bit more set up time is IV sedation. This allows us to deliver the right dose of medication to help you sleep, or get you into a nice, tranquil state almost immediately. For this option, we are required to use our outpatient surgery center, the San Francisco Rejuvenation CenterTM, which is conveniently located within the same building. For patients undergoing IV sedation, a nurse and doctor will always be in the same room to monitor you.

Monitored Deep Sleep Anesthesia

For a vast majority of our surgical patients, we recommend Monitored Deep Sleep Anesthesia or MDSA. Delivered via IV by a board-certified anesthesiologist, this type of anesthesia allows patients to breathe freely on their own, while a laryngeal mask called the LMA protects your airways from secretions dropping down so there are no issues with aspiration. Patients will be kept at a nice, even level of pain-free sleep throughout their surgical procedure, and as they awaken, their brains will register no lingering pain or discomfort thanks to Dr. Maas’ careful numbing of the treated area. Patients will slowly wake up after the IV is turned off, without the nausea or hang-over effects that are traditionally associated with general anesthesia.

General Anesthesia

By and large, we try to steer clear of General Anesthesia, where patients are all the way out, paralyzed, and on a respirator that breathes for you. While general anesthesia may be required for more intensive body procedures, our aesthetic facial plastic surgery procedures tend to have lower narcotic needs.

So again just a summary, the basic categories are local and local with sedation and that we call monitor deep sleep anesthesia. For the body surgery there may be some needed to do general and there’s some very, very nice ways to do general anesthesia where they have it comfortable for our patients but for the most part with the aesthetic facial surgery that I’m doing we have very low narcotic needs and does people are not sick after afterwards and very low anesthesia needs frankly because I numb people up so they’re awake and that makes it comfortable and easy for patients.

Choosing the Right Anesthetic

The goals of anesthesia are your comfort and your safety. We choose the anesthetic used based on your preferences, medical history and the type of procedure you will undergo. There’s no perfect answer that works for everybody, from the office-based procedure where we’re just doing tiny little injections to the larger or longer procedures. At the Maas ClinicTM in San Francisco, we want to make sure that your experience is as good as your treatment outcomes, so we make sure that you’re very comfortable throughout.

If you have any questions about the anesthetic techniques that we use, or other pain relievers we offer including icing or Zimmer coolers, please do not hesitate to contact us using our online form today, or by calling the Maas ClinicTM at (415) 567-7000.

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