Anaesthesia and cosmetic surgery This information has been developed by accredited specialist anaesthetists to help anyone who is considering cosmetic surgery in Australia or New Zealand. It will help you to understand the risks associated with anaesthesia, and the key questions you should ask before having a cosmetic procedure. Thousands of cosmetic surgical procedures are carried out across Australia and New Zealand every year. Nearly all procedures will require the use of anaesthetic drugs. This will range from a low-dose local anaesthetic to the use of sedation drugs, or a more complex general anaesthetic. Australia and New Zealand are two of the safest places in the world to have a procedure involving anaesthesia, but all anaesthetics have risks so it is important to talk to your general practitioner (GP) beforehand about your options. We recommend that your discussion includes any medical conditions or allergies you have, and the medication you are taking. The key questions to ask are listed below. You can compare the answers given by your doctor to help decide if you are comfortable with the arrangements being made for your surgery. Q1. What kind of anaesthetic will I be having? Generally speaking, there are three kinds of anaesthesia that can be used during any cosmetic surgery procedure. Local anaesthetic Small, simple procedures are often performed using a local anaesthetic, which numbs the area to be operated on. While small doses are generally quite safe, large doses can be very dangerous. Local anaesthetic may be given by most qualified health practitioners in any surgical setting. Sedation Sometimes sedation is used in addition to a local anaesthetic. This may be referred to as “twilight sedation” or “conscious sedation”. It helps you to relax while still remaining conscious and may decrease your memory of the procedure. Intravenous sedation (that is, sedation that is administered into a vein) must always be given in a licenced facility by a registered medical practitioner skilled in resuscitation, as sometimes conscious sedation can inadvertently lead to deep sedation. General anaesthetic General anaesthesia is a carefully controlled state of unconsciousness. It stops you from being aware, feeling pain and forming memories during your procedure. General anaesthesia must always be performed in a hospital operating theatre, or a clinic that meets standards set by health authorities, by a registered specialist anaesthetist who will keep you safe while you are unconscious. Q2. Is the practitioner qualified to give an anaesthetic? General anaesthetics must always be administered by a specialist anaesthetist or another registered medical practitioner specifically trained to deliver general anaesthesia and working within their scope of practice. Drugs for sedation may be given by a medical practitioner who is not an anaesthetist but that person must be skilled in resuscitation. All specialist anaesthetists have these skills. Low dose local anaesthetics can usually be safely administered, however, large doses carry significant risks of complications, including seizures and cardiac arrest. To check the registration of the person giving you your anaesthetic, search for their name via the Australian Health Practitioner Regulation Agency (AHPRA) or Medical Council of New Zealand websites. Q3. Where will the procedure be performed? Unless you are having a procedure that can be performed with small doses of a local anaesthetic and no intravenous sedation, your operation should be done in a hospital operating theatre or a clinic that meets standards set by health authorities. This document (www.anzca.edu.au/documents/day_surgery_in _australia.pdf) outlines the minimum standards for clinics which have day surgery facilities. Q4. What safety measures are in place? If something goes wrong, the facility needs to have suitable medical equipment and enough staff to be able to resuscitate patients or deal with other complications. If the procedure is deemed to be suitable to take place in the consulting rooms of the cosmetic surgeon it is essential for you to know that an ambulance is able to easily access the facility and the procedural room and that there is room for a stretcher to exit in an emergency to transfer the patient to hospital for further treatment. Q5. How will the anaesthetist know about my general health including my other medical conditions? Before you have any procedure you should be asked about any medical conditions you may have, including any known allergies and also the medications that you are taking. Your answers should be taken into account to minimise risks. If you are having a general anaesthetic, the anaesthetist will perform a detailed assessment and describe the process as well as the risks and benefits. Q6. What if I am still uncertain about the procedure? If you have any doubts about your procedure, it is very important to discuss these with the practitioner performing the surgery or with your GP before proceeding. Even if you have consented to the procedure and have already arrived at the facility, you do not have to go through with it if you feel uncomfortable. Q7. Who else should I talk to? While cosmetic surgery is the only type of surgery that doesn’t require a referral from a GP, you are strongly advised to talk with your GP about what you would like to have done. Your GP will be able to help explain the risks and offer other good advice About ANZCA This fact sheet has been written specifically to help you learn and understand the very important facts about anaesthesia for cosmetic procedures. The Australian and New Zealand College of Anaesthetists (ANZCA) trains doctors to become specialist anaesthetists and is the organisation that governments and other doctors turn to for advice on safe anaesthesia. In Australia and New Zealand, a specialist anaesthetist is a doctor who has studied for at least seven years after completing their initial medical degree. Once they have completed their training they will become a fellow of ANZCA and must continue to keep their skills up to date. Look for the letters FANZCA after their name. For advice about cosmetic surgeons, please refer to the Royal Australasian College of Surgeons or the Australian Society of Plastic Surgeons. Further reading: www.anzca.edu.au/documents/what-is-anaesthesia.pdf www.healthdirect.gov.au/guide-to-cosmetic-surgery www.betterhealth.vic.gov.au/health/conditionsandtreatments/ cosmetic-surgery Please note: This information is a guide and should not replace information supplied by your anaesthetist. If you have any questions about your anaesthesia, please speak with your treating specialist.