Mommy Makeover: Info, Photos, Rewiews, Q&A

Anesthesia techniques have improved significantly over the last several years. Many women wake up as soon as the operation is over. The full recovery from anesthesia takes longer.

When anesthesia is provided by a skilled anesthesiologist, many patients are up and walking within the hour. Normally it is recommended to have someone with you for the first 24 hours after surgery. (John J. Edney, MD, Omaha Plastic Surgeon)

Everyone wakes up differently from anesthesia. But interestingly, with the newer medications we have today, patients wake up quicker and easier than ever before. (Steven Wallach, MD, New York Plastic Surgeon)

Most patients will wake up a few minutes after the completion of the procedure for the mommy makeover.

They are usually inrecovery room with nursing care for a short period of time. We use modern anesthesia techniques which eliminates the long recovery times.

Our medications and the other drugs also reduce if not eliminate the post operative nausea and vomiting. You are very well taken care of here. (Norman Bakshandeh, MD, FACS, New York Plastic Surgeon)

In most instances, patients are leaving for home by 60-90 minutes after arriving in the recovery room from a 4 hour general anesthetic. (Otto Joseph Placik, MD, Chicago Plastic Surgeon)

Wake up time for a 4 hour operation shouldn’t be very long. Anesthesiologists currently use medications that should make the wake up pleasant as if you had a 1 hour operation. (Shahin Javaheri, MD, San Francisco Plastic Surgeon)

Typically 10-60 minutes to wake up from General Anesthesia

There are a lot of variables related to waking up after general anesthesia. Some of the common ones include your age, overall health, what procedures were done, and what medications were used.

With experienced anesthesia personnel and a healthy patient, waking up is pretty fast after general anesthesia.

There is a difference between breathing on your own and answering questions versus remembering everything!

Your mental status regarding being awake and remembering conversations after general anesthesia is unpredictable, and this is what most patients confuse regarding being awake versus being responsive. I speak to all of my patient right after surgery, and my patients answer and respond appropriately, but most do not remember the conversation.

So, rest assured the recovery room nurses will take great care of you after general anesthesia, but you simply may not remember all of the care and conversations. (Roy Kim, MD, San Francisco Plastic Surgeon)

It takes about an hour to wake up after operation.
Patients are sensitive to anesthetic agents at different levels and the anesthesiologists manage their patients differently.

However, after a major operation, most patients are awake and talking within an hour. They might not remember the conversation, however. (Vincent N. Zubowicz, MD, Atlanta Plastic Surgeon)

Waking up from anesthesia is pretty quick after surgery

Waking up from anesthesia is the easy part and only takes several minutes. It’s the “clearing your head” from the grogginess and tiredness that may take several hours after.

However, many cosmetic surgery procedures that last around 4 hours are done on an oupatient basis where most of the recovery is done at home in the comfort of your own bed. (Jeffrey E. Schreiber, MD, FACS, Baltimore Plastic Surgeon)

You will wake up right after the surgery while still in the operating room. However, you will likely not recall this due to the effects of the anesthesia.

You will slowly begin to remember events and fully wake up while in the recovery room where you will be for about one hour after your surgery.

Your pain will be well controlled during this recovery phase and you will also receive anti-nausea medication during this time.

Everyone responds slightly differently to general anesthesia, so the time that you spend in the recovery room may vary. Please discuss this in more detail with your plastic surgeon and anesthesia provider prior to surgery.  (William Bruno, MD, Beverly Hills Plastic Surgeon)

Recovery from anesthesia usually fairly quick

With newer medications, most patients wake up quickly and easily after general anesthesia, which is usually a good choice for the mommy makeover.

Other things that can help are local (numbing) anesthesia injected into the surgical areas before you are awakened, and perhaps the use of a pain pum such as the On-Q which automatically infuses numbing medication into the surgical site through a tiny tube. (Richard Baxter, MD, Seattle Plastic Surgeon)

Time in the recovery area could range from 1-2 hours max, depending on the severity and complexity of the case. Patients will wake from surgery soon after anesthesia is discontinued.

However, you are heavily sedated and may be in and out of consciousness. Make sure your plastic surgeon is board certified as well as the anesthesiologist they work with in surgery. (Tom J. Pousti, MD, FACS, San Diego Plastic Surgeon)

Waking up from anesthesia

You should be awake within a few minutes of having a surgery under general anesthesia. Of course, you want to have your surgery by a board certified plastic surgeon in a hospital or in a fully certified surgery center.

And your anesthesia should be administered by an anesthesiologist or anesthetist. These are important issues to discuss with your surgeon before surgery.(James Knoetgen, III, MD, Fresno Plastic Surgeon)

I have the great pleasure of working with a wonderful group of anesthesiologists experienced in the treatment of cosmetic surgery patients. They are very adept at timing the patient wakeup with the end of the procedure. It is not uncommon for me to place the abdominal binder and have the patient breathing on their own within a few moments.

Therefore, you are awake within minutes of your procedure ending and usually alert and oriented 1-3 hours after the procedure. Speak to your surgeon about the experience of his anesthesiology group. I wish you a safe and healthy recovery. (Paul S. Gill, MD, Houston Plastic Surgeon)

Usually the anesthesiologist will “wake” you up before you are off the operating room table. However, you may still not remember anything or be coherent for a while after this.

Even immediately after surgery, a surgeon can be talking to you and explaining things about the surgery, but patients will often not remember this conversation. Most patients will be quite cognizant within the hour following reversal of the anesthesia. (Robin T.W. Yuan, MD, Beverly Hills Plastic Surgeon)

Recovery from anesthesia

Recovery times from general anesthesia vary from person to person based on body size, anesthetic used, and tolerance to certain medications.

You are technically “awake” right after surgery in the operating room when the breathing tube is removed. However, you will be drowsy and won’t remember very much for 1-2 hours afterwards. (David Bogue, MD, Boca Raton Plastic Surgeon)

How long it will take for you to wake up from general anesthesia will depend on several factors, some of which are controlled by your anesthesiologist, and some which are related to genetics and your metabolism.

Certain anesthetic agents take quite a while to get out of your system, and can lead to a long wake-up period (and also can make you nauseated.)

I prefer using ultra-short acting agents that metabolize quickly, so patients wake up rapidly.

Most of my patients are awake and talking to us while we are putting on the dressings. (They might not remember anything for several more hours, as some of the anxiety-reducing medications create amnesia.)

I prefer this type of anesthesia, as the experience is more pleasant and there is less risk of nausea. That being said, some patients are slow metabolizers, and might take a bit longer (1/2 hour) to wake up. (Michael A. Bogdan, MD, FACS, Dallas Plastic Surgeon)

General anesthesia performed in modern surgical facilities and using the latest anesthesia drugs is very safe and very well controlled. The drugs used today are extremly short acting and you will be awake within minutes after they are stopped. The amount of time you spend in a recovery room will vary depending on the type of anesthesia used and your body’s abilty to metabolize the drugs, however, this is a different discussion. (Paul Vitenas, Jr., MD, Houston Plastic Surgeon)

General Anesthesia Safety

General anesthesia is very safe as long as it is performed by a anesthesia specialist and in an accredited surgical facility. If you are otherwise healthy, you should come out of general anesthesia fairly quickly. You will “blow off” the anesthesia effects in a recovery room where you will be monitored closely. (C. Bob Basu, MD, FACS, Houston Plastic Surgeon)

Waking up after surgery
Because the mommie makeover by definition is a combination of procedures, your surgery will be slightly longer than however any individual procedure would’ve taken. For that reason, your wake up time may take slightly longer.

With the proper management by a certified and experienced anesthetist, you’ll be up and answering questions within 20 minutes from extubation which typically ocurrs moments after the sterile operative dressing is applied.

They’ve gotten really good at waking you up very efficiently in my practice, particularly because of their expertise in this and because we have an open line of communication (anesthesiologist and myself) where I warn them about 20-30 minutes before being done so they can calibrate how much longer to keep you asleep. It’s amazing to see how well this is controlled in their hands. (Ricardo A. Meade, MD, Dallas Plastic Surgeon)

Generally- 2 hours, but expect side effects for awhile afterward…
A mommy makeover is a great procedure to address all of the changes that occur in a women’s body with pregnancy. It combines breast and body contouring procedures (such as tummy tuck and liposuction) into a single surgery and recuperation. It makes the surgical experience more convenient and cost effective for the patient, but it makes for a longer slower recuperation that a shorter surgery would. (But well worth the trade –off in most people’s mind!).

A general anesthetic is necessary to accomplish all of these changes on different parts of your body, and the longer you are asleep makes the waking up a little slower. We like to limit our operating times to 4-5 hours for outpatient surgeries just for that reason. Modern anesthetics that are shorter acting are usually used for outpatient surgeries. And they can be timed by the anesthesiologists so that you actually “wake up” while you are still in the operating room after surgery.

This means you are breathing on your own and following simple instructions, but very groggy and probably not remember anything happening at that time. You then are taken to the first stage of the recovery room where you will be closely observed by your nurse for the first 45 minutes to an hour.

During that time you are still very groggy, lying on a cot, and the nurses are giving you medicine to control pain or nausea and make sure your vital signs are stable.

Again during this time you will probably not remember much due to the side effects of the anesthetics.

After about an hour you will be awake enough to walk to the second stage of recovery where you rest in a recliner chair, visit the restroom, and begin to get instructions for what to do/expect at home. (These instructions are more for your caregiver than they are for you, because again people often do not remember details of what was said or done in that second stage)

By the time you are ready to go home you are about 2 hours out of surgery and a lot of the actual anesthetics have worn off, but there are still some of side effects of them and the pain medicines that you may experience (such as dry mouth, nausea, itching, or dizziness).

Because of these side effects it is necessary for you to have someone with you for the first 24 hours after surgery. After that point you should be recovered enough and clear headed enough to keep track of your medicines and bandages and be sage on your own if necessary, but expect as long as you stay on the pain medicines that you can still experiences side effects and should no drive or make any important decisions! (Marie E. Montag, MD, Omaha Plastic Surgeon)

With the new medications used in general anesthesia, you will wake up woith in minutes from stopping the mediications. You may not remember it but physiologicaly you are awake. It depend on the medications used. (Samir Shureih, MD, Baltimore Plastic Surgeon)

The effects of anesthesia

This is a good question, you should make sure your anesthesiologist is board certified. There have been great improvements in anesthesia that allow much less heavy sedation to keep patients comfortable. Our patients wake up almost immediately after surgery and without nausea. The tummy tuck procedure is one of the most uncomfortable for recovery, and therefore we use a pain pump for our patients which lasts about three days, getting them over the worst of it. (Miguel Delgado, MD, San Francisco Plastic Surgeon)

Waking Up from Surgery
When I do any kind of surgery where a patient is placed under anesthesia, I use a Board Certified MD anesthesiologist. A good anesthesiologist can time their medications to precisely match up with the length and type of surgery. Most patients regardless of how long they were asleep will wake up within minutes after the procedure is completed. Rarely, some patients can possibly be longer, but generally, they are still considered awake even if they are somewhat groggy.

The period to feel fully alert and for the anesthesia to leave the system can range from hours to a day or so and this can be somewhat affected by the length of surgery. However, most patients with an anesthesiologist will wake up smoothly and be fairly alert in a relatively short period of time. (Robert Cohen, MD, Santa Monica Plastic Surgeon)

Typically, the anesthesiologist will begin to reduce the anesthesia as the surgeon is finishing the surgery and putting on the dressings. As the patient begins to wake up they may begin to respond verbally but it is not uncommon for the patient to not have any memory of this time period while still in the operating room. Generally, patients become fully alert within one hour after surgery is complete. (Scott Chapin, MD, FACS, Philadelphia Plastic Surgeon)

Waking up after general anesthesia
You are usually woken up from the surgery while you’re still in the operating room, so it won’t be more than a few minutes after the surgery is done. Your anesthetist and surgeon will be there to see that you’re doing okay, then you’ll be taken to the recovery room where you’ll be observed by your medical team. You’ll probably feel a little groggy and possibly nauseous, but this will all go away gradually. (Leila Kasrai, MD, FRCSC, Toronto Plastic Surgeon)

Our patients respond at the end of their surgeries and have the opportunity to see their after pictures (taken in the operating room). It always bring a smile on their faces. (Martin Yanez, MD, Mexico Plastic Surgeon)

How long it takes to wake up after surgery depends on the type of general anesthesia

Historically, a general endotracheal anesthetic has been used for abdominoplasties and combined procedures such as mommy makeovers.

However, more plastic surgeons today are learning ways to tailor the anesthetic to your needs and avoid long stays in the operating room.

Your surgeon may inject the abdomen with a long-acting anesthetic agent after you are asleep to help with pain relief after your wake up.

The average length of stay in my recovery room is 51 minutes. We use a total IV anesthesia (no gas, ventilation, intubation, or paralysis). Advantages include less risk of nausea and faster awakening after surgery, even 4-hour cases. So it depends on the type of anesthesia that is used. It also depends on the experience and expertise of the anesthesia provider and surgeon. I talk about this in more detail on my website. A link is provided below. (Eric Swanson, MD, Kansas City Plastic Surgeon)

Most patients wake up after several minutes and are taken to the recovery room. I typically spend about an hour or more in the recovery room and then head home after their surgery. (Austin Hayes, MD, Portland Plastic Surgeon)

Advantages of IV Sedation over General Anesthesia for Cosmetic Surgery

Long multiple procedure cases, such as mommy makeovers, can be performed under IV anesthesia. I perform multiple procedure cases lasting 8-9 hours every week. The truth is that for procedures lasting longer than 4 hours, the patient is better off with IV anesthesia. With general anesthesia, the risk of pulmonary embolism increases with the length of the surgery. For a 4 hour procedure under general anesthesia, you would likely be in the recovery room at minimum 2 hours and probably more. The wild card in all of this is the type of anesthesia and technique used by the anesthesiologist with the general anesthesia.

General Anesthesia patients often have moderate to severe nasuea which can keep a patient in recovery for hours. With twilight, you would be awake in a just a few minutes and likely only need to stay an 1 hour in recovery. Additionally, for plastic surgery procedures, twilight anesthesia is usually administered with ‘local injections’ which serve to numb the area. The additional benefit of these local injections is that when you wake up from twilight the local anesthesia is still working and you will not feel any pain in the area that has been operated on. So, you don’t need to immediately load up with pain pills.

With General Anesthesia, LESS amounts of local anesthesia are usually injected into the operative area, so that when you wake up hours later from General Anesthesia, patients will often time experience pain and ask for pain pills. Thus, General Anesthesia patients usually require more narcotics immediately following surgery. Furthermore, General anesthesia patients have a higher risk of pulmonary embolism than twilight.

So, for all these reasons, we always have twilight anesthesia administered, even for long 12-hour multiple procedure makeover surgeries, by our team of Board Certified Anesthesiologists.

Read more about the Advantages of IV Sedation over General Anesthesia for Cosmetic Surgery at the web reference noted. Dr. Todd Hobelmann, one of the Board Certified Anesthesiologists who administers the anesthesia to our surgical patients, discusses why he thinks his patients are very satisfied with IV sedation.

Watch me speak with two different patients who have just undergone cosmetic surgery with IV anesthesia in our AAAASF accredited surgery center in Baltimore in the video. (Ricardo L. Rodriguez, MD, Baltimore Plastic Surgeon)

Anesthesia Used During a Mommy Makeover- An MD Anesthesiologist can be by your bedside at all times thoughout surgery

You should wake up almost immediately following surgery whether general anesthesia or MACS anesthesia has been administered.

Intra -operative pain control, with the use of Exparel and / or pain pumps greatly reduces post -operative pain. (Michael Law, MD, Raleigh-Durham Plastic Surgeon)

One hour anesthesia recovery

Most patients are ready for discharge from the Post Anesthesia Care Unit at one hour after a plastic surgery. (Gary Lawton, MD, FACS, San Antonio Plastic Surgeon)