Types of Anaesthesia Used in Plastic Surgery

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Anaesthesia is one of the parts of cosmetic surgery that patients worry about most and understand least. The honest position is that modern anaesthesia is one of the safest interventions in medicine, that the techniques used at properly regulated UK clinics have a very strong safety record, and that the right anaesthetic for a given procedure depends on factors the anaesthetist assesses with you in detail at the pre-operative meeting. This guide explains the main types of anaesthesia used in cosmetic surgery, when each is appropriate, what the experience of each is actually like, and how Centre for Surgery’s approach — built around TIVA (total intravenous anaesthesia) for the majority of our work — differs from the older gas-based techniques some clinics still rely on.

The three main types of anaesthesia

Cosmetic procedures use one of three broad approaches, sometimes in combination:

Local anaesthesia. A specific area of tissue is numbed by injecting a local anaesthetic (lidocaine, bupivacaine, or a combination). The patient remains fully awake and aware. Suitable for small, localised procedures — minor mole excisions, small skin lesion removals, some intimate procedures, and certain ear procedures.

Local anaesthesia with sedation. Local anaesthetic is combined with intravenous sedative Weight Loss Medication, which makes the patient drowsy or lightly asleep but not fully unconscious. The patient breathes for themselves throughout. Used for moderate procedures — some labiaplasty cases, some otoplasty procedures, smaller revision work, and selected facial work.

General anaesthesia. The patient is rendered fully unconscious with no awareness of the procedure. Within general anaesthesia there are two main subtypes used in cosmetic surgery:

Why TIVA is the standard at Centre for Surgery

For the majority of our cosmetic surgery — facelift, rhinoplasty, blepharoplasty, breast surgery, abdominoplasty, body contouring — we use TIVA rather than traditional gas-based general anaesthesia. The advantages are clinically meaningful:

For most patients, the practical experience of TIVA is: a smooth propofol induction in under a minute, the procedure itself with no awareness, and waking up alert and comfortable with minimal nausea. Patients who have had previous gas-based anaesthesia frequently report TIVA as a markedly better experience.

How the anaesthetic is chosen for your procedure

The anaesthetic plan is tailored to the procedure, patient health, anticipated operating time, and individual preferences. Common patterns:

Local anaesthesia alone for:

Local with sedation for:

TIVA general anaesthesia for:

The anaesthetist will discuss the planned approach with you at the pre-operative meeting and answer any questions specific to your situation.

Local anaesthesia in detail

Local anaesthetic injection takes effect within minutes and provides full pain relief in the treated area for 2-12 hours depending on the agent used. Lidocaine acts quickly with a 2-4 hour duration; bupivacaine takes longer to take effect but lasts 6-12 hours and is often used for post-operative pain relief in larger procedures.