There is currently a new debate going on in plastic surgery circles, namely which is better for a patient – being asleep or awake during surgery.

Being awake during a procedure seems to be a growing phenomenon, but a number of cosmetic surgeons are worried that this could be problematic for the patient. For instance, Dr. Michael F. McGuire, the head of the American Board of Plastic Surgery (ABPS) recently told colleagues:  “Awake cosmetic surgery [is part of a growing problem of] amateurism.”

He admits that having general anaesthetic does have its own problems, but he cannot understand why someone would want to put themselves through agony by remaining awake. Dr. McGuire added: “It’s inconceivable that anyone would do such a major procedure under anything less than a light general anaesthesia.”

Other surgeons are also worried. They believe that staying awake can pose a very serious risk to a patient. For example, the amount of local anaesthetic used (usually Lidocaine) during breast augmentation operations can reach toxic levels. The anaesthetic is absorbed slowly by fat which will remain in the body after the patient goes home. In fact, by the time the client reaches home the toxicity level could be very high indeed.

The pro awake side of the argument however believes that the ability for the patient to communicate should be the main aim; in short, patients can make decisions they are unable to do while asleep.

The ABPS says: “[this is akin to] making a decision while you are drunk.”