If you are planning to undergo cosmetic or reconstructive surgery with our London Consultant Plastic Surgeon, you will likely be administered a general anaesthetic (GA). Our consultant anaesthetists, Dr. Baldock and Dr. Millhoff, specialise in Total Intravenous Anaesthesia (TIVA), a state-of-the-art technique designed to provide smooth, controlled sedation without the need for inhaled gases.1 They pair this with advanced depth-of-anaesthesia monitoring to ensure each patient receives the optimal level of sedation throughout their procedure.
Continue reading to learn more about what to expect from this important aspect of your experience at Mr Townley’s practice.
- What Is a General Anaesthetic (GA)?
- Preparing for Your General Anaesthetic (GA)
- General Anaesthetic (GA) on the Day of Surgery
- General Anaesthetic (GA) Recovery
- General Anaesthetic (GA) Risks
What Is a General Anaesthetic (GA)?
With the help of a general anaesthetic (GA), patients are completely asleep and unaware during their procedure. In the UK, consultant anaesthetists – such as Dr. Baldock and Dr. Millhoff – are highly trained doctors with experience in intensive care medicine and perioperative patient care.
Furthermore, TIVA is associated with a higher quality of emergence (waking up) and a lower incidence of post-operative nausea and vomiting than techniques using anaesthetic vapours. These qualities make TIVA ideal for many patients undergoing short-stay surgery.
How Should I Prepare for My General Anaesthetic (GA)?
Prior to your surgery, you will fill out a health questionnaire. The information you provide will be reviewed by Dr Baldock or Dr Millhoff, who may arrange to speak with you before the day of surgery if necessary. You may also be advised to discontinue certain medications (or, less commonly, get bloodwork or other tests done). In any case, we are always very happy to answer anaesthetic-related questions before the day of your surgery.
Giving up smoking for at least a month before surgery can halve your risk of complications. Otherwise, current guidelines recommend omitting food or milky drinks for six hours and clear fluids for two hours before an anaesthetic. That said, it is fine to take small sips of water with medication or to wet your mouth right up until the time we take you to the operating theatre.
Try and practise regular physical exercise in the weeks leading up to your operation. The World Health Organisation (WHO) provides valuable guidelines on the recommended amount of exercise for maintaining good health; you can view this information at the bottom of the page.2
What Should I Expect on the Day of Surgery?
Once you are settled into your room on the ward, your consultant anaesthetist will visit you to discuss your anaesthetic and address any last-minute questions. Mr Townley will also see you before your procedure. When everything is ready, a member of our team will accompany you to the anaesthetic room, located just next to the operating theatre. There, we will perform a series of safety checks (these may seem repetitive, but they are a crucial part of maintaining your wellbeing).
The assistant to the consultant anaesthetist will begin by attaching routine monitors to track your vital signs throughout the procedure. These include a finger probe to measure oxygen levels, a blood pressure cuff on your arm, and three small stickers on your chest to monitor your heart. Your anaesthetist will then insert a small plastic tube (cannula) into a vein, usually on the back of your hand, using a fine needle. If you have any concerns about injections, please let our team know, as we have various ways to potentially help make the process more comfortable.
Once the anaesthetic drugs are infused through the cannula, you may feel light-headed. Some people experience a brief aching sensation in their arm or notice a slightly unusual taste in their mouth, but this should only last a few seconds. Very soon, you should drift into unconsciousness and remain completely unaware until the operation is finished.
Throughout your surgery, your consultant anaesthetist will be by your side, ensuring you remain asleep and safe. They will continuously monitor and adjust your airway, breathing, blood pressure, and temperature to keep you stable throughout the procedure.
What Does Recovery From a General Anaesthetic (GA) Involve?
Following your surgery, you will spend about 30 minutes in the recovery ward next to the operating theatre. As soon as possible, the team will encourage you to get up and move around. You will also be offered something to eat and drink. Daycase patients (such as those undergoing rhinoplasty, brow lift, or breast lift surgery) should be ready to go home after about four to six hours.
We will provide detailed instructions and any necessary medications to take home, including pain relief. Most patients find that regular paracetamol and ibuprofen are sufficient for managing discomfort, but in some cases, a stronger pain medication (such as codeine or tramadol) may be needed initially.
For the first 24 hours after your general anaesthetic, you should not be alone, make any major legal decisions, sign any important documents, or operate machinery or appliances. Driving should be avoided for 48 hours. Be sure to stay well-hydrated and stick to a light diet, avoiding heavy, greasy foods and alcohol. We also advise you to plan for some time off work and refrain from strenuous exercise as you heal.
What Risks Are Associated With General Anaesthetic (GA)?
Modern general anaesthesia in the UK is considered very safe. Some common side effects from the medications or equipment may occur, though they are usually mild and short-lived; these can include nausea, shivering, minor lip or tongue injuries, and a sore throat. There is also a small risk (approximately 1 in 4,500) of dental damage requiring treatment.
Serious or life-threatening complications, such as a severe allergic reaction to anaesthetic drugs, are extremely rare, particularly in otherwise healthy patients. In fact, the risks associated with general anaesthesia are significantly lower than many everyday activities, such as road travel.
At the bottom of this page, you will find a link to the Royal College of Anaesthetists website.3 Please review their information on the risks of general anaesthesia before your surgery. If you have any questions or concerns, do not hesitate to speak with Dr. Baldock or Dr. Millhoff.
A close working relationship between surgeon and anaesthetist is vital for successful outcomes in the operating theatre, and high levels of mutual respect and trust are essential. Mr Townley has chosen to work with two consultant anaesthetists, Dr Andrew Baldock and Dr Britta Millhoff, with whom he has excellent working relationships. Dr Baldock and Dr Millhoff are both consultant anaesthetists at large teaching hospitals in the NHS. Meanwhile, Mr Townley and Dr Baldock were at school together and have been close friends since childhood, whereas Mr Townley and Dr Millhoff have worked together for many years in NHS practice at Guy’s and St Thomas’ NHS Foundation Trust.
Please do not hesitate to contact our team if you have any questions about general anaesthesia.
Medical Resources*
1 Oxford Academic
2 World Health Organisation
3 The Royal College of Anaesthetists (RCoA)