The anaesthetic is often the part of surgery that worries patients most — and yet it is the part most patients understand least. Modern anaesthesia is remarkably safe in healthy adults, particularly when delivered by a consultant anaesthetist in a CQC-registered facility. Understanding what to expect demystifies the experience and meaningfully reduces pre-operative anxiety.
The Types of Anaesthetic Used in Cosmetic Surgery
| Type | What It Involves | Typical Use |
|---|---|---|
| Local anaesthetic | Injection of numbing agent into the surgical area. You remain fully awake. | Minor procedures: small lesion removal, scar revision, some lid surgery |
| Local with sedation | Local anaesthetic plus intravenous medication to make you drowsy and relaxed | Eyelid surgery, small areas of liposuction, otoplasty in adults |
| General anaesthetic | You are fully asleep, breathing supported, monitored throughout | Most major cosmetic surgery — facelift, rhinoplasty, breast surgery, tummy tuck, larger liposuction |
Who Delivers the Anaesthetic
In a properly run private surgical facility, your anaesthetic is delivered by a consultant anaesthetist — a doctor who has completed specialist training in anaesthesia, typically over seven or more years post-medical school, and who is on the GMC Specialist Register. Most consultant anaesthetists working in private practice in London also work in the NHS, where they manage complex cases routinely.
Your anaesthetist will see you before surgery, review your medical history, examine you as appropriate, and answer any questions you have. This pre-operative review is itself an important safety step.
What General Anaesthesia Actually Feels Like
The experience is much less alarming than most patients imagine. You will be brought into the anaesthetic room. A cannula will be placed in the back of your hand. The anaesthetist will talk to you while administering medication. Within a few seconds you will feel a pleasant heaviness, and you will be asleep — typically before you even register the transition. The next thing you know, you are in the recovery area and the procedure is complete. There is no sensation of time having passed.
Common Side Effects
Modern anaesthesia is well tolerated, but some side effects are common and worth knowing about in advance:
- Nausea — affects a minority of patients; can be pre-medicated against
- Sore throat — from the breathing tube if one is used; resolves within a day or two
- Drowsiness — lasts a few hours; you cannot drive or make important decisions for 24 hours
- Mild confusion — brief, particularly in older patients
- Shivering — common in recovery; managed with warming
Serious Anaesthetic Complications
Serious complications from anaesthesia in healthy adult patients having elective surgery are rare. UK data suggests the risk of death directly attributable to anaesthesia in this population is in the order of one in 100,000 to one in 200,000 — substantially lower than driving the same distance. Most surgical risk is from the surgery itself rather than the anaesthetic.
That said, risk is not zero, and certain patient factors increase it: significant cardiac or pulmonary disease, severe obesity, sleep apnoea, certain genetic conditions. Your anaesthetist’s assessment will identify any factors relevant to you.
What You Can Do to Reduce Risk
- Stop smoking well in advance — improves both surgical and anaesthetic outcomes
- Maintain stable weight at the time of surgery
- Be honest about your full medical history, including all medications and supplements
- Follow fasting instructions exactly — eating before anaesthesia can cause serious complications
- Treat existing medical conditions — high blood pressure, diabetes, sleep apnoea should be well controlled before surgery
- Disclose alcohol or recreational drug use — confidentially, to ensure safe anaesthetic management
Local vs General: How the Choice Is Made
The choice of anaesthetic depends on the procedure, your medical history and your preference. Some procedures genuinely benefit from general anaesthesia for technical reasons; others can be performed equally well under local. Your surgeon and anaesthetist will discuss the options with you and explain their recommendation.
Dr. Ferrando’s Approach
Dr. Giovanni Ferrando, FRCS (Plast), works with experienced consultant anaesthetists in CQC-registered facilities for all procedures requiring general anaesthesia. He believes patients have a right to understand exactly what the anaesthetic will involve and to meet the anaesthetist in advance of surgery wherever practical.
Frequently Asked Questions
Will I dream during anaesthesia?
Most patients have no awareness whatsoever. A small minority report fragmentary dreams. Awareness during anaesthesia is exceptionally rare with modern monitoring.
What if I have a bad reaction to anaesthetic?
Specific reactions can run in families. If a close relative has had a problem with anaesthesia, tell your anaesthetist; alternative agents can usually be used safely.
Can I refuse certain medications?
Yes — your consent is required for all aspects of treatment. Religious, ethical or personal objections to specific medications can be accommodated where alternatives exist.
How long until I am fully back to normal after a general anaesthetic?
Most patients feel essentially normal within 24 hours, with full cognitive recovery usually within a few days.
References & Further Reading
Related articles from this clinic
External authoritative resources
Considering cosmetic surgery in London? Book a consultation with Dr. Giovanni Ferrando to understand the full procedure, including anaesthetic. Read more in our FAQs.
